Finding a Proper Doctor

Wayne shares his experiences and tips.

Stigma can be a barrier to even finding out what is wrong, as well as treatment. I was up in Armidale and had a medical emergency. I thought it was associated with an old hip replacement. But it wasn't. The pain was in the hip but it was a nerve thing that was coming from the spinal column, I found that out later.

I presented to the emergency department being quite open about everything, told them about previous hep C infections — now cured, like there was no chance of anyone being infected. I was quite open about my opiate use and said I was in an extreme amount of pain. And they said, because of my previous ‘drug history’, as they called it, they couldn't prescribe anything stronger than Panadeine Forte.

So the moment I mentioned that I'd had an opiate problem, once upon a time in my life, you could see this wall go up in their eyes. It's not as if you could see a line but you just got that feeling. It was nothing that I could really put my finger on, but you could tell there was an attitude change. Like they thought that it was a drug seeking episode, because I couldn't point to a big hole in my leg.

But I thought it was associated with my hip, because the pain was in the hip and thigh, so they did an x-ray. But it wasn't related to my prosthetic hip, as we found out later. But I really got this feeling that they didn't think that I was being real when I was talking about the pain. I was there from Sydney — in an Armidale hospital where I’d never presented before in my life.

I felt a little bit intimidated. I was trying to get to the bottom of the issue, find out what was causing the actual pain in the hip and thigh. I was from out of town, I was talking to strangers, I’m in an emergency ward at the hospital. I wasn't around people I knew, I was here on my own. And I was going into battle with them, really.

It’s that whole “once a drug user always a drug user” attitude that some doctors, a lot of them, have. I've gone to doctors and before I even told them what the complaint was, because I said, “Look, my previous history is hep C, cured, IV opiate drug use, not using at this point in time,” they have said, “I can't write you a script for painkillers.” They have sort of pre-empted the consultation, they jump in straight away: “I can't write a script for painkillers” and stuff. And I've had to say, “I'm not here for painkillers, I'm here for a referral or to deal with a possible infection that I have” and stuff like that.

I’ve been around and gone through a whole lot of doctors. I've learned how to sort of be loose with the truth, so to speak. I’ve learnt over the years when you walk into a doctor's and you're trying to be upfront and you say “previous infection of hepatitis C”, the first thing they go is, “how did you get it?” And I've stopped saying IV drug use now, if I don't know the doctor, I won't say IV drug use. I've got quite a few tattoos, so I'll say that I got tattooed back in the day before they had all the Skin Piercing Act and stuff. I have to lie to a doctor to sort of combat the stigma that I think may be coming.

I feel I'm not being heard. And I honestly think that they have prejudged me because I have mentioned opiate use or mentioned hepatitis C infection. You actually sort of can pinpoint it, you just pick it up, their body language changes just a little bit and they come out with a sentence, “I can't write painkillers” and so forth like that.

So the Armidale hospital never found out what was causing me pain, but after I went home to Sydney, I found a really good GP. She sorted it out. She hit the nail straight on the head and said “I think it's related to your back. Go off and get all these scans”. And the moment she saw all the scans, she said, “You must be in an excruciating amount of pain”. I said, “I’ve been trying to tell people for months now”.

Her surgery is actually really close — like 150 meters away. So it was quite surprising. It was a doctor surgery I'd walked past a dozen times and had never been too. I get a really good vibe from her. She has proper conversations with you. She will ask lots of questions, both healthwise and of a personal nature. How I'm going, how my mental health is. And we'll talk about have I lapsed into drug use again and stuff. And I feel like I could sit down and talk to her about that.

She has long consultations. She doesn't do a quick, tick the boxes, write the script, get you out the door, get the next patient in, sign the Medicare. She just seems like a fair dinkum doctor. She seems to strike me as a person who went into the medical profession because she's actually caring, not because it pays a lot of money. I'm feeling blessed to having her as my GP. I really got lucky finding her.

The big thing that really won me over with her is when I presented with the issue that was a nerve pain, that no one could pick up. They didn't pick it up at Armidale and they knew about my back injury because it happened actually up that way, so it was all recorded. She just went straight to it. She says, “Wayne, I think it's associated with your back” and sent me off for scans. I hobbled off down to the hospital and got the scans and went back to her that afternoon.

And she just went straight, “Okay, I'm going to give you some opiate pain relief. I'm also going to give you Lyrica®”. She explained to me about what Lyrica® is and why she was writing a specific dose and why we were keeping the dose of OxyContin™ as low as possible. And she said, we will then also work out a way of getting you off these when it's time and I will work out a withdrawal program, drop the dose.

She was actually quite caring and didn't just write me a script for oxys and say when they finished, “They're finished.” And she followed it up with it with a phone call or two, to see how I was going. Was I managing with the lower dosage? Was my plan being taken care of? Things like that.

She was actually a breath of fresh air. I felt that she matched my honesty with her honesty. And she said, “Wayne, I'm concerned about giving you opiates. But from our conversation that we've had, you have alleviated that concern. You're a mature man, you know what you're getting into you. You've had a previous history of drug abuse. Well, we’ll just monitor it.”

She was being a proper doctor.

I think with finding a good GP, look around, hunt around, do your research (I sound like one of those conspiracy theorists!), talk to peers, talk to NUAA, talk to people in the field that work with alcohol and other drug lived experience people. That'd be my one advice. Confront stigma as it arises. Shop around for a doctor and I don't mean doctor shopping. I mean shop around for a good GP. Talk to your peers about finding a good general practice doctor. And not one for just writing scripts. I don't mean look for a doctor who will write a script for valium or oxys or whatever. I mean, find a doctor that's really good. And if you can't do that, go to a service set up for people who use drugs if you can.

[Editors note: We only know one in NSW with GPs doing general health check, Kirketon Road Centre (KRC). Increasingly, needle and syringe program services are offering health care, including NUAA's Open Clinic on Crown which is run in collaboration with Kirketon Road Centre. It's open Monday to Friday from 11.30am to 3.30pm pop in and check us out if you're in the area.]

Read more: If you found Wayne’s thoughts on stigma in the health system useful, read Molly and Siobhan share their experiences and ideas.