Judged at the clinic

[slsleazybreeder]

Not sure if there was asked before, but has anyone felt he/they/.....(insert pronoun) been judged by the nurses/personnel at a clinic when you were tested positive for std/hiv? As if it was a burden for them...

[fskn]

Unfortunately this is quite common. It can occur in public health clinics, private non-profit health clinics, and private doctors' offices. It is more common when a patient who is a member of a minority group (such as a gay man, a trans person, an HIV-positive person, or a person of color) seeks care from a medical provider who does not serve lots of similar patients. An experienced provider who has served a critical mass of similar patients is less likely to react this way.

Judgment, shame and stigma make correct medical care impossible. They are contrary to the US CDC's Sexually Transmitted Infections Treatment Guidelines. The Guidelines say, "Effective interviewing and counseling skills, characterized by respect, compassion, and a nonjudgmental attitude toward all patients, are essential to obtaining a thorough sexual history and delivering effective prevention messages."

[think before following links] [think before following links] [think before following links] https://www.cdc.gov/std/treatment-guidelines/clinical-risk.htm

Anyone who is judged or who feels that they have been judged by a medical provider when seeking sexual health care services should get the full name, title, and license number of the medical practitioner and submit a formal, written complaint to the medical facility and/or to its owner or funder, and also to the state agency that licenses the medical practitioner.

Most importantly, leave the facility and seek medical care elsewhere to prevent further harm. (The harm is not just emotional; it can also be physical, because the medical provider may not be providing standard care for the patient's condition.) Getting sexual health care at a community clinic in a major city can improve a patient's emotional wellbeing and physical health.

In my opinion, any medical practitioner who is confirmed to have used judgment or shaming, or to have created stigma, should lose their job and their license immediately, and be barred forever from the medical field.

Edited February 17, 2022 by fskn
Linked to CDC guidelines

[backdoorjimmy]

I wasn't judged at a clinic for testing positive for an std but I was judged by my PCP for being a bottom. This happened when I was 18 and switched from a pediatrician to a regular doctor at the family practice I've been going to my whole life. The new doctor was female and it was our first appointment so she was sitting on a stool asking me questions and going through my chart on the computer in the room.

She saw a note from my pediatrician about me not being able to get an erection and then saw I was on PrEP. She put two and two together and gave me a long, disapproving look that made me feel ashamed for the first time in a long time. Then she got cold and her tone went from friendly to harsh and she hurried through the rest of the appointment. My mom found out what happened and lost her mind, called the practice manager and went off while I begged her not to. Since I was an adult the practice manager said I had to call in the complaint or she couldn't even discuss it. I was too timid to go any further so nothing ever came of it that I know of.

[Guest]

I have two vastly different experiences.  As I am not Poz the both  were related to collecting mist of the rest ofgg by the connection. With lots of frequent fucker awards for multiple syph and gono rounds. I was a known entity to my home county health folks.  As a sparse population mountain county it may be surprising that the folks were wonderful   When I added hep c and herpes they showed concern but still zero judgement.   Even as my name came up with some regularity on disclosed partner forms , I never felt anything but professional and personal curtesy. Seven years of a very active and increasingly non-vanilla sex life with the resulting interactions could have given a less professional team much ammunition for a biased attack on my seeming lack of concern for the residence of Madison County.  But in that time I never had a single negative interaction.   One nurse even would call after a period of no issues.  While she never said they missed me, my good behavior (luck) was noticed equally with the infections.  The closest to a negative remark came from the same nurse.  You know,  she said,  we don’t offer any prides for most infections  in  NC a year.  That might have been a “ouch” but it was a remark I could have made as well. And her big smile did not hurt.   
 

when I returned to a Piedmont region county the story was different. A larger county by a factor of 5 to 1 in population it was one of top ten in NC. But that team never missed a chance to make very pointed judgements.  A bout of super gono was typical.  They went so far as to suggest  mental health care. That was ramped up when I missed a doctor visit for a check up/after care.  Another miss and they would execute a court order for the gono check up and a mental health evaluation.  
 

Others had said that court orders were common.  The staff liked dumping things  to the court rather than providing personal care.  That was equivalent to waving a red flag at a bull.   The three years since the gono orders have seen much fewer reasons to interact with me.  But I have had to appear in court 6 times.  The two mental health evaluations were expensive scams.   The LCSW for the second even suggested it was punitive.  Given I was already a client at that same practice I clearly was not ignoring mental health issues.  
 

Just as an BZ added note, the same county employees steered the number ten population to number 4 in COVID deaths.  Something of a minor shakeup has changed some managers   I don’t have first hand experience. 
 

To me it is how the department  defines itself that sets the tone.  I don’t believe one county has all super stars and the other rejects from the post office customer service team.  Madison County, despite much lower per capita county budget has mad service to residents a priority in all departments.  Lower cost choices for office space allowed more employees to staff the department.  
 

My company applied for and was granted the counties first industrial reuse grant.  That process was picture perfect echoing the quality of the health department.  
 

The Rowan department was huge and were housed in several al near new office buildings.  Pay grades were at state minimum and turn over high. The choice was not compassionate care and service.  It was a choice  to provide minimal service and maxiximum statuary control.  The rule book was the focus not citizens.  I applied for a similar grant for a new start up I was managing. On paper it was a much stronger application. I used the same grant writers in both applications.  The team lead  for both was a seasons guy I knew well   He was very vocal about the Rowan. package being much stronger.  
 

Slow processing and lack luster support from the county killed the grant before it was sent to Raleigh.  Again the development department was not mandated to provide anything  other than the minimal required support  absent a champion, a large grant was stillborn. 
 

I have no doubt some folks may experience a rogue employee with a cross to burn.  However, my experience suggests that the local leaders have a huge influence on how departments are managed.  In many cases citizens have nothing on which to base expectations.  
 

The good news is most key departments in many counties and towns have citizen boards to offer oversight.  Judgmental care can be addressed but it requires being active and vocal.  That’s something that is in our queer DNA 

[SleazyCumPig]

Yes. I can’t imagine the judgement if I told them the truth instead of toning it down for her.

I have switched doctors because I knew that I caught what they had just treated me for and didn’t want that judgement.

[ErosWired]

37 minutes ago, Snakeslammer said:

The good news is most key departments in many counties and towns have citizen boards to offer oversight.  

How good that is depends on where you are. Where I am, the chance of populating any kind of citizen oversight board with non-judgmental people is remote.

Candidly, I take an extremely dim view of LCSWs. I have dealt with more than one, and have found them from inept to incompetent, and apt to cause as much harm as they address.

Am I to understand that you were threatened with a mental health evaluation simply because you were diagnosed with gonorrhea? If so, that’s beyond outrageous.

[PigBoyDallas]

Every time I’ve been in to the county health department for testing and treatment I’ve been treated OK but really more like just a number, which is fine. I don’t want to be judged or have to answer a lot of questions and honestly I really don’t give full or complete details as I’m embarrassed about being judged or lectured. I know I have a lot of anon sex and that I shouldn’t have so much anon sex or any anon sex and shouldn’t bareback at all.
 

I switched from my pediatrician to a regular doctor but even with the new doctor I’m not fully honest about my sexual activity even though I know based on HIPA they can’t tell my parents anything. They know I have sex with guys and I got “the talk” about using condoms, safe sex, Prep, and the rest. They were polite about it and wanted to keep talking about it when I come in, but honestly I rarely go to my doctor as I don’t have any health issues.

[Pigforcum]

I didn't feel judged when I started using prep. The nurses were pretty sound and not judgemental

[DarkroomTaker]

Gotta say the NHS clinics I have attended the assessments and outcomes were excellent. The staff nurses and doctors treated me ok and were non judgemental, even the male nurse Mike ( gay) told me I had a luvly ass lol. Anyway, only difficult thing I had was trying to get an appointment.

[AirmaxUK]

It likely depends a lot on where you are and the local NHS trust/provider.  I live in a small town, and in my clinic the medical staff are generally fine,  but the member of staff you see after a diagnosis to talk about contract tracing is a totally different matter. She thought I was being evasive because I couldn't tell her who I'd had anon encounters with and it spiralled down from there. She pretty much demanded to know who my BF is because "it was very important he is aware he's been put at risk by your behaviour." Actually he was the first to know. The conversation ended with her telling me that "if you don't change your attitude you'll only end up in the clinic again" as I left I said "well, certainly I hope so because I'm obviously getting a lot more fun than you are...". 

[Loveitraw]

It sucks to see any negative treatment, especially from healthcare workers, but it's naive to think it can't happen.  Sadly every department has so many individuals it it and for every one there will be an opinion.

I have been lucky in as much as the specialists at my clinic are friendly and professional, even joking with me when I attend. I always approach them openly and honestly and I genuinely believe that is the reason for my overall experience. Even on the two occasions I have had treatments for syph infections there was no judgement at all. On the second time when I took the penicillin shots with ease the nurse joked that it was only because I was used to having pricks in my behind. Which I am sure they only said because I am easy with them so they felt comfortable to let it slip.

Outside the clinic and away from specialists, however, I do feel that there is a long way to go before acceptance is widespread.

[AirmaxUK]

2 hours ago, Loveitraw said:

On the second time when I took the penicillin shots with ease the nurse joked that it was only because I was used to having pricks in my behind.

That reminds me - a friend mentioned that you don't have to have the penicillin shots in your butt - they can give you tablets instead (particularly if you can't tolerate penicillin).  The downside is that it takes a bit longer to resolve. So next time I needed it, I asked about having tablets instead. The nurse said  "you have to do some sort of penance for your actions" - It could have been said in jest, but the tone said otherwise.  I insisted on seeing the doctor and complained: They gave me the tablets instead. 

[Loveitraw]

53 minutes ago, AirmaxAndy said:

That reminds me - a friend mentioned that you don't have to have the penicillin shots in your butt - they can give you tablets instead (particularly if you can't tolerate penicillin).  The downside is that it takes a bit longer to resolve. So next time I needed it, I asked about having tablets instead. The nurse said  "you have to do some sort of penance for your actions" - It could have been said in jest, but the tone said otherwise.  I insisted on seeing the doctor and complained: They gave me the tablets instead. 

Context is everything, in my case there had been a bit of back and forth beforehand and there was no barb to the comment.  I had been offered the course of tablets but opted for the shots because its quick. From your description there was a lot of subtext in that comment that went beyond the line.

[tallslenderguy]

All sorts of people work in healthcare (i'm a critical care nurse).  The same people who vote conservative or liberal, work in healthcare as well. 

i work in a fairly liberal Hospital. It's a teaching hospital in a college town, but the people who work there come from all sorts of different backgrounds and persuasions. There was a doctor there a couple of years ago who i thought was pretty cute and i had a crush on him. i had not seen him for a few months until they returned after transitioning. That gave me a Victor/VIctoria moment that i had been crushing on someone who identified as a woman lol. She had been shy and quiet when presenting as a male, but was outgoing and open as a woman.

Everyone was polite and accepting to her face, but in the break rooms, when she was not around, some would let their true thoughts and feelings slip. 

There are plenty of people working in health care who have decided bias and judgement. Many hospitals were started by religious organizations. There are plenty of people working in health care who believe all gay people are going to hell, then others who think sex is only supposed to happen between men and women in marriage. Healthcare workers get tons of ongoing education about bias and not bringing it into ones practice, but many believe they are right and righteous in their beliefs and won't hesitate to show their disdain and present as superior. 

[fskn]

8 hours ago, AirmaxAndy said:

It likely depends a lot on where you are and the local NHS trust/provider.  I live in a small town, and in my clinic the medical staff are generally fine,  but the member of staff you see after a diagnosis to talk about contract tracing is a totally different matter.[...]
The conversation ended with her telling me that "if you don't change your attitude you'll only end up in the clinic again" as I left I said "well, certainly I hope so because I'm obviously getting a lot more fun than you are...". 

It sounds as if she has been there since before gay sex was legalized in Britain. Is there a framed commendation from Thatcher on her wall? I'm glad to hear that you told her off. I wonder whether she'll ever learn that her judgmental outlook increases STI transmission by discouraging people from coming in for testing and treatment, and leaving those who do scared to identify their sexual contacts.

 

On 2/16/2022 at 8:53 PM, backdoorjimmy said:

I wasn't judged at a clinic for testing positive for an std but I was judged by my PCP for being a bottom. [...]

She saw a note from my pediatrician about me not being able to get an erection and then saw I was on PrEP. She put two and two together and gave me a long, disapproving look that made me feel ashamed for the first time in a long time. Then she got cold and her tone went from friendly to harsh and she hurried through the rest of the appointment.

Not to make light of what you experienced, but to make fun of this doctor, she was probably jealous at the prospect that you might be getting more dick than she was.

 

7 hours ago, Loveitraw said:

Even on the two occasions I have had treatments for syph infections there was no judgement at all. On the second time when I took the penicillin shots with ease the nurse joked that it was only because I was used to having pricks in my behind. Which I am sure they only said because I am easy with them so they felt comfortable to let it slip.

This is how it should be, pragmatic health care with compassion and a sense of fun!