I hope the doctor is in ...

I hope the doctor is in …

Mary: “Doctor, I think I might have ADHD.”

M.D.: “Were you diagnosed with it as a child?”

Mary: “No, I wasn’t.”

M.D.: “Then you can’t have ADHD. It starts during childhood.”

The above is my version of a conversation that was related to me by the person I’ve called ‘Mary’ (not her real name). It’s pretty accurate as far as her memory of it is concerned. If she has ADHD we might suspect that her memory isn’t trustworthy. But the doctor assured her that there was no chance that she had ADHD. There has to have been a childhood history.

What’s wrong with this picture?

Yep, the doctor didn’t realize that Mary, who just celebrated her 50th birthday, could not have been diagnosed as a child. ADHD did not exist as such back then. If there was a diagnosis at all, it would have been MBD, Minimal Brain Dysfunction. Relying on a little bit of ADHD information, Mary’s doctor may have made the wrong call. Having a history of ADHD symptoms in your childhood is not the same as having an ADHD diagnosis in your childhood.

This bothers me

Dismissing a patients concerns through lack of familiarity with the issue at hand is about as helpful as using an eye chart to diagnose heart disease.

Dismissing a patients concerns through lack of familiarity with the issue at hand is about as helpful as using an eye chart to diagnose heart disease.

Another line that I’ve heard about Adult ADHD is this: “There’s no such thing. It’s a fraud, perpetrated by big Pharma to sell ADHD medication to a larger segment of the population.” Again, this is my version of the conversation, it’s not verbatim. But I was there when the doctor said this. You see, it was said to me

I didn’t accept that

I asked for a referral to an ADHD clinic in a nearby city. My doctor refused, but offered to refer me to a local psychiatrist to see if he (the psychiatrist) would agree to refer me to the clinic. I accepted this concession.

So, there was this shortcut, see …

When I saw the psychiatrist, he diagnosed me with Adult ADHD. Right then and there. In just over an hour, I was certified. No clinic!

My own doctor’s opinion of Adult ADHD was shaken by this turn of events. That worthy practitioner is now on board with the concept of Adult ADHD. I’m glad, because my doctor’s patient load is nearing 2500 people. The mathematics of statistics tells me that there could easily be 100 people or more with ADHD in that group. Many of them will be adults.

But back to Mary – what can she do?

Here’s my hope for Mary. She can print this blog post out and hand it to her doctor, the next time she goes to see him. And she can point to the part that follows and say “Read this.”

Dear Doctor:

It has come to my attention that you are unaware that ADHD did not exist as a diagnosis in the sixties and seventies. While it is important at this point to ascertain a history of ADHD symptoms in childhood, a diagnosis of ADHD is not the only acceptable proof of that. If you are uncomfortable, as a general practitioner, making a mental health diagnosis, that is perfectly understandable. It is, after all, not your bailiwick. But, do please, by all means, refer your patient to a psychiatrist. You have taken a pledge to do no harm. Surely, your inaction in the face of your patients distress would go against that oath?

And then?

Well, then I’d hope that the doctor would not get upset with Mary for telling a loud mouthed blogger her story. And I’d hope that he would do what is best for his patient, refer her to someone who knows about ADHD and can say yes or no based on more than just mistaken information.

After all, Mary could have gotten that first diagnosis from some naysayer in a coffee shop or on a mall bench.

But not from me. I can’t diagnose anyone. I’m just a loud mouthed blogger.

 


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    Last reviewed: 12 Jan 2013

APA Reference
Babcock, K. (2013). Errors In ADHD Diagnosis At The Doctors Office. Psych Central. Retrieved on July 23, 2014, from http://blogs.psychcentral.com/adhd-man/2013/01/adhd-diagnosis-errors-at-the-doctors-office/

 

 

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