Greetings all,
As a retired family physician, who is about your, Ruth's, age, I wanted to weigh in, particularly because I have trained roughly 100 family doctors. Firstly, I believe most family docs including me would not understand much about the human trafficking issues, but if it is appropriate and makes sense, you and they may just accept that and get that care elsewhere--maybe psychiatry or psychology (will leave that to you and others). Regarding being a former drug addict--that we should be able to work with. If you are in a recovery program it might be nice to comment on that--although the level of understanding of recovery programs varies from doc to doc. (If you can find someone who is known in the recovery community to be friendly, consider them. The communities know the docs who are more likely to treat them with respect.)
Something I have learned from a dear friend is to take someone to every visit with you, again, only if that makes sense for you. I find that it gives the patient some emotional comfort and helps you to be less "intense"--I don't really know how to say it beyond the fact that the person "holds space" with you and for you. You get to dictate if the person says something or nothing or only if you ask. You could use them as a scribe to keep notes on what is said and/or keep track of the questions you want to ask. I have been honored to go on several doctor visits with this friend--and it is an honor and we usually go out for lunch afterwards.
Another idea might be to talk to the office manager ahead of time to ask them to help you navigate your care. Some hospitals have care navigators, usually for special populations such as those who are high utilizers--might not hurt to call them even if you don't fall in the population. Also, some systems have social workers (or similar) assigned to the primary care practices and that might be helpful.
I suspect you know that there is a ton of pressure on physicians to pump out numbers-it is disheartening for doctors and patients. It is not good medicine in most cases. Some practices worry about this less than others--or just make less money in order to spend more time. Not sure you could afford it but concierge practices and occasionally direct primary care practices work in this way. You could also call your county medical society and/or county or state family practice/internal medicine associations to see if they have ideas I have not considered.
Also, regarding ACEs and primary care docs. We are way behind the 8 ball here. Pediatricians are doing much better. I learned about it after I retired--and I taught for 20 years! Nothing I can do about the past, but now I do share the news with family doctors. Get the docs the link for Nadine Burke-Harris' TED TALK--it talks to the medical aspects (pun intended). Also the original ACE study by Felitti and Anda are unbeatable! (https://www.ajpmonline.org/article/S0749-3797(98)00017-8/pdf)--print it out for them--don't just give them the link--we are more likely to read it if it is easy! Highlight that 6 + ACEs decrease life expectancy by 20 years. Highlight the adversity that is occurring in your town/state--e.g. opioid epidemic. Also, give them the CDC website: https://www.cdc.gov/violencepr.../acestudy/index.html so they can see more.
I wish you the best on this journey. Being on ACEs Connections and being your own advocate sure does seem a great place to start. Happy to talk more if you would like-private message me even if all you are saying is to read this blog again. My viewpoint is but one, but I have worked with a fair number of docs over the years. After retiring I am doing a lot of work on ACEs, Resiliency and helping places become trauma informed including teaching family physicians. It is hard work, but worth it--so I wanted to offer you support and personal experience.
