Monetary remedy – none
The doctor should be required to take part in educational training on treating older women – on specific tests recommended, prescribing medications, and chronic illness among the elderly, etc, including training on how age affects women’ bodies, including ‘stress incontinence’ and how that differs from ‘urge incontinence,’ as well as how these differ from other kinds of incontinence including the kind men may experience.
The remedy should also include taking part in an educational course on ageing and ageism, in particular how these affect women’s sense of well-being, health and status in society, and the interaction among a person’s gender (sex), age, family status and marital status.
Remedy for future compliance
There needs to be more specific regulations on how doctors end the physician patient contract so it isn’t simply a matter of choice for the physician. Physicians need to take responsibility for their decision, by having to defend it, if they think they have a good reason not to continue, and more importantly, by being encouraged to seek the advice of the CPSO or other organziation when they run into difficulties through lack of either experience or training in communication and problem solving.
Re urine testing, I would like to see (the doctor), and the wider medical community, institute a non-discriminatory, random method of selecting a sample of patients - from those who are taking prescribed narcotics - to submit to urine testing for “street drugs” on any given day. As a precaution, if particular patients are asked to submit, they should be given the details as to why, and if the patient does not accept the doctor’s decision, they should be able to contact a higher local authority about the lack of proper methods.
A local organization could deal with such patients’ complaints, such as the local Academy of Medicine – LDAM in London. Any doctor who believes a given patient to be at risk of misusing such drugs, or feels like taking his frustrations out on a patient, should not simply be able to demand a urine sample or cut the patient off needed pain medication. Details of such a method that doesn’t place the doctor’s views over the patient’s should be a requirement at all physician’s offices, unless specific circumstances, such as long-term drug abuse, has been a problem.
Finally, there needs to be a better way of setting up the agreement between physician and patient so that both of them know what they are getting into. As it stands now, the patient does not always get to see the doctor before registering with him or her. And if the doctor does have biases they might find themselves stuck with a patient whose life s\he does not appreciate. Relying on Healthcare Connect isn’t the answer for everyone as it simply puts a third party into the picture, making decisions on the basis of their own biases, and suppositions of the physician.