I think you should write the letter, but I'm wondering what recourse the clinic has if a patient complains about a course of treatment-- don't doctors have pretty much complete discretion to determine treatment, particularly if their concern is something like dependence? If that is the case, I would describe the course of treatment that he prescribed that you didn't like but focus also on some of the less discretionary aspects-- he ignored your specialists' advice without reason, he was dismissive, his exam was cursory, he didn't allow your ride to describe (xyz)-- all suggestive of the idea that even if he does have absolute power of his diagnosis/treatment, he was likely working with limited information and made a mistake.

don't doctors have pretty much complete discretion to determine treatment

Not if it's harmful/negligent. ita's medical history clearly shows that she's not an addict trying to score some narcotics, because it shows that standard migraine treatments have failed to work for her, repeatedly.

When other medical professionals have devised a treatment plan that's meant to be carried out by another doctor (meaning, the neurologist and migraine specialist came up with the plan intending for an ER doctor to carry it out), and the doctor ignores that treatment plan, I would call that negligent. I won't go so far as to call it harmful, or malpractice, but it's negligent bullshit that I don't think can be excused under a blanket permission slip granted by "MD" at the end of the doctor's name tag.

God, I remember a particularly fun migraine ER visit. We waited, what, six hours before they even took her in? Ooh! That was the night I got to watch the Red Sox win the World Series! Migraine + ER = total misery

Em, remember the screaming when they won? I thought I was going to die. Or kill someone. My favorite ER visit, though, was the one when A met me there and we waited all night while I was having SEIZURES IN THE WAITING ROOM.

Like...

• I like your hospital

• My last visit sucked and I was treated like shit

• here's how it went down

• here's how it made me feel

• here's what it will change

This is exactly what you should do. I can send you a copy of a letter I wrote to a primary care facility where I was treated shitty if you’d like an example.

Bon, that's the stress I'd like to make. I've jotted a rewrite down on my notepad and will post it when I'm out of this meeting.

Basically, he was a prick (evaluating me from behind a curtain? For real?) who refused to follow suggestion (the rec isn't on file, but it's what they administered the last time) and who was ineffective.

I'm advocating a shock collar for msbelle's wayward coworkers. Boss too. They get too difficult and ZAP.

evaluating me from behind a curtain? For real?

Definitely emphasize this, hard. How can a doctor determine a diagnosis, much less a treatment, if he doesn't even make the effort to evaluate the patient properly?

I think it's imperative to be upfront that you were not in fact looking for Dilaudid or other narcotics -- you were attempting to follow a regimen that specifically avoids them as prescribed by a specialist. I mean, you shouldn't get flagged as a possible drug-abuser faking for meds, but rather that you are seeking proper treatment for a complicated condition, and the doctor didn't even pause to consider what you were attempting to communicate.

That Welsh car phone salesman dude from connie's link is about to be on NPR news!

Nattering along, here's an amusing video. The mathematically inclined may find the name amusing.

ita, I think all of the advice you've gotten on the letter is very good, and I definitely hope you send it and copy everyone you can think of on it. That Doctor sucks ass, in a huge way.