Mhàiri Agnew has suffered from recurring abdominal pain for more than half of her life.
When she first complained as a child, her longtime family doctor in New Brunswick suspected food allergies. When tests ruled that out, he blamed stress.
“That was always his answer … ‘You’re too stressed,'” said the 20-year-old university student. “But no matter how much counselling I got, or no matter how many relaxing things I tried to do, the pain never went away.”
When puberty began, Agnew said, the pain got worse, but her family physician wouldn’t do any sort of gynecological exam or refer her to another doctor or specialist.
“He refuses to touch me,” Agnew said of her doctor. “I’ve asked him, ‘Like, push here. It’s … hard or it hurts here,’ and he won’t touch me. I’ve asked him to give me an exam if he doesn’t want to send me to a specialist. He refuses.”
Agnew’s struggle to find a doctor who would listen eventually led her to a private women’s clinic where she is now paying out-of-pocket for gynecological care. She is part of a growing number of women who have given up on getting timely care in New Brunswick’s public health-care system.
Agnew doesn’t know why her family doctor is uncomfortable doing physical exams. She has tried to find another family doctor, but with a shortage in the province, it simply isn’t an option.
“The wait list is something like five years long,” said Agnew. “So I would have to rely on walk-in clinics if I lost my family doctor, and I have other issues, too, that I need prescriptions [for] … it’s just easier to keep him for those issues, and then I’ve been trying to find a way to treat my other issues that he won’t treat.”
Jacqueline Gahagan, a professor of health promotion at Dalhousie University and director of the gender studies unit, isn’t surprised by Agnew’s experience.
“Women are still struggling to get the type of care they need for patient-centred, women-focused, competent care. And that’s a problem,” she said.
“If somebody doesn’t feel comfortable providing an internal exam, then they probably shouldn’t have patients in their care who have an intact uterus and ovaries.”
Women face barriers to health care
Dr. Jeff Steeves, president of the New Brunswick Medical Society, said family doctors have the right to refuse to perform any type of care they find morally or religiously objectionable, although “the vast majority of family physicians would be comfortable and capable of providing that care,” he said.
“The physician’s moral belief shouldn’t get in the way of the care a patient receives … that physician is not obliged to provide it, but they are obliged to refer the patient to a resource [where] they can get that care.”
When her family doctor refused to refer her to another doctor, Agnew tried visiting a walk-in clinic, but was told doctors there don’t treat abdominal pain. In the last year, she visited a hospital emergency room three separate times, each time waiting for hours before leaving without seeing a doctor.
Gahagan said the mix of attitudinal and structural barriers Agnew has faced in the health-care system is not uncommon, and can often lead to what is known as “foregone health care.”
“In other words, the interaction with the health care provider is so unaffirming and so unsafe that individuals … will forfeit or forego trying to find other ways of getting that dealt with in a health-care system that just doesn’t hear them, it doesn’t see them and doesn’t know how to treat them.”
Gahagan said this, combined with a shortage of family doctors, creates a “perfect storm” for people to go untreated and undiagnosed for years.
‘It’s all in your head … sorry’
Agnew believes she tried everything, short of making a formal complaint against her doctor, because she fears he could drop her as a patient, and she depends on…