it has, once again, become necessary to write a biting letter of complaint to my local doctor's office. i have only stripped the full names from this version, but otherwise, it's as i delivered it to the doctor's office today, capital letters and all. i'm putting it here so i remember what happened and when. sadly, it probably won't be the last such letter i have write. if you want a bit of insight into the danish socialized medical system, read on...

Dear Lægehuset,

It’s been awhile since my last letter to you (that was back in March 2012). I hoped I wouldn't have to write another one, but it seems that I do.

I have had contact with your office on a number of occasions over the past week, due to severe and debilitating pain in my back. Because I knew from past experience that it likely wouldn’t end well, I actually visited the physiotherapist/chiropractor during the efterårsferie, when the issues began, instead of calling your office. However, when the problem took a turn for the worse last week, I had to call. I was, unfortunately, not at home when the problem started, so the first calls were on the phone - one with the assistance of a chiropractor in Copenhagen and the second one (which actually took more than 5 separate telephone calls and a nauseating amount of “ik' aws” from the secretaries to accomplish) myself on Friday, October 30. The first two calls resulted in prescriptions for Diclofenac and Tradolan, neither of which seem to be even remotely effective against severe back pain. (You’d think that you, being the doctors, should know that.)

On Monday, when I returned home, I called for an appointment and saw dr. MM. He took my pain rather lightly and sent me on my merry way to the physiotherapist with very little advice or insight into what might have caused my problem. Happily, the local physiotherapist is much more thorough and professional and dare I say, interested in his work (you all could maybe take a lesson from him on that front). He put me through a battery of tests and explained that he was pretty sure I had a slipped disc at #4 (up higher than the usual slipped disc), and said that I needed an MR scan to confirm it. Luckily, he made the next phone call to dr. MM and I was put into the system for a scan immediately. The physiotherapist also recommended that I have a steroid blocker put into the secondary issue of bursitis in my hip and sent me back over to the doctor’s office to get that, so that I could at least have a little relief from the pain.

Naturally, your office gave me absolutely no information on what the next steps regarding the scan would be. So, I called again on Tuesday during telephone hours and was huffily told that your office had nothing to do with scheduling, but I could call the x-ray clinic at the local hospital and ask (looking up the number myself, as no number was offered). It might have been an idea to give me this information when I stopped by on Monday afternoon to make the appointment for the bursitis block. I sincerely can’t imagine that I’m the only patient who would like information about what’s next and when it will take place. It doesn’t seem too much to ask, and yet, inexplicably, it is.

But, where things got really bad was yesterday when I came to my appointment for the bursitis block injection. I saw dr. TVM, tho’ funnily enough I don’t know his name from him presenting himself to me, I had to look it up on your website. I knew it didn’t bode well when he called my name from across the room and then didn’t even wait for me or greet me with a handshake until I had managed to find which room he’d gone into, far ahead of me. He could surely see that I was in severe pain and not able to walk quickly, but that didn’t matter. He was also very dismissive of whether I needed the shot and at first indicated that he wouldn’t give it to me. But, after checking my hip, he realised there was an acute need and agreed to give the shot. However, he just went and got a needle and the steroid, asked me to point out with my finger where it hurt most and then stuck the needle in and blindly shoved it around in a haphazard manner - not even using ultrasound equipment to find the correct spot as would be NORMAL and INDICATED and STANDARD PROCEDURE in such an instance. Then, without giving me a bandaid to cover the site of the injection, which was disturbingly leaking quite a bit of clear liquid, or letting me know that I could get dressed, he just went back to his desk AND OPENED THE DOOR TO THE HALLWAY. I wasn’t even dressed and furthermore, I was feeling very unwell from the pain and needed to lie down for a few minutes, but he was in a hurry to just get me the hell out of there. I was shocked, but in too much pain and feeling to unwell to protest.

I tried to ask about how I should remain still on my back for the MRI the next day, when I couldn’t lay flat on my back due to the pain. He just dismissed it and said I could try taking two of my Tradolan tablets ahead of the scan. This, despite me telling him that the Tradolan wasn’t effective in taking away my pain, except perhaps the top 10% of it. He just could not wait for me to leave that room and he was unafraid to show it.

When I got out to the counter, where I had to inexplicably pay 50kr for something or other that was inadequately explained (a clean needle? perhaps otherwise we’d have reused an old one on the foreigner?), I became very unwell while I was standing there waiting. I said, in Danish, to the secretary that I needed to sit down. She apparently didn’t hear me and came storming out the door into the waiting room after me, asking what was going on. I must have been white as a sheet and looking very unwell, but she insistently and loudly asked what was wrong, as if I were a small, dull child. There was no discretion and no kindness in it. I realise the office staff are not medical personnel, but it wouldn’t hurt to have a bit of bedside manner when you’re dealing with people who are already feeling ill or who might be in severe pain. Instead, I felt embarrassed and singled out by her loud, gruff treatment in front of the whole waiting room of patients.

Is this really the way you wish to treat your patients, or is it just the non-Danes? I admit I can’t help but think that my accent has something to do with the way I am treated like a second-class citizen. I would note that although I feel the need to write these all-too-frequent letters to you in English, I speak Danish when I’m at the office and have been in Denmark for 18 years, so I have a certain level of fluency. It also means that I have not misunderstood the way I’ve been treated. And I find it completely unacceptable.

You can feel free to call me if you wish to discuss in more detail. But, in any case, I’ll be eagerly awaiting word of what steps you will take to improve your interactions with your patients.