What should I do?

Question

I've recently qualified as a junior doctor and I'm supposed to start working in a hospital next week. I've suffered from quite severe depression in the past 2 years, for which I've been seeing a psychiatrist and I am on medication. I've also been struggling with self harm and I've taken two small overdoses as well in the past 2 years.

My depression is resolving and I'm a lot better than I was. I still struggle with the self harm, but I don't have any suicidal thoughts anymore.

Anyway, I got a letter in today from the hospital I'll be working in, asking me to sign a release form to let them have access to my records and to ask for a report from my psychiatrist to "assess my fitness to work" in the hospital. I'm really worried about them knowing the details of my illness, particularly the overdoses and the self harm.

It says I can refuse to let them have access to my records, but what happens then? Can they insist on seeing them? What should I do?

Answer 1

Here's the question - do you think that you are in anyway unable to treat people? Would your illness affect how you cared for people? Sometimes our own selfishness can be destructive.

You could refuse to sign, they will tell you what may or may not happen - they may refuse to hire you, they may ask you to sit down with their own psychiatrist to evaluate you, or it may be just something they don't need.

Typically the hospital does this to cover themselves, they need to know that they aren't putting someone dangerous or incompetent in charge of patients, patients who could get hurt and then the hospital would be liable to. So, chances are they will want to see that stuff. Perhaps you could just ask that you let their doctor evaluate you.

Answer 2

Get on the phone to the BMA and see what your legal situation is, find out what happens if you release the form, and what happens if you dont. This way it will be easier to make a decision about it, with all the facts.

I dont know what i would do. Can you get a psychiatrist report without releasing the notes? cos then the psych can give you a 'yes' to working without including too many details.

I would be inclined to release the notes I think, that way there are no secrets, but ive never been in that situation Im afraid.

Either way, make sure you know all the options before you decide, and best of luck with the new job!

Answer 3

They cant insist on seeing them but it might hinder your chances, this is difficult. Really though they cant discriminate against you for having depression. If they see your records then its proof that you are getting better and arent ashamed, they will probably ask for an interview to give you the chance to talk about this in which you could explain that, yes you have had troubles in the past but now you have a focus in life and are much much better. As long as you can prove that your ok now they cant refuse to let you work (or at least i dont think they can) Surely having these past problems will make you a more sympathetic doctor, they just want a guarantee that they arent putting you or patients at risk and they are investing in you so want the best candidates. You just need to prove they are not wasting there time taking you on.

Answer 4

I understand what you mean. Many people suffer from self harm and suicidal thoughts. You don't have to be ashamed of the fact that you've suffered from depression. You should be proud of the fact that you've stuck in there and tried to make things better. If the hospital does not recognize how well you've done to get past the worst of it, then move onto another one. If you keep on trying to be doctor, i promise that eventually you'll find a place that is grateful to have someone so strong minded, and determined. Don't worry about things you cannot control. Take care.

Answer 5

Can I suggest you DON'T tell them your Yahoo ID?
Other than that, honesty is definitely the best poilicy. Hopefully your being honest will go a long way to showing how well you've recovered. Working in a hospital, it's really important that your employers are fully aware of any risks. Hopefully they will still employ you but with some safeguards in place to make sure you are coping ok.
Oh and WELL DONE for overcoming all of those challenges and becoming a doctor! You have done really well, keep it up and you will get there! I feel quite inspired just hearing your story.
Take care and good luck.

Answer 6

In my opinion this largely depends on the Pshychiatrist's analysis on your present state of mind. From what I read above you are analytical and I think you have pretty much better control on your thinking and action than probably u had earlier.

Talk to you Pshychiatrist and get his report included in that report. If its possible probably you can schedule a meeting with the management. Since it is a hospital, Im positive they appreciate the system and understand better than anyother company.

However I dont know the legal system over there as to if they can insist on getting access to your records. Probably you should go through the offer letter which Im sure will contain such details.

Answer 7

If you deny you place of work access to records, that proves that you have something to hide, and in most highly important careers, you need to cement a trust with one another in order to get along, and that friendship could possibly break your depression (not saying that you don't have friends now...I didn't mean to imply that). And as for the self infliction of pain...I say put what you use to do it on a high shelf, but somewhere you can still see it, if you have good self control, you will know that you can look, but not touch. I'm going through the self pain infliction thing right now...using pins, razors and a knife, but I want to let it continue because it can be used in my religion. But anyway, good luck to you...

Answer 8

Maybe you should ask your psychiatrist and GP. They'll have done fitness reports before so will be able to tell you what they will be saying. I would imagine they can insist on seeing them as the type of job you will be working in is quite sensitive. I would find out more before you sign the release.

Answer 9

If you have the job, refuse to release the records. If you don't have the job yet, talk to your psychiatrist before making a decision. You have a relationship with your doctor and he/she is better qualified to help you.

If it was me, I would exercise my right of privacy just for the hell of it. If it cost me the job, I would threaten them with a law suit, and maybe follow up on it. Either way, you have the right of privacy, and even they gave you the option to not release your medical records.

Good luck, and I hope you get the job.

Answer 10

If you refuse, they may rescind the employment offer which would be in their rights. Herein lies the problem with the whole mental health system. People have to work and seeking help leaves these kind of paper trails and often the stigma attached with these kinds of diagnoses. Unfortunately, you may be negatively impacted by this, but it will certainly prepare you to be a better doctor now that you understand what millions of people face each year. I hope it works out for you.