Doctors Need More Training in ED

In my book, most of the families talk about the challenges of finding people within the healthcare system who are trained in eating disorders. One dad related a terrifying example of an emergency doctor who didn't know that low heart rate is a common side effect of anorexia. The doctor kept asking what the child's  heart condition was and dismissing that it was related to her eating disorder.  


Here are his words (page 27):

It's scary, even doctors... doctors don't even know enough about this! Because when Cassie initially started having all the heart problems and her heart rate went down to 32 beats a minute, I remember being at the hospital in Rocky and we kept saying, "She's got an eating disorder" and the doctors had no idea what we were talking about. It's scary. I remember being very firm with one doctor and saying, "No we need to get her to Edmonton." He had no clue about the eating disorder clinics in Edmonton and the one in Calgary--- we had to educate the doctors. We just about lost her; it scared the living daylights out of me.

Since writing the book, I've heard many other frightening stories. One mother was told, "Don't worry. Boys don't get eating disorders." Another parent was told her child's dramatic and sudden weight loss was no big deal because his BMI was okay, so he was "probably overweight to begin with". This was said in front of her child who was refusing to eat! Other families have been told, "Well, she just needs to eat. If she eats, she'll be fine. " and sent out of the office with no further instruction.

Three years ago, our 14-year old daughter left her second appointment with a GP (which confirmed her rapid and uncontrolled weight loss), with a prescription for Prozac in her hand and the promise of a follow up call from a dietician.  Baffled that a 14-year old would be given a prescription for an anti-depressant without involving the parent,  I asked the nurse if I could speak to the doctor.  I was told the doctor was not available and I needed to make a separate appointment. I didn't go back. Instead,  I immediately began seeking treatment for our daughter and was lucky enough to get her admitted quickly in the Eating Disorder Clinic at the University of Alberta Hospital. Weight restoration was difficult, painful and slow for our daughter, even with a whole team of skilled professionals at her side. Four months later, the phone rang and a woman, identifying herself as a dietician, asked to set up an appointment for our daughter. I was confused, as our daughter had weekly appointments with a dietician at the hospital, so it took me a while to figure out that this was the referral from the GP.  At the four month mark, my daughter was only just beginning to get out of the woods. I was livid and tore a strip off this poor, unsuspecting woman: "You are calling me NOW? Do you realize how critical my child would be if I'd been waiting for this call?!" 

In truth, she could have easily died.  Anorexia has the highest mortality rate of any mental illness and somehow this doctor had failed to recognize the gravity of the situation. 

At first I was angry about this incidences. But in my role as Executive Director for EDSNA, I've had the opportunity to chat with doctors, PCN nurses and dieticians.  I realize that they have received very little (or no) training in eating disorders. It is a gaping hole in our medical training and hopefully something that can address. 


EDSNA has submitted a proposal to the Field Law Community Fund for a one-day symposium to help share best practices.  You can learn more about this idea and VOTE for our proposal by visiting: 
http://fieldlawcommunityfund.com/idea/ed-ucate/

In the meantime, it's important for parents and caregivers to be armed with knowledge. As part of the Children's Mental Health Symposium,  I will be giving a webcast presentation on June 16, which is free and will be available all across the province. In it, I will touch on ways to work with health care professionals and provide a step by step guide for that first doctor's appointment. It is free and you can  sign up here.

If you are a healthcare professional wanting to learn more, I highly recommend this video, created by the American Medical Association on the role of the primary care doctor in screening for and being informed about eating disorders. All healthcare professionals and parents should know about the SCOFF Questionnaire. It's a simple screening tool which has been proven 100% effective in screening for bulimia and anorexia. 

When healthcare professionals and families work together, we can  all shed more light on eating disorders. 

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