An Open Letter to Lady Gaga
From a Primary Care Physician
An Open Letter to Lady Gaga -
I am going to start this letter to you as I do all the other similar open letters I have written. I realize that the chance of you reading this is slim to none; however, I am discouraged by a statement you recently made, and I strongly feel a correction to this is necessary. Proud of the voice you have for women around the world, I never thought in a million years that I would be writing one of these to you, and for this, I am saddened.
I am a primary care physician. I have been in practice for five years, and my job is hard. In primary care, we spend much of our time, not just diagnosing and treating common ailments but managing chronic issues as well. We often spend (consistently) upwards of 60-80 hours a week working, while also trying to raise children, be a spouse, and find a few minutes sprinkled throughout our hectic days for ourselves. The truth is, the healthcare system is adamant and, in many regards, broken, becoming more and more challenging to practice quality based medicine that is sustainable for the physician and safe for the patient. For all physicians, we can pay upwards of half a million dollars (often to be paid back as student loans), for this endeavor, to spend a lifetime, giving altruistically to others. For a moment, I would like to focus on something you said while sitting down with Oprah Winfrey, speaking openly about your battle with depression (which for the record I find to be very noble).
By the way, if your primary care doctor is prescribing you an antidepressant, this should not be happening. Primary care doctors should be introducing you to a psychiatrist, an expert in brain medication.
<Insert prolonged, drawn-out, exasperation here>.
At first, when I began to watch this video, I said to myself as I often do when I listen to you: I love this woman! However, while listening to this particular statement, on the inside, I was screaming. And on the outside, my face could only be described as looking like a despondent Napoleon Dynamite, whose tots just got stolen. Let me for a moment tell you why that statement is not only wholly inaccurate, completely dangerous but also very much entitled.
One in five humans will experience some form of mental illness in their life. That is 20% of the population. Do you think there are psychiatrists available for all of these people (66.5 million to be not so exact)? Did you know there are approximately 25,000 practicing psychiatrists in the United States? Did you know that in some regions of this country, psychiatrists can't be found for more than a thousand square miles of land? I am a physician. I am the expert on the medical treatment of ailments in humans, yet you are declaring what I should and should not be doing? I am curious, do you state opinions on how pilots should operate an airplane because you have traveled in them? Am I qualified to tell you how to be a musician because I played the recorder in grammar school? Do you realize how dangerous it is to say to an entire nation that one-fifth of the physicians practicing medicine in our country are not qualified to diagnose and treat depression and other mental health conditions? Nearly 90% of those individuals are seeking care from them for this exact reason, and by discouraging this practice, you are, in essence, helping perpetuate an already multi-factorial epidemic which furthers the gap between the accessibility of mental health services with those who need them. You are inadvertently setting an expectation that services from a primary care physician are less than that of a psychiatrist and, therefore, will limit the number of people who get access to the care they need. Not to mention, the number of individuals of low-socioeconomic status who we treat and who only have me as an option. Not everyone has the opportunities you do, and for that, this statement is very entitled. Many insurance companies have limited coverage available for mental health services, and many psychiatrists are cash-pay due to the underwhelming reimbursement given from these insurance companies for their incredibly dedicated and educated services. While this statement, I know, was not made in vain, it is in its own right, incredibly inappropriate (and quite disheartening) nonetheless.
Having a mental illness does not make you an expert in mental illness. This experience in so many ways will make you more empathetic and further capable of helping others who have gone through similar situations. However, it will never be a substitute for an educated opinion which would allow you to state a declaration with such certainty, that a primary care physician should not be prescribing what is considered first-line treatment for certain mental illnesses. The only thing that comes from making a statement like this, is weaken an already broken system that other physicians and I are so desperately trying to repair. If only I could show you what a primary care physician does, how exhausting we are in all our efforts to bring people from a place of despair to hope, illness to wellness, empty to fulfilled. Every corner we turn, we are being told that we are not doing our job correctly or being told by less trained individuals how to do our job, and it is wearing on us all.
With all due respect Stefani, if you want to do something to help the mental health community, advocate for better services for those with little to no resources. Advocate for the education system to stop charging obscene amounts for a medical school degree. Most of us are left to pay back hundreds of thousands of dollars (mine $456,000 to be exact that I have barely put a dent in), discouraging more and more new graduates from entering into the lower-paying/reimbursed fields of primary care and psychiatry. Advocate for people like me who try so hard to create a village around those in need. I work tirelessly every day to build the trust of the patients who come to me and how easily someone like you, with a platform, in one fell swoop, one statement, can disrupt all of that. Can you see my point of how dangerous that can be while even if done with the best of intentions?
Time and time again, we see individuals with mass followings speak on topics that their education does not dispose of them to understand fully. As a result, those statements can have profound consequences (dare I bring up what Jenny McCarthy did to our vaccination rates). I implore you, sit down and talk with us, educate yourself on how horrible the system is currently for so many. Listen to our story. Learn from us so that you may help others in a safe and effective way. I encourage you to consider reading a powerful piece inspired by one of these patients who myself, just like all the other primary care docs, fight so hard to help every single day of our existence (holidays and weekends included):
Your voice is so powerful. Be with us, help advocate with us, as my intention and yours are one and the same.
Dr. Megan Babb, a proud primary care physician.