The Angry Letter

When my birth control prescription ran out recently, I found out that the student clinic I go to couldn't issue birth control anymore. Apparently the resident MD objected to it on religious grounds and refused to prescribe it. Naturally, I was furious...but how to respond? Bust out the pitchforks and torches? Organize a protest? Form a Facebook mob? Those certainly would have been entertaining and fun, but once I calmed down a bit I figured I should at least try going through official channels before I unleashed my wrath upon the world. So I got the contact information for the UF Clinical Administration, did a little research and composed a sternly-worded e-mail:

I am a grad student at UF and I have used the Student Clinic at Shands as my primary care provider for the past six years. I have never had any problems there and have always found the staff and doctors to be helpful and knowledgeable, if sometimes inexperienced. Recently my birth control prescription expired and I received a phone call from the student clinic explaining that they could not issue a refill. Inquiring about the change in policy at the Women's Clinic across campus, I was shocked to learn the reason that the Shands clinic was not providing such a basic service: the resident MD, Dr. Nahum Beard, objects to birth control on religious grounds and refuses to prescribe it to his patients.

I was appalled that the University of Florida Administration would defer to Dr. Beard's personal preferences at the expense of his patients. More than half of UF grad students are female, with health needs that do not go away because they make Dr. Beard uncomfortable. I am aware that the female residents who handled women's health issues at the Shands student clinic in the past have resigned and that Dr. Beard is not a women's health care specialist. I also understand that the State of Florida's Conscience clause means you can neither compel Dr. Beard to prescribe birth control nor fire him for not doing his job. But surely he could have been transferred to another position where female patients did not rely on him for their birth control, or a second resident been transferred to the student clinic who was willing to do the job he would not.

The situation as it is now sends the message to female students that their care is not your priority. Shuffling patients off to another clinic as a matter of policy when their care becomes inconvenient is entirely inappropriate and sets an unfortunate precedent. I fervently hope that the administration will correct this matter as soon as possible, or at the very least act to prevent it from occurring in the future once Dr. Beard's residency ends in June. Thank you.

I was quite pleased with it, but I had no idea how the administration would respond or if I would be taken seriously. The first response I received was surprisingly understanding:

I am the assistant for the Associate Directors of the Medical and Nursing Departments at Student Health.  I will forward your email to them, so you should hear from one of them in the near future.  I am so sorry about the shuffling of your care and understand your concern for yourself and the female patients that are seen at our Shands clinic.

This will be addressed to our staff and will be corrected soon.  Again, I apologize for the disappointing care you were given.

Please feel free to contact me for further assistance.

Wow. I hadn't expected an apology, let alone admission that this was a real problem. And it seems like they intend to do something about it! So what did the Associate Director have to say?

I received your email from this morning.  I am sorry you were inconvenienced by the situation at the Shands clinic.  It is a dilemma for us and as you correctly pointed out we must be able to allow our providers to practice within their levels of comfort for whatever reasons.  Typically the nursing staff at the clinic can obtain a prescription refill or extension on your pills-so I am not sure what happened on that end.  We are in the process of hiring a practitioner for that clinic and we will be certain that there will be women’s health in the repertoire of that provider.  We have considered sending one of our Women’s Health ARNPs  to that clinic which we have done in the past-but this is our super busy time as the semester is ending so we find keeping all our Women’s Health in the main building is best for right now.  We do have other providers who rotate to that clinic and it should be possible to schedule with them.  Again I apologize for the problem that you encountered.   We always try to meet the needs of our student customers-I do hope that you were able to get your prescription needs met.  Thank you for your thoughtful letter. 

This response was a lot less satisfying. I never complained about the inconvenience or my own experience, and the rest just seems like a bunch of excuses and 'I just don't know what went wrong'. Here is my response:

Thank you for your response, but I fear that you have misunderstood. My personal inconvenience was minor and I found the staff to be quite helpful in accommodating me. I am certain that the nursing staff at the Shands clinic would have been able to refill my prescription, had the resident MD been willing to do so. This is not a mistake or a problem on their part.

What I am complaining about is the situation itself, in which Dr. Beard's personal preferences and bias have been permitted to negatively affect patient care. I do understand that this is a difficult and unanticipated situation. If the female residents had not resigned, I am certain that Dr. Beard would not have been called upon to fill this particular professional obligation. But they did, and he was and he refused. Maybe you have never had to deal with a medical resident in charge of a student clinic who refused to administer birth control before and therefore had no contingency plan in place for ensuring patients needs were still met. In the future, please note that 'do nothing' is not an appropriate response, and 'because we're busy' is not a satisfactory explanation.

What I am hoping to accomplish from this exchange is to make the administration aware that this type of unfair treatment of female patients is noticed. We do not like the idea of someone's personal beliefs affecting our access to medical care, and we want assurances that the administration will prevent that from happening. Under the Conscience clause the actions you can take to prevent this are limited, but they do exist and I implore you to take advantage of them. If not with Dr. Beard, then as an established plan for dealing with any future 'moral objections' to women's health that limit patient access to the treatment they need. Thank you.

So, as you can tell, I was a bit annoyed by the shifting of blame and dismissal of my real concerns in favor of my superficial inconvenience. Guess we'll see where it goes from here. Thoughts and opinions on the situation so far are greatly appreciated.