Episode 131 | 3 Ways ‘Doctor Shaming’ Blocks Your Body From Healing (And How to Prevent It)

[00:00:00] Dr. Katie Deming MD: What happens when your decision challenges the expectations of doctors, institutions, or society?

[00:00:07] Dr. Katie Deming MD: Today we're talking about something many patients experience, but few people name doctor shaming. This isn't about blaming doctors. It is about understanding what happens when authority is challenged and why shame appears in moments that are supposed to be about care, because shame is never neutral. It changes how [00:00:30] people think, how they decide, and how they relate to their own authority.

[00:00:35] Dr. Katie Deming MD: So this. Episode and this series of episodes, actually, this whole series on reclaiming authority started because of one of my followers messaged me on Instagram, telling me a story about how she had been diagnosed with melanoma, had ended up going to Mexico to have treatments and surgery done there, and now has a recurrence, and came back to her surgeon and [00:01:00] basically.

[00:01:00] Dr. Katie Deming MD: The surgeon's response was terrible and really upsetting for her and hard for her to even move past to know whether she could work with this surgeon. And I think the emotional impact of an experience like this is something that a lot of my listeners can resonate with, and I think it's important to call out that she didn't just return for care.

[00:01:26] Dr. Katie Deming MD: She returned for judgment, and this conversation wasn't about [00:01:30] healing, it was about compliance. And so what is doctor shaming like? This is when you are interacting with a doctor and they are using fear-based statements. I'll just give you some examples that I've heard. Well, if you want to live to see your children grow up, then you need to do this treatment.

[00:01:51] Dr. Katie Deming MD: Or if you want your kids to grow up without a mother, then go ahead and do your own path and things like that where you're, they're [00:02:00] using fear to motivate you to comply with what they are recommending. There's often moral pressure, like that example of with the children, it's like, are you a good mother if you're gonna choose to do something that's outside of ca standard of care?

[00:02:16] Dr. Katie Deming MD: it also is often giving blame after outcomes. And this one's really interesting because, and I know this like as a doctor, I've had people who haven't followed recommendations and then they come back and you're like, [00:02:30] okay, well this is potentially a natural. Consequence to whatever choice the person made, but it also happens when we do the treatments that we recommend.

[00:02:40] Dr. Katie Deming MD: So I, there are many of times where someone did the treatment that we recommended that this was considered standard of care, and you know what? They had a recurrence and we don't blame those people. We blame people who went and chose their own path and did something that was outside of standard of care.

[00:02:59] Dr. Katie Deming MD: But let's be clear [00:03:00] that recurrences happen even when someone follows the recommendations of the doctor and the standard of care. And doctor shaming happens in retrospect after someone has an outcome that wasn't according to what was I guess what the ideal outcome would be and had done something that had gone against the doctors because they don't shame you if you do their treatment and it comes back.

[00:03:25] Dr. Katie Deming MD: Right? So this is something that is unique to the blame [00:03:30] comes after someone has made a choice and now you're dealing with a recurrence or something happens as a result of whatever decision that that was made. And It may not even be overt. Like the Dr. May not say the overt things like I just described, um, about, you know, if you loved your children, you would do this treatment or whatever that is.

[00:03:50] Dr. Katie Deming MD: Sometimes it can be very subtle shifts in their tone, like before they were, you know. Very much, supportive and you felt like [00:04:00] that there was a caring environment. And suddenly when you've made a decision like this, they become cold, they become disconnected, they're less invested in you, and that's also.

[00:04:09] Dr. Katie Deming MD: Affects the experience that you have. And this is meant to be a healing, caring environment of interacting with a doctor. And so these subtle tone changes can also affect you. Um, maybe not as overtly as some of the comments that are said, but you can notice this just in the subtle tone changes and [00:04:30] also.

[00:04:30] Dr. Katie Deming MD: Oftentimes you'll see conditional care based on this, and I saw this in my practice. So I had one client who she really fundamentally did not want to do chemotherapy because she had watched a loved one recently, um, or shortly before her diagnosis. End up receiving chemotherapy and dying of stage four cancer despite the therapy.

[00:04:54] Dr. Katie Deming MD: And basically the time that they had spent was pretty miserable and she really felt conflicted [00:05:00] about that and for a long time was resistant to having chemotherapy. And I remember I was working with her. It was clear that she had a blood clot. She had a DVT. And so I told her, okay, go call the triage nurse and you know, let them know what's going on.

[00:05:16] Dr. Katie Deming MD: And what was so interesting was that the nurse was completely ignoring her symptoms because she had been resistant to chemotherapy. And the nurse was like, well, this is just because you didn't treat your tumor. [00:05:30] And you know, this is not related to anything else. And because the. The client had me in her back pocket, you know, saying, well, tell 'em this, and this is the symptoms because I knew what was going on, but I can't diagnosis.

[00:05:42] Dr. Katie Deming MD: And in my current practice, I'm, I'm not in that role. And so I'm re like relying on their team to do the right thing and. Literally, I had to say, okay, put me on speaker phone to talk to this nurse and basically tell her what you're saying is incorrect. You don't even have your anatomy correct. This woman [00:06:00] has signs of A TVT.

[00:06:01] Dr. Katie Deming MD: She needs an ultrasound, and so she was able to get it, but she would not have gotten that ultrasound if I hadn't been on the phone to argue and fight with this nurse, because the nurse had basically. You know, labeled her as noncompliant and was not giving her adequate care for the symptoms that she was reporting.

[00:06:19] Dr. Katie Deming MD: So this is definitely something that I see and I'm sure many of you have experienced, whether it's the overt statements, whether it's the subtle shifts in their tones, [00:06:30] or whether it is like the conditional care that you receive based on the decisions that you've made. And let's just define this simply.

[00:06:40] Dr. Katie Deming MD: This is really about fear. Fear. These are fear tactics to try and get you to do what the system wants you to do. It's also about blame. It's about moral judgment, and it's about withdrawal of support, none of which should be in. The healing space. [00:07:00] None of those things like we shouldn't have fear. I mean, fear is the biggest problem actually in healing.

[00:07:05] Dr. Katie Deming MD: And specifically within cancer. We definitely don't want these things in the environment of where we are seeking healing and where we are seeking care. So Dr. Shaming is the use of fear, blame, or judgment to enforce compliance. Shame is not a therapeutic tool. And yet we see it like it's, it's really common to see [00:07:30] this, in the healing space with, uh, western medicine doctors.

[00:07:34] Dr. Katie Deming MD: And not saying this is not, I'm not trying to bash all doctors, but these are things that, that. We see, and especially when you step outside the system, you see it very clearly that this is a problem and this is something that many people face when you're pursuing more holistic approaches or, you know, a, a blend of holistic and conventional therapies.

[00:07:58] Dr. Katie Deming MD: So. Let's talk about [00:08:00] why. Why does this happen? Like why, why is it that we see this? And if you think about it, doctors are highly conditioned and trained into a specific system to. Make them think in a certain way and make them function according to the system that they work in, right? They, and you think about this, I did not finish my training until I was 32 years old.

[00:08:27] Dr. Katie Deming MD: So that means I was in school from the [00:08:30] time I was five and kindergarten all the way until I was 32. So what is that? 27 years of training. So the, in, in, actually education is one of the forms of conditioning into a system. And so doctors are the most highly conditioned, authorities because they have been trained into a system.

[00:08:53] Dr. Katie Deming MD: And I can just tell you from my medical training that there are a lot of things in there that, that are, [00:09:00] you know, done to doctors that to break them down to. Help them become what the system wants them to be. The other thing is doctors also have liability, right? So there's, they're highly trained into the system, but the other thing is that they are.

[00:09:15] Dr. Katie Deming MD: Liable for, you know, the outcomes that happen with patients. And this is one of the things that I really empathize, empathize with, is that, you know, it's a risky business to be caring for people who are dealing with life-threatening illness and give some of these treatments that they [00:09:30] do. And so the doctors are always concerned about making sure.

[00:09:34] Dr. Katie Deming MD: People don't have bad outcomes under their care because number one, they don't want that. They, I really do believe that the doctors want the best for you, but they, they want you to have a good outcome, but they also don't wanna have bad outcomes in their practice that result from people doing things that are not, What that doctor perceives as the best, and kind of more, most, uh, appropriate therapy for whatever [00:10:00] illness that they are, dealing with. doctors also want predictability, right? Again, ties into that liability thing, but they want to be able to predict what's going to happen and the more uncertainty that is brought in.

[00:10:13] Dr. Katie Deming MD: The less likely they can predict what is going to happen. And this is one of the biases that they have, that they want predictability, and that when you're starting to incorporate all these other things and they can't predict the outcome. Now that makes them nervous. And, and I understand this, this is [00:10:30] justifiable.

[00:10:30] Dr. Katie Deming MD: That they, they want you to get the best results and they wanna be able to predict that. And I'll just give the example of like Ivermectin and Abend, ISOL or Femazole, you know. There are so many people who are just taking these medications now, even despite having chemotherapy. But the doctors get very nervous because they just don't know, they're not trained in these things and they don't know what the outcome's gonna be.

[00:10:52] Dr. Katie Deming MD: And because they can't predict, it creates this level of uncertainty for them. and systems [00:11:00] specifically resist or reject. The loss of predictability. So systems really want to have predictability. So you have the system that wants predictability, and then the doctor that wants predictability. It's a setup for, you know, really not dealing with uncertainty very well.

[00:11:17] Dr. Katie Deming MD: And also doctors are rewarded for certainty, right? So doctors are rated according to Medicare outcomes and you know, their outcomes are ranked, and so they are [00:11:30] rewarded for having certainty. And I think understanding why this is happening and what are the underlying or the underpinnings of, incentives and priorities that lead to this, you know.

[00:11:44] Dr. Katie Deming MD: Shaming of doctors I think is, is important. So these are not, doctors are not evil people. I, I swear most doctors go into medicine because they really wanna help people. They really start out with their heart in the right place. so this is not [00:12:00] about doctors being evil. This is about conditioned system behavior.

[00:12:06] Dr. Katie Deming MD: The doctors are functioning exactly as the system designed for them to function within it. Okay, so systems that depend on compliance, experience, autonomy as a threat, and when something challenges the system, the system is gonna push back. And you can just expect that that's just something that is inherent in the way that the system [00:12:30] was designed and the way that the doctors were trained within the system.

[00:12:34] Dr. Katie Deming MD: And I think sometimes just knowing that can be helpful. But let's talk about what does shame do to patients? Like what are the implications of these behaviors that can occur when. A patient chooses their own path, has an outcome that is maybe not expected or not what they had wanted. There is a recurrence.

[00:12:56] Dr. Katie Deming MD: What is the impact of that shaming on [00:13:00] patients? And I think this is important for doctors to hear, like, what is the result? Of this behavior when we are charged with number one, doing no harm, right? So as doctors, we take the Hippocratic oath, which says, first do no harm. So what are the implications of this?

[00:13:21] Dr. Katie Deming MD: The first is that your nervous system is going to react to any kind of shaming behavior, whether it's subtle or whether it's overt. And we know that a [00:13:30] dysregulated nervous system. Is a disaster for healing. That is the one thing that I've learned in this practice of stepping outside of Western medicine, is the very first thing that I am always wanting to do with clients is to help calm their nervous system, to get them into a state of calm and, That, that's where clarity comes from, is from a state of calm. So when you have a dysregulated nervous system, you now have people who are in fear, who aren't able to make good decisions, you have loss of [00:14:00] clarity, right? So when we're in fear, basically you can think about it like as an aperture that you're looking through when you have, you know, no fear and are in a state of rest.

[00:14:12] Dr. Katie Deming MD: Your aperture of vision is wide. Open and when you have fear in a dysregulated nervous system, this aperture just gets smaller and smaller and smaller, and all of a sudden you're looking out this tiny little pinhole and that absolutely clouds your ability to make good [00:14:30] decisions. So your clarity is affected by any kind of shaming and any kind of fear-based approach that can be happening.

[00:14:39] Dr. Katie Deming MD: in the healing setting, you also start to lose your voice. Because it's really hard to speak your truth when an authority figure is challenging you. Again, overt or subtly like this is a way that people start to diminish their voice and stop speaking up because they know they're going to be punished for it.

[00:14:59] Dr. Katie Deming MD: It also [00:15:00] creates a power imbalance, so when you see these tactics used by doctors or nurses or anyone within the healing space. You're basically creating a power imbalance. So now the patient has even less power. So started out with a power differential with the doctors and the system having more power.

[00:15:20] Dr. Katie Deming MD: But now when you have the shaming, you actually worsen that imbalance of power between the patient and the the doctor or nurse. And then you have [00:15:30] collapse of real consent. And this is something that I really wanna call out because informed consent. Is assuming that people are hearing information in a setting where it can be absorbed.

[00:15:45] Dr. Katie Deming MD: They're able to understand the risks and benefits of a therapy, and they're able to make a decision from a really clear, balanced place. When we have shaming in a medical setting that collapses consent. [00:16:00] This is not informed consent when someone is being shamed about their decisions or about what they're, you know, supposed to do next.

[00:16:09] Dr. Katie Deming MD: So shame disconnects people from their own authority and the moment shame enters the room, informed consent leaves. It's as simple as that. So let's talk about authority versus approval. And like I said before, oftentimes patients are seeking approval. You want your doctor to like you, right? You go into a [00:16:30] doctor's appointment, you this person.

[00:16:32] Dr. Katie Deming MD: Has power over what you have access to in terms of treatments, in terms of options, what they explain to you. They are holding a lot of power. And so when you go into an appointment like that, of course you want that person to like you and to want to work with you and to have a good working relationship with them.

[00:16:55] Dr. Katie Deming MD: And then, you know. In the cancer space, specifically with this people pleasing [00:17:00] thing, this can be even heightened that you want the doctor to approve of you and to be supportive. And the doctor's positioned as an authority figure, right? So this is like why you're deferring to them, why you're seeking them, their approval.

[00:17:14] Dr. Katie Deming MD: And oftentimes this is a setup for us, basically giving up internal knowing. In place of external validation that we want to be validated by the system, by the doctor, whatever. And [00:17:30] we give up our internal knowing in that process of seeking the external validation. And I don't think that anyone is doing this consciously.

[00:17:37] Dr. Katie Deming MD: Like, I'm gonna give up my internal knowing to the doctor because I wanna be externally validated by them. No, like this is not something that is happening necessarily on a conscious level, but this is happening under the surface. And so you can receive guidance. Without surrendering your authority and reclaiming authority isn't about rejecting medicine.

[00:17:58] Dr. Katie Deming MD: It's about refusing [00:18:00] to outsource your power. So let's talk about this. How can you do this? How can you respond in a setting like this if this is happening, so that you can call back your power and your authority and make the best decisions and have some kind of alignment with this doctor that you're, interacting with, that you're working with.

[00:18:23] Dr. Katie Deming MD: And sometimes you need to just leave. I'm gonna say that, but like, how can you. Approach problems like [00:18:30] this. The first thing that I would say is staying grounded and calm is the most important thing. if this starts to happen and you're in a visit, calming your breath would be the place that I would start using a four eight breathing pattern where you breathe in for four and out for eight is an easy thing that you can do while you're listening.

[00:18:52] Dr. Katie Deming MD: So that you can start to activate your vagus nerve, activate your parasympathetic nervous system to get yourself [00:19:00] out of that natural fight or flight response that is now gonna be arising in your body, because naturally you're gonna start to get defensive and feel flustered, and you don't have the same.

[00:19:11] Dr. Katie Deming MD: Language and jargon and expertise to argue, so you start to like really deflate and kind of collapse. Using your breath to call your power back to calm your nervous system is a very, very helpful tool. The other thing is that I would be really clear about not [00:19:30] defending your identity. And basically not allowing this to become an attack on your identity and like that you are the type of person who does this or whatever that they're gonna say potentially, is to not let this become somewhere where you're having to defend who you are and what your values are.

[00:19:51] Dr. Katie Deming MD: And then you can redirect the conversation and, and bring it back to what you do want to know from the doctor, so that if they start taking you down this [00:20:00] path of shaming you for, you know, your decisions and making claims about you, you can redirect the conversation. And then ultimately you may have to set some boundaries.

[00:20:10] Dr. Katie Deming MD: I'm sorry, but you can't speak to me this way, or it's not acceptable for us to be having this conversation. I would like to talk about X, Y, z, you know, so you can redirect and then create firm boundaries if you need to. So. You can use phrases like, you know, if, if someone's shaming you for a decision that you [00:20:30] made in the past, you can say, I made the best decision I could with the information I had, and I'd like to discuss next steps.

[00:20:38] Dr. Katie Deming MD: And I'm asking for care, not judgment. So these are just some things that you can say to a doctor who starts down this path so that you can hopefully move out of that and redirect the conversation into a more productive realm, which is helping you make decisions now like you are here now with this, you know, set of [00:21:00] circumstances.

[00:21:00] Dr. Katie Deming MD: Like what can we do from this point forward? And so you're allowed to receive care without accepting shame. It's important for you to remember that, that you're allowed to receive care without accepting shame. So let's talk about this in terms of like the bigger frame of how this affects us and, and the system.

[00:21:21] Dr. Katie Deming MD: So choosing your path. Is disrupting the system. So just recognizing that like, oh, when I choose my path, it's [00:21:30] basically disrupting the system that has been created. And that doesn't make you wrong, but I will say that reclaiming your authority requires courage. So standing in your truth, choosing your path requires courage.

[00:21:48] Dr. Katie Deming MD: If you choose your life based on your values, some systems will be uncomfortable. That discomfort is not evidence that you are wrong. I'll repeat [00:22:00] that. The discomfort of the system pushing back is not evidence that you are wrong. As you think about this, I would love for you guys to send me a message on Instagram or comment and say like, I, yes, I've experienced that.

[00:22:17] Dr. Katie Deming MD: This is, this has happened for me. Because my guess is that most of you who are pursuing holistic treatments in addition to conventional care or maybe have, you know, decided against conventional [00:22:30] care, have experienced this, shaming. To some degree or another, and as you're reflecting on your own experiences, your own journey, I want you to think about, okay, like when has this happened?

[00:22:44] Dr. Katie Deming MD: And what, what, how was I deferring my authority and how did I allow myself to collapse? How did I give away my power in the scenarios and how could I have done that Slightly different, and not [00:23:00] because we have any regret about how anything's happened, because I always believe that everything is happening exactly the way it's meant to, and everything that's happened up to this point is perfect.

[00:23:10] Dr. Katie Deming MD: Right, and you are here now at this moment. So looking back at those experiences is how can you pull forward what you learned from that experience? And maybe it's that I'm not available to see a doctor like that, and that you're like, I'm not, you know, I'm firing that doctor. I'm not doing that anymore. Or [00:23:30] maybe it's okay.

[00:23:31] Dr. Katie Deming MD: I could have set clear boundaries and made this less personal, but I allowed myself to collapse and be, have my identity, challenged by this. How, how could I do that differently? And just looking at that, you know. And then the other thing is having compassion and seeing your doctors as. These are human beings who've been trained by a system.

[00:23:57] Dr. Katie Deming MD: They're highly conditioned [00:24:00] into this system. Their whole reality and livelihood is tied up in this. And just having compassion for that, like I get it, like I can see how this could happen. Like even good people who mean well and have committed their lives to healing. Could be influenced by this and their behavior may have nothing to do with who they are as a person and really about the system that they work within.

[00:24:25] Dr. Katie Deming MD: Because even myself, I am sure I did this [00:24:30] subtly or overtly. I don't think that I said some of the things that I've heard, you know, that I think are just terrible. But I know that I've probably done this in the past because I was. I didn't understand the other side. I didn't understand what the system was about.

[00:24:44] Dr. Katie Deming MD: So I have tremendous compassion for doctors and nurses and anyone who works within the system, and I understand how this happens and I'm not condoning it, but having that compassion and just awareness is going to serve [00:25:00] you. Because when you have compassion, it takes away the defensiveness where you're like, oh, that person is just like terrible.

[00:25:07] Dr. Katie Deming MD: And then you're just like coming out punching. It allows you to stay more grounded and calm in your interactions so that you can realize like, oh, well why do I care what they think anyway? They've just been conditioned in this system andit's fine. You know? It doesn't mean anything about me personally.

[00:25:26] Dr. Katie Deming MD: So. Authority is not about winning [00:25:30] against the system. It's about staying in relationship with yourself. Choosing your path requires courage, especially when others don't understand it. So I hope you're enjoying this series. For me, this is incredible because I feel like this series gets to the core of why I do what I do.

[00:25:50] Dr. Katie Deming MD: And so I hope you're enjoying this. And in the next episode in this series, we're gonna explore how fear and urgency shape medical decisions [00:26:00] and why clarity requires more than just information. So I look forward to seeing you on the next episode. If this episode has been helpful for you, I please request that you subscribe.

[00:26:13] Dr. Katie Deming MD: If you're on YouTube, leave a review or share it with someone that you love, who you think would benefit from this information. You know, I put out tons of free content, and my goal is just to help you, and the way that you can help me reach more people is by sharing, making a review. [00:26:30] Or, you know, leaving comments on the episode.

[00:26:32] Dr. Katie Deming MD: So thank you so much for listening. Thank you for being here, and I look forward to seeing you on the next episode.