At my visit I was quickly taken back to a room where a staff member came in to go over why I was there. I noticed that the staff member's mask was the type with exhalation valves on it. I had researched different types of masks and their appropriateness for different settings early on in the pandemic, and found universal recommendations that valved masks are never appropriate for Covid protection, especially in a medical setting, let alone one where the patient will have their mask off for the exam. Valved masks only filter the incoming air that the person wearing it is breathing in. Standard facial masks with valves do not filter the outgoing exhaled air and the valves can even function as a mini aerosol generator making them more dangerous to the patient than the provider not wearing any mask at all. The person wearing the valved mask is protected from others, but anyone in their vicinity is not protected from the germs or droplets they are breathing out. Thus not appropriate for Covid prevention in any setting, let alone an ENT's exam room. I immediately spoke up that I was concerned about their mask not being medically appropriate. I received a denial that this information was accurate, an "it's ok I'm boostered", and a "this is the only type of mask that doesn't fog my glasses". I reiterated that this person didn't need to listen to me but should go look it up. She asked if I wanted someone else to take care of me. I said, ok have someone else come in. The next person who came in was Dr. McBrien. I told her she needed to look into the guidance around valved masks. She asked if I wanted to continue with the visit, and went out of her way to, not acknowledge the information about the valved mask, make the excuse that it must be ok because that staff member was the only person in the office who hadn't had covid, (yes, because the valved masks protect the person who is wearing the mask, i.e. the staff member, it's the patients they would be interacting with who's health would be at risk) and pointed out to me that the surgical mask she herself was wearing wasn't really that protective, that the only real protection was a tight fitting n95 (yes, exactly, so why wasn't an ENT who's examining patients without their masks on wearing exactly that?) and she wasn't going to wear anything else at my request (I hadn't made one), and insisted it was all fine because she was boosted, as if Delta and Omicron breakthroughs, the immunocompromised, long covid, babies who still aren't vaccine eligible, and 2500 positive cases a day in Oakland County were not factors at all in what kind of ppe she was choosing. I said I did want to continue and we began talking about why I was there. I use a cpap, but struggle with it because of nasal obstruction, have a deviated septum, wanted to be evaluated for septum and possibly turbinate surgery. I specifically had recommendations to try two prescription nasal sprays, and also to get a CT scan to establish the basic pre-surgical anatomy of my septum and turbinates. She was ok with the nasal sprays but said she didn't do CTs for septum surgery, only for sinus problems, according to her because the septum can be evaluated just fine by the surgeon with a visual exam. I already knew it wasn't universally standard to get a CT for pre-op septoplasty/turbinate reduction, but that not getting an objective quantitative before picture of the turbinates with a scan, and surgeons relying on their subjective visual assessment alone, has a lot to do with some people suffering from over-aggressive turbinate surgery which is something I'm trying to avoid, but never got the chance to even bring up. I asked Dr. McBrien, can you explain why you wouldn't get a CT for my septum and turbinates, because that's anatomical too right? (This is all still about 5 minutes into my appointment, not some long discussion) This is when she told me that it was not going to work, and she would refer me out but did not want to work with me as a patient. I just said, seriously, I came to my appointment with specific questions and information and you're refusing to treat me because of it? She started talking over me that my "information" was from the internet. I explained that the recommendation I had to get the CT was from an ENT (who was not available to treat me in the immediate future). She continued talking over me, "well they're just a doctor, not an ENT" and I again explained that the recommendations I had come in with were from an ENT, "well go see them then" was the reply. By then I realized I was just having my time wasted and got up and left. Again, this was not some long drawn out process, the entire encounter took maybe 10 minutes. For the record, I spoke calmly and respectfully in a normal tone of voice and was talked over and down to in return. All in all, my health was put at risk and my time wasted in service of yet another doctor's fragile ego. Patient beware read more
