Family Doctor Battles Health Care Inequities for Clients While Fighting Multiple Sclerosis

In her new book, “Up the Down Escalator: Medicine, Motherhood, and Multiple Sclerosis,” Doggett offers a down-to-earth and inspirational memoir about her shift from doctor to patient, her frustrations with what she calls an “unfair” healthcare system and her insights about how social determinants and human connections are some of the most important factors when it comes to our own health and well-being.

THE IMPACT OF SOCIAL DETERMINANTS

“We now know that the conditions in which we live, work, learn and play – called ‘social determinants of health’ (SDoH) – have a far greater impact on health than any medical treatment we can offer,” she writes. “It’s the social determinants – like access to housing and healthy food, transportation, and safe neighborhoods – that drive 80 to 90 percent of health out-comes on a population level.”

As the director of a clinic in Austin, Texas, Doggett witnessed daily how financial and other disadvantages became a barrier to quality health care. She worked tirelessly to diagnose and seek support for her impoverished clients, which she described as “an eclectic mix of uninsured patients – from a manic pink-haired stripper to an undocumented man, paralyzed by high voltage power lines.”

To help her clients receive the medicine and treatment they needed, she wrote how she would “navigate the highways, side streets and dark crooked alleyways of Austin’s health care system.” She knew the discount pharmacies and the ones that overcharged. She had a long list of generic medicines she would recommend instead of expensive new drugs, and she would call in favors from specialty doctors that she knew.

She was exhausted and discouraged. And that was before she received her MS diagnosis.

FEELING POWERLESS, MORALLY DISTRESSED

MS has long been known as the crippler of young adults, usually affecting people between the ages of 20 and 50. It is an autoimmune disease of the central nervous system. The immune system attacks the myelin, or coating around nerve cells, which affects how the brain and spinal cord communicate with the rest of the body. The wide range of symptoms makes MS difficult to diagnose. They can include mobility issues, fatigue, sensory changes, visual and cognitive changes, bowel and bladder problems, and depression. The disease affects women at a ratio of 3:1 to men, and, although research has identifed certain risk factors and possible triggers, its cause remains unknown.

“MS made me feel powerless. I was now ‘Less Likely to Succeed.’ I couldn’t cure poverty or fix our broken healthcare system,” she writes.

“I think I was depressed, but more than that, I was demoralized,” she said. “That sense of powerlessness was triggered by my own health and also by my work. Each kind of fed off the other. We’ve learned in recent years that a lot of healthcare professionals are suffering from what has been termed ‘moral distress’ or ‘moral injury.’ That’s this feeling as a doctor or another health professional that you know what your patient needs but you can’t get it for them. It was very common at my clinic that I couldn’t get someone the medicine, the specialist, the behavioral health counselor, or the test that they needed and that I thought they deserved.”

BEING INSPIRED BY PATIENTS

Despite the discouraging times, Dr. Doggett also says she was inspired by her patients. One of her clients said that her diabetes diagnosis actually made her take better care of herself. “One of my very favorite patients had the worst asthma I have ever seen. In addition to the usual asthma medicines, she needed daily oral steroids, which is fairly uncommon for asthmatics to have to take a pill by mouth every day. That caused her to have a lot of weight gain. And she struggled a lot with arthritis, in part because of the weight. But she was resilient and ultimately, she was able to change her diet. She lost 60 pounds and her asthma improved dramatically.”

Doggett took those lessons to heart and decided MS was not an excuse for her to stay at home. Instead, she decided it was her “launchpad to do more and do it now” because of the uncertainties of the disease. “I really did make self-care a top priority.”

MEDITATION, CONNECTIONS AND BIG GOALS

She started meditating to manage stress. Ultimately, she found that mindfulness and meditation have helped her dizziness more than anything else. “It’s been a very good tool for me to cope with anxiety as well as help me sleep better. It’s been a huge improvement in my life.”

She also learned more about the healing power of social connection. “I had patients who were isolated. Language barriers contributed to their feelings of isolation. Some were estranged from family. One client struggled to get sober. He didn’t have a support circle.”

As her symptoms improved, Doggett decided she wanted a big physical challenge. She started training for a marathon. She kept her goal to herself but kept pushing to run one more mile every week. On Valentine’s Day 2016, she completed a marathon. Since then, she also has completed a half Ironman triathlon (70.3 miles of swimming, biking, and running). She continues to exercise every morning and participates in the Texas MS 150 bike ride each spring to connect with others with MS and to push herself.

Today, her life continues to be very full, “like an overstuffed suitcase,” she says, as she and her husband raise their daughters, now ages 15 and 18. She works for a company that designs programs for people with Medicaid and Medicare to help them be as healthy as possible. And she recently started a part-time position at the Dell Medical School’s Multiple Sclerosis and Neuroimmunology Center, where she will provide preventive care and lifestyle medicine support to others with MS.

“Writing and publishing the book has been a dream come true,” she says of “Up the Down Escalator: Medicine, Motherhood, and Multiple Sclerosis.” It’s available now on Amazon and at libraries and bookstores around the country. FBN

By Bonnie Stevens, FBN

Hear more from Dr. Lisa Doggett on Zonie Living at StarWorldwideNetworks.com https://starworldwidenetworks.com/episodes/up-the-down-escalator-in-health-care-with-dr-lisa-doggett-as-family-physician-and-ms-patient-video

Courtesy Photo: Dr. Lisa Doggett touts the health benefits of exercise, a healthy diet, meditation, a strong support circle and big goals. Since her diagnosis she has run a marathon, completed a half Ironman triathlon and participates in the Texas MS 150 bike ride each spring as well as other outdoor sports.