[Okay—so it should be
Pfizer’s PHQ Fallacy
I like to play with words.]
Let’s start with what PHQ means. There you have it in the image below:
PATIENT HEALTH ASSESSMENT
It was created to determine depression levels
I’ll never forget the first time [and the last time] I ever filled one of these out. I was in a Neurologist’s office at Mt. Auburn Hospital in Cambridge Massachusetts. I had chosen this hospital because I was impressed by their Harvard-affiliated credentials.
I am EXCRUCIATINGLY honest in most things. This is not necessarily good. I had to learn to ‘white lie’. If you are wearing a favorite shirt and ask me if I like it, even if I despise it, ‘White’ is the game now. I will gush over how great it is.
But in the days I actually thought Medicine cared, I toed the line and honesty was my game.
I was in the Neurologist’s office because I have autoimmune disease, so you can imagine how this form went for me. Not to mention I was on four or five pharmaceutical products that caused more than a few of the items the form asks about. MDs never take such things into consideration. Pharmaceutical companies pad the paychecks of MDs prescribing and/or touting their products.
I filled the form out and, boy, did I score big. The fact that I had autoimmune disease and was on pharmaceutical products that caused side effects that were represented on the form was not factored in at all. I hit in the 20-27 range, so I was tagged with severe depression.
For some time, I believed that Dr Linda Buchwald denied me access to the neurology department’s special clinic because of my inappropriately high depression score.
I WAS FURIOUS!!
Once something like this is on your health care record, it is impossible to change. You can bitch and moan all you want, but your health care record might as well be chiseled in granite.
An MDs word is Godly, and what they say might as well appear in a bible as not. A ‘patient’ cannot even file an opposing view without the approval of the MD who created the record in the first place.
How do I know? I’ve tried. And if that MD no longer works at the institution that created the record, forget it. You’ll be told that MD is no longer available to approve anything you contest.
Partners in Health hornswoggled me for years after not recording anything about my allegations regarding an MD child rapist. I had many conversations with health care workers regarding him that were never recorded. It wasn’t until years later that I discovered he had worked for that particular institution for a time. It was before its affiliation with PIH, but I requested to amend my record after PIH took charge.
[PIH, by the way, are these guys:
NewsFlash: Mass General infectious diseases chief, Rochelle Walensky, to lead CDC under a Biden Administration?
Who will apparently be running the CDC.]
So my displeasure at being denied would be recorded, but allegations of workers deliberately keeping my numerous conversations of sexual assault as a child out of the records would probably not.
I covered the story of that particular offender. In 1989 and 1992, local papers [reporters] ran stories almost daily for a week. Below is my synopsis:
[There are records available through the article, written by employees of that institution showing clearly that they broke the Mandatory Reporting law by not reporting assaults on children in the 70s. They were not legally beholden to report under the law when I discussed my own sexual assault in 1981 because I was well past the age of majority.]
All efforts are made to control any narrative. Patients are bugs.
The moral of this story here is be very, very careful what you tell anyone professing to work in these fields. It could very well end up chiseled in granite in your records. And we can thank Obama [damn—I voted for that guy twice] for electronic records which means anyone with an MD can squeeze your life electronically. I’ve met some idiot MDs who rode on their MD parents’ coattails into these lucrative professions.
And even if these people are really bad at their jobs, you are required to pay them. Cushy job.
But I digress…
I was so angry with my erroneous forever score that I tracked down one of the co-authors of the PHQ-9 form and emailed him.
He answered my frustrated email with this:
“I am sorry to hear a diagnosis of depression was made solely on the basis of the PHQ-9. It is not intended to be a diagnostic measure for depression. The 9 symptoms simply measure the criteria for depressive disorders but, as you mention, some of the symptoms can also occur in a number of medical conditions and other diseases. Thus, it is incumbent upon the clinician to determine whether the symptoms endorsed on the PHQ-9 are due to an underlying medical illness, to depression (or in some patients a combination of both).
Also, it is important when a PHQ-9 score is obtained, to incorporate the patient’s perspective since she or he often has salient insights about the potential underlying cause of the symptoms that can complement (or override) what the clinician believes may be the cause.
As I occasionally teach about recognizing and treating depression, I will continue to remind the audience that a simple score on a brief self-report scale is nothing more than a measure of symptoms and not a diagnosis of depression. I have typically communicated this but your experience and words convey more poignantly this caveat.
Kurt Kroenke, MD
Professor of Medicine
He did better than that. Pfizer had commissioned the PHQ-9 form [which is now required to be filled out by all Medicare patients.] Kroenke parlayed complaints from people into the new PHQ-2 form. Full forms proudly display his name.
It now only takes two questions to depress you—or at least get you started. All physical manifestations were removed.
And note Kurt’s name mentioned at the bottom of an instruction form for the PHQ-2 [highlighted in yellow.]
Have a death in the family? Lose your job? Get over it immediately or take a Pfizer pill.
Frequently, these pills are being shoved down our children’s throats. This is happening at younger and younger ages. Children have no chance to physiologically develop emotional controls. Pfizer corners that market for life.
And what a market…
Doesn’t this make you feel fabulous about Pfizer’s COVID care?
Copyright January 2021 by Joyce Bowen