Friday, December 14, 2007

my life is a farcical drama

I've said many times that a lot of the events I undergo from time to time resemble something you'd watch on TV. Case in point:

Bad Apples, or, My Drama with the Doctor

I have been feeling poorly for quite some time -- since just before I moved, in fact. Granted, the stress of living in the Crack House would get to anyone, but it really took a nasty toll on my depression. Moving helped a little bit, but then, accounting for the stress of the move itself, the bulk of which I did alone (though I thank the Good God for the help I had with the heavy stuff), and then the following "settling in," which has taken forever due to the limited space in my new abode, the general stress of attending my beloved sister's lovely wedding, and the financial crunch I've been in, I've just felt down in the dumps since September.

The antidepressants I have been taking since April are no longer effective; I feel like the proverbial crap nearly all the time, and have recognized in my increasing agitation and horrible dreams (which didn't start till I began taking the stuff) a negative reaction to my medication. I had a bad reaction to an antidepressant before, and I can tell the difference between chemical and biological based on that experience (and a couple of others).

Not to mention some sort of stomach bug that has plagued me for a couple of weeks. It feels mostly like post-nasal drip, which, combined with the chemical stuff and the insomnia, have reduced me to a state of general mal-being.

So I made an appointment with my doctor. I happened to have made the appointment before the stomach troubles started, to do a med check, and then decided to include my recent illness when I got there.

Here's where things took a wild turn for the absurd.

When I first began seeing this physician, his staff informed me that if I were five or more minutes late, they would have to reschedule me. With that in mind, I prepared yesterday to leave twenty minutes early for the appointment to ensure a timely arrival. Unfortunately, the receptionist (who is generally wonderful, but doesn't always know how to handle new situations) paged me just as I was putting on my coat to pass me a new client call, and the person on the phone was in hysterics. Being that I'm in the business of people, I took the call, calmed the caller as best I could, and left immediately following my hanging up.

I called the doctor's office to let them know that I would be about three minutes late. They said that if I were any later than that, I would have to reschedule. I drove as quickly as I could, considering that all of the people in front of me had taken it into their heads to drive ten miles an hour below the speed limit. When the clock said I was four minutes late, I gave up, unhappily called the doctor's office to reschedule and then returned to the office.

My boss saw me upset when I returned, and, as he has taken me into a fatherly consideration generally, he decided to call the doctor's office to see if they could get me in that day anyhow.

There was an emotional explosion from the doctor's office. Although M'sieur had merely called to see if I could get an appointment that day, and requested nothing further, they alleged a HIPPA violation on his part, said he was requesting a disclosure of information (he wasn't), and threatened us with their attorney, regardless of the fact that I was standing right there and authorized them to talk to him once they started getting nasty. They were excessively discourteous.

Now, I understand confidentiality. I work for a lawyer. I have had relatives of clients call the office out of concern, and have always told them, kindly and courteously, why I could not disclose any information to them. But when anyone calls wanting to make an appointment for someone, I make the appointment. There's no confidentiality violation there. And if I'm ever in doubt, I let them know -- again, kindly and courteously. And nine times out of ten people respond well to what I tell them.

So their reaction was more than a little overboard. The escalation took me by surprise; however, they did arrange to see me that afternoon, through, I believe, their attorney.

Naturally I was upset and nervous about going there at all, but I did want my appointment. The staff there wouldn't speak to me, and then the doctor told me that because of that day's events, they could no longer keep me as a patient.

I had rather awful flashbacks to when I lost my job over a year ago -- the doctor's manner was exactly the same as the CEO back then: fakey-nice, falsely cheerful, patronizing, and insinuating that everything was my fault and I had inconvenienced the whole office and they simply couldn't keep someone who was as thoughtless and selfish as I was to throw off the whole schedule for the day. He also denied the five-minute window of lateness, and said I could have been ten or fifteen minutes late and it would have been fine, and they would have seen me if I had come in; he had nothing to say except to continue denying the five-minute rule when I informed him that that rule was given to me by his staff since my initial visit as a new patient, in addition to its reiteration by them that afternoon when I had first called. I became rather highly upset. I tried to tell him the problems I'd been having with my health, and his answer was immediately to prescribe an intensive medication used to treat bipolar disorder, to deal with what he called "an extreme episode" -- never mind that my state at the time was a direct result of the situation with his office.

I've always done my best to be an intelligent patient. I know my body and my state of mind better than anyone else, so I had a lot of things I wanted to tell him -- that my agitation seems chemical in nature, that I believe I've been having a bad reaction to my meds, that the dreams correlate with the start of my taking said meds, that I further believe my stomach problems stem from the allergy medication he prescribed, which contains a decongestant which I don't need, since I'm not congested. But he wasn't interested in listening (which of course upset me further; he wanted to treat all of my symptoms as psychological backwash when I believe they're not completely interrelated); he just wanted to get me out of there. He seemed worried enough about my emotional state, made an appointment for me for today, and asked if I were going to do "anything stupid" that night. I curtly assured him I wouldn't.

I never respond well to injustice. I firmly believe that if my boss hadn't had "attorney" in front of his name, their reaction would have been more polite. And any doctor's office that responds that badly to an attorney isn't one I want to have treating me. It raises my suspicions regarding whether they've had problems in the past.

So, although the doctor said he wouldn't "let me go" until "we've gotten through this," I canceled my appointments for today and Monday (pleasantly, I might add. They'll never be justified in saying that I was rude). I don't want to see him again. And I'd rather be the one to make the call to leave, and not wait for them to say, "Okay, you seem better now, so..." No thanks. I don't trust his medical judgments at this point; I was being treated as a problem, not a patient, and I will not be taking that bipolar medication, when all I needed was a simple med switch, and when I've been wondering if it's time to stop taking antidepressants at all, if my reaction to the meds which helped me when I first started taking them is my body telling me, no more; you're all right now. Depression has been situational for me historically anyway; I was on antidepressants temporarily in college, and then, through the course of therapy, taken off them altogether, and didn't have to start taking them again until things began going downhill at the Center. But these are things the doctor didn't seem willing to discuss.

Furthermore, he seemed on board with the way his staff had handled the situation, and I won't be treated by a facility that sees fit to be so incredibly discourteous to someone who cares about my wellbeing, even if they aren't sure they can talk to him.

Altogether, the events of yesterday were insane. But at least life is never boring. I figure that something like this would have come up eventually, and on the whole, I'd prefer to find out now rather than later. I haven't been impressed lately with the doctor's treatment anyway. So it seems Providence took a step in and gave me a nudge.

The general physician I've seen before at the University of Michigan has scheduled me for an appointment on Monday, and I look forward to seeing him. He's top of the line, pleasant, courteous, competent, and enjoys my input.

Oh yes; and my boss is the one who e-mailed him to ask if he could see me soon. Rather than freak out over bogus HIPPA violations, he had his staff call me to get me in. Nice, eh?

And I'm feeling, though tired and worn out from yesterday, in a decent frame of mind today. Bless my parents, and my bosses. They've been extremely supportive.

So there you have it, folks. The continuation of my strange little life.

4 comments:

none said...

Oh. my. goodness. This makes me ashamed of the medical profession. I would have been in tears by the end of that appointment if I were you. I hope this other doctor turns our to be great. And you are wise not to take that new Rx since the Dr. clearly was not listening to you and simply trying to patronize and medicate you away. That is really just appalling.

The Prufroquette said...

Oh, I'm so glad this didn't offend you. I worried about that.

I take great comfort in knowing that I have a friend who will be a fabulous doctor, regardless of the patient or the situation. You're my shining beacon of hope for the medical profession!

And thanks for backing up my instincts -- I feel strongly that a bipolar medication would make me borderline catatonic, or emotionally flatline, or really really loopy at the very least, and that's not the sort of help I need.

la persona said...

yeah, doctors and lawyers do not a merry match make :(.

sorry about your situation, sarah. it sounds rough. i would encourage you not to blame any one individual though so much as an incomprehensible and unfortunate health care system. trust me, my mother is a psychiatrist, and despite our long-standing issues, she is a good one. get sued once or twice though by patients you're trying your best to help, and trust is eroded across the board. it's not fair, but i think a call from an attorney would sound alarm bells anywhere.

the way you were treated was just wrong though. i hope you have better luck at your next appt. sounds like the next guy has less legal baggage to project.

Mair said...

you should find a practice with a mid-level practitioner: a PA or NP. They are usually much better at patient care.

The Year of More and Less

Life continues apace. I like being in my late thirties. I have my shit roughly together. I'm more secure and confident in who I am....