I actually have little trust for any MD. My preference is my PA, she cares, and its very apparent. While I've never been in a mental facility, the hospital where I used to receive outpatient psychological therapy made me feel as though you were just a customer. It was a sterile environment, unlike the small holistic treatment based office I have been a client for almost a year. Here you matter, or you are made to feel you are important. What annoys me the most, the hospital charged my insurance $211/hour, while my therapists office gets reimbursed less than $100/hour.
I do agree that the healthcare industry is just that, an industry. I remember hearing how its all about making more money, and keeping people sick. Should be referred to as the "sickcare industry." There are however many dedicated professionals, and there are also those who work in healthcare that are miserable and they should seek a new career.
Today I was informed that I've exhausted my allowed therapists visits and owe a little over $1000.00. Now granted its not alot of money, but what aggravated me was the woman I spoke with said, just ask your therapist for a sliding scale charge. WTF, how do you ask to be charged less, when the therapist who is not a PHD, has helped me more than the PHD who when I would speak to seemed like I was asking her to buy some aluminum siding, and the hospital was chargeig twice the amount, and getting reimbursed alot more. The really annoying part was that had I been diagnosed with Bi-Polar disorder, I could have received 60 visits/year, instead of 20. All I could think about was the scene from the movie 17 Again, when the sales supervisor states, "I've been in the phamaceutical business going on 2 years, blah, blah, blah, and then promotes to regional manager an attractive girl who has been there for 2-months." That is the aggravating part. You have insurance company's making health decisions who have with no real understanding of the therapy process. They will pay for a lifetime of anti-anxiety drugs that will have some negative impact somewhere further down the track that will require more drugs, and the other symptoms will occur, needing more drugs. Who in the end benefits, its surely not the patients.
Hey there
Yeah I have had some great PA's too. Sometimes the nurses and physician assistants are better than the docs and they spend more time with you.
What you said here:
You have insurance company's making health decisions who have with no real understanding of the therapy process. They will pay for a lifetime of anti-anxiety drugs that will have some negative impact somewhere further down the track that will require more drugs, and the other symptoms will occur, needing more drugs. Who in the end benefits, its surely not the patients.
This is so on the mark. The big question we should always ask is who benefits from this? Whether it is how the insurance companies seem to favor drug treatment over talk therapy or how some patient bloggers demand pharma to take them on resort vacations to have a "conversation"...you want to ask...
Who benefits from this?
With any aspect of health care and related industries...you follow the money trail.
The sad reality is that patients are usually low on the list of priorities.
Great comment...thanks so much for participating in our discussion.
WTF is right...What is a sliding scale charge? I hate insurance companies. They are a multi-billion dollar business. They are your best friends when you are signing up but...when you need them...they try their best not to pay. My therapist has to jump thru hoop after hoop to get my visits approved 10 visits max. Then she has to do it all again.
I just has to try a generic wellbutrin (which I had a terrible allergic reaction to) before I was approved for Lexapro. My Dr said that we had to do this first, before the insurance company would cover the lexapro. The medication my doctor really wanted me to take. The insurance companies control what type of care we get. I just hate insurance companies.
It is terrible, the pain and suffering patients have to go thru because of the medical industry/insurance companies.
Good luck to you. :)
I understand a sliding scale as, a therapist will charge you a rate that is acceptable to the patient/client based on one's ability to pay. You will find, or from my experince therapists who don't accept insurances tend to cost less for their services because they don't have to wait for reimbursements, which are alot lower than what they are charging.
I was reading one of your posts saying that their is no cure for panic disorders. You are correct because we ourselves cause the attack based on our negative thinking. There is no way to get over something that has no medical cause. You can't take a medical test that says, "oh yes, its anxiety." Its a complex situation that with practice/therapy it can be alleviated.
MM, whenever I hear stories like this, it makes me want to go postal! I don't trust drug companies and, while I haven't had a lot of problems with insurance, I don't much trust them, either. I think the whole health care system in this country started going to hell with the invention of HMOs. The purpose was to save money but what they really did was add another layer of "management" into the picture, which means another layer of people to pay. Where I live, most of the ones I hear about are making big profits - why??? I have a friend who works for a huge insurer and can't believe the money they spend on stuff for their own employees and programs and the benefits they get. While we're here begging for a few extra therapy hours, they're at seminars in resort cities living it up.
My son goes to a county-run mental health clinic, which I'm hoping to get him out of now that he has insurance through his work and will have more options. They turn over psychiatrists there about every six months and you don't find out about it until you come for your next appointment. They're so jammed that they give you 15 minutes and now want you to only come every 4 to 6 months. How the heck can they know anything about a person in that period of time? Several years ago, my son was seeing a therapist there who obviously didn't know how to work with him, probably because he is developmentally disabled and autistic. She had him come once a month for half an hour! When she retired, she didn't recommend anyone else because she didn't think he was getting anything out of it! Huh??? Luckily, we did find someone for him who works mostly with people like my son and knows how to reach him. You wonder sometimes why these people go into this field of work if they don't give a damn.
Yes, there are some very good mental health professionals out there but it might take some work to find them. I've learned to trust my gut and not put up with stuff the way I used to because none of them are God and they aren't being paid to CARE - if you find one that does, you are very lucky.
I have always felt a desire to work with children or adults with autism. But I don't have any training. Are there ways I could help? I could give to a charity for the treatment of autism, but I don't know what they are or which ones are legit. I'm very patient and very individual-oriented and could at least assist. Plus I'm sure there are community college courses or seminars somewhere...I live in a large metroplex.
Thank you for any suggestions.
Hi, Donna. I know there's a National Autism Society but there are probably places (non-profits) in your state, as in mine, that are called Day Training and Habilitation (DT&H), Supported Employment (SES), and Adult Day Services (ADS); here, they are licensed by the Dept. of Human Services. They often serve people with autism, along with people who have a number of other disabilities. My son got his full-time job through one of these companies and the people there aren't working there to make a big salary, believe me. Anyway, they're always looking for volunteers to spend time with the clients or to help on committees. Maybe there's something like that in your state. You are a very giving person, Donna - I'm sure you'd be greatly appreciated. Thank you so much.
You are preaching to the choir Miss Judy!
Which part of your comment to respond to first?
We finally switched doctors for my son. More so we switched clinics. The other hospital would not get back to us on the phone...actually there was no way to speak to a live person on the phone. We were lucky to get an appointment in 4-6 months. There was absolutely no support and I felt like my son was a widget on an assembly line of a prescription mill. I am fairly happy with my son's new neurologist and hey...a live person answers the phone there...I am thrilled. Funny how it takes so little to thrill me these days with health care...our expectations are so low.
Genuine care...is hard to find nowadays but not impossible. There are people who are ethical, caring, compassionate, and want to do the right thing. The two things which get in the way of this are greed and ego. Which is why I sometimes crack up over the words we use such as Health Care, the Helping Profession, and Patient Advocate. In some cases the words are a thin disguise for a host of unethical behaviors all wrapped up in a shiny bow.
Resort vacations are great. It is interesting how some people manage to go on so many of these types of seminar vacations. Meanwhile...back at the ranch...us lowly patients are struggling to pay for our medical expenses and our time is taken up with mundane tasks such as pleading with insurance companies or trying to get an appointment in the first place.
It is an interesting world...and it keeps getting more interesting.
Thank you as always for your insightful comments.
Hey Donna
I just want to say that I think you would be great at working with children or adults who have autism. You are very compassionate and caring and you have an innate understanding of people's differences. There is a shortage of people to work with people having disabilities and especially autism. It is sometimes stressful work but it is so meaningful and you would be making such a difference in someone's life and also for the family of that individual.
Just when I am ready to give up on humanity...you come along and make me have hope that there are kind and decent people out there.
Let us know what happens. As Judy mentioned...the autism society would be a good place to start to check things out.
I just went to a new counselor last night. My depression and anxiety have worsened in the past months because I wasn't getting enough help.. I looked forward to the visit, maybe too much. I'm in a place to where I'm close to giving up. My first therapist I could totally trust, she really listened and gave advice .. I learned so much and was able to see her once a week. That was back in 1995-98 and it was in a little office.. Last night I went to a clinic. The counselor suggested to me to get into this program called PROS. It's not what I wanted to hear. I just needed someone to listen. I gave her a paper for VESID. I'm thinking, if I get back to work it will help me from dwelling on my depression. Maybe getting a part-time job is what I need.. She said she didn't think I was ready for work and said about the PROS program - which is Mon-Fri.,., This seemed more overwhelming then part-time work.. I told her I'd think about it.. I won't get to see her for 2 weeks, which to me is like way too long!! I got mixed vibes when I was there. I know talking with someone will help. Maybe I waited too long because I need help now. My unemployment will run out June or July. I had asked her about Depaul, which I was enrolled in in 2002. I don't remember what her answer was but it wasn't what I needed. I also asked her about a Case Manager. She said they only help the SEVERELY mentally ill because of budget cuts!!! This is why I'm ready to give up.. Everywhere I turn I get no help. My chest is hurting, it feels tight thinking about this.. I know if I have help I will feel so much better and be a better mother. My focus will be on the more important things= my kids,, instead of my depression.
Hey there
I am so sorry to hear this. What exactly is the PRO program? Is it like group therapy? Why did this person think you were not ready for work? I hear you on case managers...my son hasn't had one in months. One used to keep contact once a month...then it turned to once every three months and now...I am not sure we have one anymore. The state of affairs for people with mental illness or disabilities is dismal. It is extremely worrisome.
Please don't give up though. We all have to keep on the best way we can. Any time you want to vent...we are here to listen.
Thank you Merely Me for responding. PROS is Personalized Recovery Oriented program. I wish it was more personal,.,. meaning that I don't like the fact that I would be with other people. The counselor said I would be in a group, different groups. I need one on one counseling right now until I'm more confident. I believe the counselor said I wasn't ready for work because I told her I don't like being around people right now.. When I go to the grocery store I hate everybody,,sometimes. I like to be out, but just don't like crowded places. I went to the library just now and it was busy, but it didn't bother me that much. I'm worried that I'm going to lose my unemployment benefits. I told the counselor this. I'm barely getting buy now. The bills get paid enough so nothing is shut off for the month.. I don't know what to do.
I was reading your post about not wanting to be around people in group. A short-story of me to share to you. I felt that way about getting in a group in 1991 when I was 24. My then girlfriend, now wife, went and checked it out, as I was experiencing agoraphobia and anxiety with some depression, she told me how the people seemed consumed by their situations, and it appeard some liked the oddness or whatever she called it. That was all I needed to hear. It was no way I was going to ever attend group with a batch of whining people. Twenty years later I joined a transgender group at the office where I am being treated by my therapist for what she describes as the worst case of anxiety and diminished self-esteem that she has ever seen, add the crossdressing too. Just great, I get the award for being the worst. She didn't suggest the group, but the crossdressing issue became apparent three years ago. The first night I hated it, I didn't want to go back. All it was for me was a group of T-girls making fun of me saying I wasn't honest with myself. They were graphic about their sexuality and really were in my face most of the night. I remember blurting out, that I looked better than all of them. That week in therapy I began to cry uncontrollably with my therapist saying I wasn't like them. I decided I wasn't going back, as I hated them, especially this one girl who kept bashing me. I continued and you know, its helped me understand who I'm not. I'm not like those others, I'm just me and, I still dress better and my make-up looks great when compared to them. I grew up in the 1980's and played in a hair band, so of course I'm great at make-up applications.
My other group is a 12-week codependency group. There are 14 participants, all professionals, and all have some type of issue. I remeber the first night thinking, they're mostly woman ages 22-54, and on the outside they seem to have the perfect lives, as their aura makes them seem everything is just great. Many have had affairs, alcoholism, gambling addiction, female same-sex attraction, anxiety, depression, bi-polarism, have been incarcerated, drug addiction. We all, including myself have spent our lives being codependent on others. While we all come from different lives, we all share a commonality. Its been a therapeutic experience for me, and one that has allowed me to begin to accept who I am. It an odd thing when you don't know who you really are.
Give it a try, your life is waiting for you become engaged with again. Think of it this way, "you can't go back, because somewhere back there is how you got yourself to where you are right now." Take baby steps and you'll begin to become engaged again. Joel Osteen always has a great inpirational saying, It's something like, "Give your worries to God, he's gonna take you places you've never dreamed of."
Group is tough, as the participants hold nothing back. Last night we were on the verge of a knockdown, second week in a row because we all have overcome the fear of fear. Its a great experience.
Thank you Rick for taking the time to help me.. I am considering going even though there are some things stopping me. I was in a group of 5 back in 95 - 97. The first thing we discussed was boundaries. We all added what we needed. I think it took a month or more.. This is one very important issue that is stopping me from going. I imagine the worse case scenario if I was to go - a huge room full of people that have no respect for themselves let alone others - and that they are only going because of a court order not because they want to improve themselves... Another problem is transportation. I have no car!!. I don't like depending on others. This group meets Mon-Fri, for how long I'm not sure. The thought of being so far from home without my own car to jump into if I need scares me. I like to be able to leave when needed..- especially if my 7yr needs me.. If I'd have my own car I know I would be in alot better place mentally you know the feeling of some control. I did have my own car, but lost it when I lost my job and was really depressed.. It's funny, but not really, that I have 7 brothers 4 sisters that know I need a car and know how I am mentally and they don't help. I guess this is what has added to my depression big time - knowing I have a big family and that family is suppose to be there for you but mine is not,,,not at all.. I know too, that alot of us here have that in common.. Well I've gone on enough. I hope I haven't confused you. I think I really need to build my confidence the most. I have to figure out ways to do this without depending on therapy.. Thank you again for taking the time to help,,,I do appreciate it..
I trust my psychiatrist totally! She does not even charge me a copayment for her services, which would run into hundreds of dollars. She has been there for me since she diagnosed me with bipolar, depression, and anxiety. I don't know what I have done to deserve her kindness, careing, and intellect, but it's a blessing. Through all that I have been through this woman has been there for me.
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Which doctors do you tend to trust? Which types of hospitals or mental health facilities do you avoid? Which ones make you feel at ease? What about the health information and support you find on-line? Which health sites do you trust? What personal guidelines do you have for trusting an on-line health blogger? What elements make a person or a system trustworthy in your opinion?
I don't think I actually trust any of them. I mean, yes, you have to trust that they have a medical degree and have some expertise in their chosen field. But trust them enough to let them know what I'm really thinking? No. Trust them enough to tell them why some procedures scare the sh*t out of me? No. Trust them enough to say I am only taking 1/2 of the prescribed dose? No. Why? I don't think they listen. They don't even seem to bother to read the chart most of the time.
I know some mental hospitals to avoid because I have been an unhappy patient there -- unhappy with the standard of care and the fact that roles are imposed arbitrarily. I was also severely overmedicated at one such hospital to the point where I could not walk or eat. I was not given access to informational DVD's about ECT once I had had the procedure (and I couldn't remember what they had showed me BEFORE the procedure because it destroyed part of my memory.) All seemed a bit underhanded at the time. I was also put in a psych-ICU twice where the patients ran amok, crushed their pills and smoked them, stole my clothes and wore them, where the bathrooms went uncleaned for days, etc. It was horrible. Of course, there were a couple of acceptable places that I would return to, if need be. They had caring, compassionate staff. The food was good. They kept the noise down at night so I could sleep. I could smoke whenever I wanted as long as we weren't having therapy sessions. And they were kept clean. They also did a complete physical each time I was admitted to rule out any physical causes of my confusion and depression.
I don't much trust drug company online info. I think their "studies" probably skew the information to their benefit. You can make statistics say just about anything. As far as other online sites, I steer away from anything that smacks of sales-talk, whether it is hawking alternative cures or a book someone has obvoiusly written for profit. (I know some out there write books in order to inform more than for profit.) But funny thing, I often feel I get more and better information online than I do from my doctors simply because they do not take the time.
Thanks for responding Donna...
I have this feeling that your thoughts and experiences mirror many other people. A lot of people are turning to the Internet because of the reason you mention...many doctors are not taking the time to talk to their patients.
We just changed my son's neurologist and this new guy spent well over an hour talking to us! I was astounded. That...has never happened before. So many doctors nowadays seem to be human prescription mills. And it is all the more scary because they don't know the patient very well.
I am sorry you had such bad experiences in some of the hospitals. I have seen some very sad and distressing things in my time within the confines of mental health facilities.
Not sure what the answer is. But maybe a frank discussion can help people be more aware of both the good and the bad in our health care system.