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Between pdocs....

Posted by Noa on January 16, 2002, at 19:23:10

....or "how I fired mine after all these years":

My pdoc is knowlegable. Up to date. Helped me a lot. Was agressive in treating my hard-to-treat depression. Believed me about side effects. Answered my questions, wasn't threatened by my learning stuff from the internet.

I started working with him over 8 years ago. In a run down outbuilding of a once-prestigious psych hospital that had seen better days. He was a bit disheveled and disorganized and wasn't good at keeping to the scheduled times, would run over with the patient before. I'd wait on the musty plaid furniture, sometimes in the company of a patient muttering to him or herself in the old stuffed chair. It bothered me to wait, but I felt I could tolerate it because he was helping me a lot.

His disheveled-ness made him human, he was more disorganized than me. Kind of comforting in a way. He was a computer nerd. He kept his records and notes on his laptop, and once he got past the usual fumbling with wires that somehow weren't connected properly, he'd slump into his bent wood rocking chair and hunker over his lap top to see where we were from the last time. He was pretty friendly back then, in his socially inept kind of way. But first, the hunkering over the computer notes, and only a kind of grunt of a hello. Slowly, he'd be able to focus more on me and the room and some eye contact. And he'd explain things well. And conveyed respect for my intelligence. So the lateness and the waterfall of paperfiles cascading from the mountain on his desk over onto the floor, where the flow mingled with the wires and crumpled brown lunch bags and assorted random objects didn't bother me much.

Back then, he returned phone calls.


Then, he joined a practice. This was going to be better. Secretaries and such, calendars, people to file the waterfall for him. But it wasn't better. It was worse in a big way. He ran behind all day. Getting in touch with him became very difficult. Still, the cascading files and the hunkering and grunting, although still the eventual recognition of another human in the room and some smiling and eye contact and meaninful connection about what really mattered--my depression and my treatment and the exchange of information and the strategizing and working together.

But somehow the secretaries and filers made it much worse. Gatekeepers keeping me from direct contact not out of their gatekeeping duty, but out of ineptitute, mostly. And the overpacking of the waiting room to meet the managed care demands. And schedulers who scheduled me on days when the doctor was actually on vacation, who would call the day before the appointment to cancel and then not be able to offer another appointment for a month. Or two months. I'd tell the pdoc. He'd be sympathetic. Blame it on the owners of the practice. As if he weren't one of them, although I imagine he was a lesser partner. He'd tell me to page him directly, he'd schedule an appointment early in the morning before his first appointment, or another time not on the calendar. This worked for a while. I endured the waiting, mostly. But not always. Sometimes I'd witness other patients storming out of the practice office, furious at how long they had been waiting. For him, for one of the other doctors. I learned to manage the doctor by asking for the first appointment of the day. Can't be behind on that. I'd arrive at five to eight. No doctor. Another patient in the waiting area--someone he had scheduled himself, off calendar, before the day's appointments officially began. No doctor. He hurries in, hassled and messy at 8:17. Two of us waiting.

I thought about changing. Talked to other doctors. They don't take insurance. Of any kind. I am broke. Besides, my pdoc knows the ins and outs and ups and downs of my history. He does have his strong points.

It gets harder and harder to reach him by phone. Or refill a prescription. I am furious sometimes.

Then, he breaks away to start his own practice. He is tired of the chaos of the mill. I am optimistic. In some ways, things improve for a while. In some ways. He is looking more with it, even seems ironed and tucked and combed.

TO be continued, as they are kicking me out of the library...closing time.


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poster:Noa thread:16861
URL: http://www.dr-bob.org/babble/social/20020112/msgs/16861.html