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Reply to "My therapist dumped me"
As a physician with ADD myself who also specializes in treating ADD/ADHD, I can see both sides. Certainly, I empathize with all of the issues you had to navigate just to get to the doctor's office in the first place, as the same type of things often happen to me. On the other hand, physicians often keep very busy schedules with little to no room for any deviations. Pressure is on us to be efficient, which may include having some patients re-schedule if they are late. Most of that pressure, in my opinion, comes from the feeling that docs have to see so many patients per day just to make enough to keep the doors open, because insurance reimbursements have declined significantly over the years. (Contrary to what many people think, most physicians, especially those in primary care, are not making huge salaries! But the CEO's of insurance companies sometimes make millions! I have suspicions that, even with the so-called healthcare reform, there will be even more hoops to jump through and documentation to do in order to get paid by insurance companies for patient claims in the near future. All of this has eroded the physician-patient relationships more than people realize.) Anyway--perhaps your doctor also had pressure from office staff, who urged him to set limits and turn away patients who tend to be late so as to keep on schedule. I don't know, but trust me, many docs are feeling pressured, especially if they have their own practices and are business owners, and are having a harder time enjoying the practice of medicine nowadays. Maybe your doctor was having a particularly bad day, and yelled at you out of frustration. I always try to give my ADD/ADHD patients the benefit of the doubt if they are late, but truthfully, sometimes strong boundaries and limits can actually help us ADDers to stay on track better. It is a shame, though, that your doctor "dumped" you. It would have been very nice, I think, if you could have had a good conversation about how frustrating it is to have to navigate all the many obstacles and time constraints, take care of details, etc. just to keep going each day. As for your having to go to 2 different docs to get your ADD treated, that's tough, too. But that happens a lot. If doctors don't feel comfortable dealing with ADD/ADHD, it's easier to just refer those patients to others who take an interest in it.
I used to have a primary care practice where I saw teens & young adults, but I had to close it due to poor insurance reimbursements that adversely affected our cash flow tot he point that we could not keep up with overhead expenses, even thought I (the owner) often worked without a salary just to keep bills paid. I now have a smaller practice where I focus only on treating ADD, ADHD, and other mental health-type problems, and I no longer file insurance (which has eliminated many of my headaches!). That gives me the luxury of spending more time per patient, but it also keeps some patients from seeing me because I do not accept insurance. Some of my former patients still see me, and pay out-of-pocket, for me to handle their medications for ADD/ADHD, even though it has been frustrating for them to go elsewhere for primary care. That's certainly not what I want for them, but the reality is that there is no way I can still do all the primary care stuff I once did and take the time I need to do a good job on their medication adjustments.. Some of the other doctors in the community understand that I really like working with ADD/ADHD, and they refer patients to me for this only. There is no easy way to deal with this problem, but personally, I think more people would be far healthier if their healthcare providers could spend adequate time with them and not feel rushed. Our current payer system, with the insurance companies deciding IF and how much a doctor can be paid for our work (despite the time we put in) is just not working to benefit patients' overall health anymore--and people are getting sicker as a result of this and many other things. Have you thought about writing a letter to your former doc and telling your feelings? That may help him to see things from a different perspective. (Although I have ADD myself, and understand my patients better than someone who may not have ADD, I still learn from them. They teach me many things about how they view the world!) Writing such a letter may help to ease any tension between you, if it is there, and you could not only educate him, but get it off your chest as well.
Hope these rambling thoughts help! I wish you the best.
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7 Jul 2010 @ 4:49 PM
9 Jul 2010 @ 12:57 AM