How To Talk To Your Doctor So You Don’t End Up Dead: A Comedy of Medical Errors. A friend, who I will call Sylvia, needed a medical letter from her psychiatrist to release the pension she has paid into at work for 20 years. He had already filled out her long-term disability forms so she didn’t think the pension form would present a problem; she simply mailed it to him. When the form wasn’t sent in, Sylvia made an appointment with her doctor.
Sylvia: Would you please fill out my pension form.
Doctor: I don’t know your case well enough to fill out this form.
Sylvia: How does this form differ from the long-term disability form you filled out?
Doctor: The pension form has different criteria so I can’t fill it out.
Sylvia: What criteria?
Doctor: They want to know your treatment plan and since you are not willing to take antidepressants and not willing to do a neuropsychiatric evaluation, I’m not obligated to do this paperwork.
Sylvia: But I explained that my health insurance was cut off temporarily so I can’t afford the neuropsychiatric evaluation right now but I will do it as soon as possible. And I’ve never been unwilling to take antidepressants but I thought we both agreed that they wouldn’t be necessary for a traumatic brain injury (TBI).
Doctor: Well, it still boils down to your unwillingness to take antidepressants.
The doctor must have told Sylvia 3-4 times in various ways about her failure to comply with treatment. Then, in her brain-traumatized state and through her tears, she realized he was trying to prompt her to “play the game.” Finally she got the message and said:
Sylvia: May I have a prescription for an antidepressant?
Doctor: Certainly, here it is.
Sylvia said the prescription appeared in her hand so quickly he must have already filled it out. The next day, the doctor mailed her pension form to her company leaving Sylvia numb but happy.
Sylvia was still stunned when I debriefed her. The “game” I told her consists of the doctor having to fulfill bureaucratic requirements and comply with the standard practice of medicine. He couldn’t tell her directly that he had to give her a prescription to fulfill the requirements in case she was ever questioned.
The standard treatment for her condition is antidepressants so, if Sylvia was not on medication, her pension would be denied and his practice could come under scrutiny. It’s becoming more evident that every word on bureaucratic medical forms finds its way into a computer program and Data Collection can pinpoint statistics of who’s on what drug and who prescribed it.
Here is some advice for patients like Sylvia. Most doctors hate filling out forms and writing letters, so, if you have forms for your doctor – ask if you can print in the basic information and just have him/her sign it to save time. You can even offer to write letters for them to edit and sign. When forms are involved, read them carefully. If they are asking about medication, then be aware that you may have to accept a prescription from your doctor.
Then, be sure and fill the prescription because that will be registered in the Cloud! It is up to you whether or not you swallow the pills. When they put GPS chips in the pills, then we will talk about what small animals you will befriend to take some of your pills so they will appear to have been ingested. Oh, sorry, we can’t do that – you could be charged with cruelty to animals!
Sylvia’s story underscores the hi-tech apparatchik (what my husband calls the “Android Meme”) that has overtaken medicine. Drugs and the machines that dispense the drugs are in charge. The medical system is now geared to accumulate statistics, nothing else. Seven-minute appointments ending in a traceable prescription that can be tallied at the end of the day. If people end up getting better in this scenario – that’s not even registered. After all, they don’t really expect people to be cured.
Carolyn Dean MD ND
The Doctor of the Future™
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