Friday, January 27, 2012

We Fired the Pediatrician

A lot has happened since Danielle's most recent explosions at home and at school,  A lot of it, I'm not going to share publicly, because it's complicated and messy, and for the entire story to make sense, we'd have to share a lot of personally identifying information, which I am not prepared to do at this point.  What I will say is that it has involved talking to a lot of people, including school staff, therapists, law enforcement, the crisis hotline, Danielle's pediatrician and even an attorney.

They all say the same thing.  They all give us a list of what we (and they) can't do.  The list is very long and complicated, but if we break it down into its most basic components, it boils down to two things:
  1. We can't get Danielle the help that she needs.
  2. We can't give custody to someone else -- not to the county, not to another foster home, not even to another adoptive home.  We are stuck.
Everybody agrees that this situation is intolerable and unsafe.  They agree that nobody should have to live this way.  They agree that this isn't good for any of us.  Danielle's explosions are violent and dangerous; her behavior is completely unacceptable.

Yet, they all come back with pretty much the same answer:  There isn't much we can do.

Sure, some of the people we've talked to have agreed to help, but the help they can provide is very, very limited.  Danielle recently qualified for one-on-one therapy that will be provided, at school, by a licensed therapist.  That's great, but it's only for a single hour per week.

I feel like we are trying to sop up the ocean with a single sheet of paper towel.

Several of the mental health professionals we've talked with have been surprised by Danielle's relative lack of medication.  All have recommended that her doctor re-examine her pharmacological interventions.  We sent the pediatrician a formal request for a referral to a psychiatrist, and she responded by screaming at us.

Yes.  She called us up and screamed at us.

Even though we were warned by our current family therapist that firing our pediatrician would result in her counseling services being terminated, this was the last straw.  This was not the first time, or even the second time, that this doctor had unleashed a heap of verbal abuse upon us.  Once, she even screamed at us for taking Danielle to the ER when we thought she might have broken her foot.  Why was she so angry?  Apparently, we were supposed to obtain pre-authorization for an ER visit, which we hadn't done.  We weren't aware of this requirement, but the doctor felt it necessary to yell so loudly that hospital staff looked on with sympathy and rolled their eyes.

I hope the next pediatrician will be more helpful.  If not, perhaps I can at least hope that she won't scream at us for trying to get our kid the medical treatment she needs.

As for our current therapist, I hope that our change in pediatricians won't create an unfortunate cascade of events.  At this point, though, it's clear we need to try a different approach.  Our fired pediatrician had a reputation for being difficult, obstinate and disagreeable, but we were told she was a competent professional.  Our experience proved otherwise.  Her tendency to scream at us, combined with the fact that she would forget important details between visits and deny we'd ever discussed them, finally made us pull the plug.

Here's to hoping that the next doctor will be more willing to listen, and to help.

10 comments:

  1. I found out a few years ago that the medical group that the state insurance in our area pays for has a policy that encourages primary caregivers not to make referrals. The medical group has a certain allowance for referrals. At the end of the fiscal year, if there is anything left in the allowance, it is split up between the primaries in the group. The docs get a bonus for not referring kids to specialists. Under no circumstances is a kid to ever be referred to a specialist outside of the group. One of our kids broke his wrist. I took him in to the primary who ordered x rays, then made us come back and wait nearly an hour to be sent to the ortho group in the big city at rush hour on a Friday afternoon. (an hour or so drive) I called an orthopedist that we had used before in the same building and he was happy to see us, set the wrist and send us on our way within 30 minutes of us walking in without an appointment. On Saturday morning I got a call from the primary doc, wanting to know why we hadn't showed up downtown. He had a fit when I told him, screaming at me that I had probably done permanent damage to the boy by not using the orthopedist within the group. (he healed up just fine though) The guy was truly livid. I couldn't understand why he was so upset until I found out about the annual bonus. Apparently the docs set a goal and try to meet it.

    I'm not saying that it's the same issue, just thought it was an interesting parallel.

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  2. File a complaint against the pediatrician for unprofessional behavior. No one deserves to be screamed at for trying to get help for a seriously disturbed child.

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  3. I think a family doctor would be more helpful. Pediatricians, to me, aren't exactly accustomed to dealing with teenagers and their unique issues.

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  4. What do you have to lose by going totally public with this? If a reputable journalist wanted to do a profile of you to show how badly the system in your state, or even nationally, works?
    ina, not anon.

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  5. I won't be commenting here anymore since I've been censored.

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    1. Huh? I am not aware I haven't published any of your comments. I have, however rejected a ton of anonymous ones, which I pretty much do universally, unless they have something interesting to say.

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  6. I hear you about the censorship on this site. It is pretty strict!
    Po (not anonymous)

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  7. No, it wasn't anonymous, I always post under Boysmom. Anyway, it was about my opinion that you should have fired the ped the first time he yelled at you since you are a consumer of his services.

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    1. That comment was NOT deliberately rejected. I have been doing some blogging and moderating from my cell phone, with sometimes unpredictable results. It may have gotten zapped, because I don't recall deleting any comments from you.

      I agree, we probably should have fired the pediatrician long ago, so if you want to repost your comment, please do.

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  8. You're such a meanie head, for moderating on your own site. What with the way people leave you alone, don't go after your readers...

    Oh.

    Wait.

    *eye roll*

    I hope you're able to find a doctor that will work for you and Danielle. I hate looking for a new pediatrician.

    - Not Kristin

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