19th Septmember 2012 (With comments edited in at a later date)
By Friday I was agitated. I usually take two tablets a day, and now I only had a two left and was biting them in half, making do with quarter of my usual medication. I got a little letter in the mail, saw it was from Dr Hanne's office, didn't open it, took it straight to the chemist with a sense of relief. Relief vanished quickly once I opened it.
The bill was for $103. Weird, my doc apt cost $35 with a community services card, so I couldn't fathom where this additional charge came from. I was devastated. Being Friday, it meant I'd have to go without medication for at least another two or three days, and I felt bananas as it was. To suddenly withdraw from any medication isn't a good idea, and for a doctor's office to do so without any prior warning seemed incredibly unethical. It actually felt like I was being punished!
Of course, I rang and left a message telling them so. I ranted. I raved. I cried. Later I left another message specifically for the nurse explaining that I was feeling terrible and sorry for leaving such a full on message, but it was a shock to suddenly have medication ceased without warning. I did not swear, and everything I said I'd still stand by, but it seems that the receptionist took it personally and I don't think she's passed the messages on.
On Monday I rang. Then I emailed, apologised that my phone calls were so emotional, said I could pay off some of my bill, but please, please send my prescription. On Tuesday I emailed again. No response at all.
Receptionist:
Today (Wednesday) I finally got a call from the receptionist and boy was it a doozy. She was one angry and embittered woman. She started her cold and clipped tirade with a level of contempt and condescension that must have taken many years to perfect. I was trying to get ready to go to my teaching and didn't want to be late, but my stomach was churning even before I picked up the phone. She told me in a tone you'd reserve for criminal imbeciles that
"you don't know how the real world works, so let me give you a lesson Can-dis!"
I sort of laughed and said I didn't feel she needed to speak to me that way. It seemed incredible that she wasn't calling to apologise for my unnecessary distress and kindly explain what had happened.
"Hey," I said, " I'm sorry my phone messages were so full on, but it's real shock to the system to suddenly have my medication stopped without any warning. You do understand ADHD don't you?"
Her tone was scathing ...
Her tone was scathing ...
"Yes. I do. Your email was also very over the top. Very colourful. You need to LISTEN Can-dis. You need to listen. Are you going to listen Can-dis?"
"It's Can-deese, and yes, I'm listening ... " but I was thinking that this woman has no understanding or compassion at all. She seemed to be offended by my email, one not addressed to her. It was for Dr Hanne and the nurse to view, and there was nothing offensive about it. She repeated a number of times that I didn't know how the REAL WORLD worked, and in the meantime I felt a bout of diarrhea coming on. It was gettin' real.
I tried to interrupt to say I had to go (quite literally) but she wouldn't let me finish sentences. What she was dying to tell me was that they have 1000 patients at that doctor's surgery, that it costs MONEY to PAY the people who are EMPLOYED at that surgery. I think she was angry that I'm on a benefit. It seemed she thought I needed to know about people WORKING and being EMPLOYED. I only think that because she stressed these words so much. She had absolutely no concern for my state of mind. In a voice dripping with hate she informed me that it did cost $17 to send out my script each time I got my medication.
Oh. I didn't know that.
"How could you NOT know that? It's on the bill every time you get your prescription!"
Er, because it's never happened to me before? In my experience, I've never ever paid $17 a month in addition to the cost of the actual medication. I've been going to The People's Centre for more than 10 years and they only charge $16.50 for an actual doctor's appointment. Even when I was on anti-depressants about 8 years ago, I only ever paid for the cost of them and of the appointment every 3 to 6 months. I didn't get to explain any of this because whenever I tried to speak she would cut in with ...
"are you going to listen? You need to LISTEN Can-dis."
I thought $17 was the amount you paid for the prescription if you didn't have a community services card, and didn't think it was anything to do with me. Instead of agreeing that it had been a misunderstanding, she seemed further enraged.
She couldn't let it go. She wanted to go on and on about how I had to learn, that if I wanted to still go to those offices then I better start listening and learning. Problem was, I really had to attend to the rather urgent matter of my bowels, and I wanted to get to my teaching job in time. I tried to explain that I did have to go, but I felt black mailed. If I could LISTEN and LEARN from her (shut up and let yourself be bullied) then she MIGHT send out my prescription ... but ... my tummy ...
"Look, it sounds like it's really busy there for you, but I do have to go or I'll be late .."
And she interrupted AGAIN!
"Can-dis," she made my name sound vile, "Are you going to listen? Are you going to listen?!"
"Well I would, but I don't like the way you're speaking to me and I'm going to be .."
"Well if you're not going to listen you'd better think about whether you want to come to this practice! You need to learn about the REAL WORLD."
"Oh my god" I groaned, feeling so horrible as I sat down on the loo, phone in one hand.
Trying to listen to someone being so condescending was hard work.
Trying to listen to someone being so condescending was hard work.
"That's it" she said, and hung up.
Shaking, I attended to the urgent matter at hand. I realised I couldn't teach this morning, I was absolutely exhausted and felt like I'd been dealing with one of those nasty sort of teachers from high school. Mrs White or Mr Lisette from Takapuna Grammar in the 80's. They were those stoney eyed sorts, autocratic and compassion free. Probably had posters of Thatcher and wished they could continue to administer corporal punishment.
(Post Note: In the following blog entry you'll see that we did eventually come to an understanding. What I had failed to recognise was that she had felt bullied by my original message (left on the answerphone) and sincerely did feel the need to 'teach me' how to behave in a more appropriate manner. She also believes that suddenly coming off Ritalin would have absolutely no side effects "because it's not like an antidepressant". The leaflet inside warns that suddenly ceasing it can result in depression, and if you do even rudimentary research it's clear that coming off it suddenly is not advised. She told me that my reaction was just anxiety, not a result of ceasing meds. I do agree that my handling of the situation was not ideal. Probably because I was having a panic attack, and one that I think was pronounced by having my medication suddenly withdrawn!
(Post Note: In the following blog entry you'll see that we did eventually come to an understanding. What I had failed to recognise was that she had felt bullied by my original message (left on the answerphone) and sincerely did feel the need to 'teach me' how to behave in a more appropriate manner. She also believes that suddenly coming off Ritalin would have absolutely no side effects "because it's not like an antidepressant". The leaflet inside warns that suddenly ceasing it can result in depression, and if you do even rudimentary research it's clear that coming off it suddenly is not advised. She told me that my reaction was just anxiety, not a result of ceasing meds. I do agree that my handling of the situation was not ideal. Probably because I was having a panic attack, and one that I think was pronounced by having my medication suddenly withdrawn!
I found a forgotten tablet in a handbag yesterday, and I'm hoping I'll find more. This is not a good place to be in. Going off so suddenly is like being hit by a truck of exhaustion and high emotion. when I started taking Ritalin they upped my dose slowly, and then here I am coming off 40mg a day without any kind of graduation in the process.
Why on earth would they not send out advance warning? Surely it's not that hard. Something like "In case you did not realise, you do owe (whatever the amount it) for the cost of posting prescriptions which is $17 each time. This has now been unpaid for (whatever period of time) and we need to to pay a minimum of (amount) before we can send your next prescription. Please call or email to let us know how much you will be paying as soon as possible."
I'm not even a doctor or a receptionist, yet if I were working with ADHD people, I would send out a warning before cutting them off! It seems so logical.
So what to do?
I've made an appointment with The People's Centre and am hoping to the great gods that they will be able to get my prescription from now on. I may have to wait awhile before the People's Centre can get the Ritalin, if they can at all. From what I understand a doctor has to apply for special permission to prescribe it. It is strictly controlled to prevent abuse.
Post Note: I need to find out about other 'brands' of 'Ritalin', a friend advised that Ritalin is just the brand name and it's possible I can get my prescription filled somewhere else. In the meantime, I do feel like I've learned more about diplomacy from this experience.
The Health and Disability Commissioner (phone 373 1060)
- 1) Are doctors allowed to cease
medications because you are behind in your bill?
- 2)Is the receptionist allowed
to speak to me like I'm shit?
- 3)Shouldn't I have been given
advance warning that the bill was overdue?
- 4)Can I get my medication
elsewhere, and when?
POST NOTE: If I want to fight a battle because the receptionist did not communicate effectively and with held my prescription with out warning, then I can go for it. Fact is, I'm too tired to do that. I just want my prescription.
Take a look at what the website says regarding The Code of Rights in Clause 2:
The Code (summary)
This establishes the duties and obligations of providers to comply with the Code, to ensure they promote awareness of it to consumers and enable consumers to exercise their rights.
This details the ten rights of consumers and the duties of providers.
Right 1: the right to be treated with respectRight 2: the right to freedom from discrimination, coercion, harassment, and exploitationRight 3: the right to dignity and independenceRight 4: the right to services of an appropriate standardRight 5: the right to effective communicationRight 6: the right to be fully informedRight 7: the right to make an informed choice and give informed consentRight 8: the right to supportRight 9: rights in respect of teaching or researchRight 10: the right to complain
The Code of Rights makes it clear that the receptionist has really crossed the line. She spoke to me with blatant contempt and could not explain why I had not been given warning that my medication was being cut off. I was not fully informed, the services were of poor standard as she did not return my communication until Wednesday. She could have easily replied to my email with one sentence. Something like "The extra cost was due to (blah blah) and we're sorry you are feeling so awful. We thought you knew how our system worked, so we apologise for the distress caused. We will of course send out your prescription as soon as possible, please do let us know how much you can pay this week."
See, that wouldn't be hard would it?
Well I look forward to updating you on this. I think it's going to be more important than ever before to stand up for ourselves in a climate that's encouraging anger towards beneficiaries. It seriously is not the cushy ride many employed people seem to think it is. It's a safety net for people who are struggling, and if doctors start to put the boot in, I dread to think what could happen to people who are seriously ill. Are we going to become like The States? I hope not. I really hope not.
On the up side:
The trees are looking good outside, the birds are singing and I am loved. Life is good. :)
On the up side:
The trees are looking good outside, the birds are singing and I am loved. Life is good. :)
post note: the trees are looking so good that I cannot put up a fight. See next blog entry ....
In the end, it is better to assume that someone might have their own reasons for behaving in a way that causes stress to others. The receptionist was genuinely trying to communicate that the doctor's offices are busy, there just isn't time to deal with people having emotional blow outs. So I understand her point, and I imagine she is a doctor's receptionist because she cares about people, but it's easy to get overworked and feel unappreciated in that setting. Her world and mine may not have a lot in common, but at least we ended up finding a way to be civil.
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