Incompetence

[Variform]

Right. Great. Awesome.

After six months of waiting on an invitation for ADHD diagnostics, I found out that my doctor did not send any letter to the clinic where I wanted to go.

I am filing a complaint against her. She got a letter from my psychologist which is very clearly a request to her to refer me to the clinic. Instead, she denies it was a clear letter, that she didn't know what to do with it, that she was confused. Instead of contacting me or my psychologist, she told me she doesn't have time to call after people.

When I called her assistant I got the assurance all would be fine, that the doctor would send a referral to the clinic, where they then would send me an invitation for the procedure.

Last March my gf contacted that clinic because it was taking so long. Apparently, they hired a new desk employee or secretary and she informed us that in May I would probably receive the invitation, that I was in the computer. But they never had a letter so she lied on the phone. Last week we called again and now another secretary said she never got a letter.

So I have talked on the phone with my home physician who became defensive and had the audacity to ask me why I didn't contact her sooner and waited so long. Well, I did contact her assistant and she assured me all would go well.

I contacted her because per 1 januari the rules had changed, that only home pjysicians can now refer people to specialists. Where otherwise, in 2013, any specialist could refer. But no, all would be fine, all would be well.

So, 6 months of writing posts here and mentioning I was waiting for ADHD diagnostics... The doctor only had to make one call to my psychologist to ask what she was supposed to do with his letter or contact me.

So I have a doc who belittles me and tries to maneuver around so she is not responsible, is neglectful and one secretary downright lies on the phone about seeing me on the list to be invited.

I am filing an official complaint against my doctor and I will drag her ass before a committee.

Two things I hate in life.

1: Myself
2: Incompetence / inconsistency

To nr. 1 I have all right and am quite capable of that, aye.

As for nr. 2, I am INTP, bitch. You wanna have debate or argue with me? I'll take everything you said apart and debate you back into the fucking stone age.

I wrote, no, beautifully crafted a letter to the committee. It is a work of art. Time to own up to your incompetence, doc!

It is going to take a lot out of me, but I cannot let this go, not again.

 

[rick1959]

Hello Variform,

Your exasperation with incompetence caught my eye.

It seems more prevalent as time goes on. And, more folks look to dodge their inability to do the job they are supposed to.

I've lived with it for a long time and I need to find a place to leave it behind.

Hope you fight the good fight!

Regards, Rick

 

[Jennywocky]

If your doc didn't understand, and since it involves your physical/mental well-being, I think professionalism would demand they at LEAST inform you of what they do not understand so you can remedy the issue. To just ignore it is ridiculous. What you describe is not necessarily incompetence, but at least unprofessionalism IMO. If someone did that on a project at my workplace (not understanding something, so they don't follow up), they would get a bad review and eventually let go if it persisted.

It also sounds like you now know you can't "assume" anything. If you don't hear within 1-2 months, you need to follow up because they might have dropped the ball. And you are the one who suffers, not them.

---

I had an issue with a blood test last summer. The billing code was wrong and my insurance would not cover, so the lab requested new codes from the doctor, then claimed my doctor never responded. I ended up calling both the lab AND the doctor's office three times each over the next eight months, I would think the problem was resolved, and then I'd get another $600 bill from the lab.

Finally the lab claimed they would no longer contact my doctor and told me I had to just pay the money; my doctor claimed they had no idea what the lab was asking for, because they had sent the response three times... and suddenly this last time, my insurance paid the full bill for me.

But it took eight months, and at least either the lab or my doctor office was lying about following up on my problem. It was one of the most frustrating things I've had to deal with lately... because I had no control over their actions, and I was the one stuck with the bill.

 

[nanook]

This kind of unforgivingness is typical for Fe. The doc feels that she can't manage everything in the world, she has a right to limit her "competence". Society feels, that everything must be taken care of, twice, just to make sure. Your original doc should have been less ambiguous in her note, it's her fault says Fi. You seem to take sides, giving bad review to only one of them. People draw boundaries somewhere, but Fe likes the overlap. It's seems to me the world of office life is defined by Fe and i admit that this works best. It's why i don't want to come near offices.

 

[Jennywocky]

You don't "limit your competence" to the degree that the patient does not get treated.
Doctors typically have people called "office staff" to handle mundane work, to make sure nothing drops by the wayside.

However, if the psychologist writing to the doctor failed to follow standard format, to make his intentions clear, he can (and should) also be blamed rather than obsessing solely about the doctor.

 

[Red myst]

To say it sucks is an understatement. I have been patiently waiting to see how your diagnosis would come out, and how ADHD meds work for you.
Is there any way you can use this SNAFU as leverage to expedite your invitation for ADHD diagnosis?

 

[Luzian]

I am INTP, bitch. You wanna have debate or argue with me? I'll take everything you said apart and debate you back into the fucking stone age.

 

[Variform]

You don't "limit your competence" to the degree that the patient does not get treated.
Doctors typically have people called "office staff" to handle mundane work, to make sure nothing drops by the wayside.

However, if the psychologist writing to the doctor failed to follow standard format, to make his intentions clear, he can (and should) also be blamed rather than obsessing solely about the doctor.

That is just the thing. My doctor had my psychologists' letter on screen and only read to me the last paragraph, which I thought was strange. Because that is titled a 'Brief summarization of the history'. Meaning what happened before all this. In that paragraph there is no mentioning of ADHD. So that clears her, she figured.

However, in all the letter, ADHD / ADD is mentioned 7 times! And I found this out only because in an act of sheer will and defiance, so much unlike me, made an appointment at my psychologist's office to look at my records. Which is all quite official stuff, had to sign even for the fact I was from there on responsible for the information handed over to me.

In the letter the topic line clearly states 'referral letter for diagnostic clinic' They name the clinic but privacy...

It then says: "Hereby you receive our "request for referral to the XXX in MYCITY of client MYNAME".

It then says in bold "Reason for referaal". And goes on explaining. Because, doctors need a reason, can't just make medical costs for nothing.

In then says in bold "Question/goals" And mentions ADHD again. It then goes on "Clients help-question".

So my doctor was just bullshitting me. Nothing vague about it. The format is clear and I can't find fault with my psychologist here. Even then, she should have called him or me. And because I, by default, it will be my paranoia as StPD, worried that I would be forgotten and that I would be victim to faulty procedures... - e.g. I have this great fear every time I am in a waiting room for an appointment, that something went wrong and that I am gonna be skipped over, or that the appointment was changed, or the person I am to see is not there - and that is why I called my doctor's office. So I already did more than should be needed.

And still she fucks it up. I could have been on medication now as an experiment that is my goal, to see if that helps with my extreme lack of motivation and so on.

Unfortunately, my psychologist is sick. He is ill. They cannot tell me what for privacy reasons. But I fished. And got some semi-reply. He got burn-out.



So I am out of mental help for the time being, because even if they get a replacement... there is just no way I can bring anyone up to speed about my complex issues atm.

I even had a dream about him.

In this dream he was back at work, seeing patients on a...what do you call this in English... therapeutic basis. In my dream I heard it say that he would need at least 2000 hours of therapeutic work before being fully back.

I checked it roughly. That is over one year of 40 hours per week. Sounds about right.

How weird is that.

He was on his knees stacking tupperware storage boxes. Or lunch boxes, or the type you put food in and put in the freezer.

God I love dreams lol.

 

[Variform]

To say it sucks is an understatement. I have been patiently waiting to see how your diagnosis would come out, and how ADHD meds work for you.
Is there any way you can use this SNAFU as leverage to expedite your invitation for ADHD diagnosis?

Yes, I was angry and emotional on the phone with my doc and told her that she better not be too nice requesting immediate diagnostics for me. Because at the clinic I was supposed to be referred to they just lied.

What happened there was, this new assistant just assumed my referral letter was on the pile because that was the logical bet, I mean, it doesn't go wrong a lot one assumes. But she didn't actually really check. Not for a physical letter, not for a remark in the database that the letter had beenr eceived and that I was in the mill, so to say. The only reason my name comes up in their system is because of diagnostic procedures in 2001. So I guess I am still in their system and probably will be for the next 8 million years.

So I kinda told her how to do her work and she didn't like it. But at least I got her to call immediately the clinic. Then again, I have no proof she did. And on a Friday afternoon you gotta wonder if the clinic printed out a letter. Nothing here yet, so they did fuck all. But I said to her to call the Chef de Clinique. My old doc used to do that. She was a great doc. She would not be afraid to do that and yell at him.
She was rewarded by our Queen actually, for her work as one of the first female physicians to start a practice in .nl, which she did in a new suburb where I came to live as a kid. She actually trained other doctors. She retired some years ago :-(

I should be put on the extreme shortlist.

 

[Red myst]

Are there other avenues to getting an ADHD test in your country? I am just curious, I am guessing that there is a public, and a private side to your health care system. What would it take to just make an appointment with an independent physician? Can it be done? And how much is they typical cost? And how much are the meds? In the U.S., a person could get a diagnosis one way or the other for about $200, and the meds run about $10 to $12 a peace for 30mg of Concerta. All just out of pocket, no insurance. Not cheep, but I am curious as to cost for similar services and items in other countries.

 

[Variform]

Are there other avenues to getting an ADHD test in your country? I am just curious, I am guessing that there is a public, and a private side to your health care system. What would it take to just make an appointment with an independent physician? Can it be done? And how much is they typical cost? And how much are the meds? In the U.S., a person could get a diagnosis one way or the other for about $200, and the meds run about $10 to $12 a peace for 30mg of Concerta. All just out of pocket, no insurance. Not cheep, but I am curious as to cost for similar services and items in other countries.

There is only one side: privatized. It used to be different, but we americanize everything here.

We used to have private insurance from a certain income level up. And below it it was public health care. You would never ever see a bill then.

Now it is all privatized but in a socialist way. So lots of government restrictions on tariffs. Lots of rules and regulations. Mandatory insurance for all. A base insurance covering most important things you could ever not hope to need treatment for, but has an own risk of, what is it, it is always rising now...because we are graying out...€360,- But because home physicians are so vital and should be easy to go to, the own-risk is not used for them.

You cannot go to an independent physician because the system is different. Yes there are 'private clinics', but all medical practitioners are in the same playing field. They all have deals with the private insurance companies. So as a citizen I have mandatory insurance I can get at any insurer. They cannot refuse me. It is mandatory for them to have me.

I can get extra packages of insurance that I will pay for. So I can shop around. But all medical practitioners need to make deals with the insurance companies about tariffs and medical procedures, how they are covered, for how long, how many treatments etc. The government keeps an eye on things to make sure the insurers aren't undermining the health care quality and influence doctors to do what they want. Like cheaper meds or shorter treatments.

These days all treatments are categorized and defined. These are Diagnostic Treatment Combinations. So for some physiotherapy you can only get 12 sessions paid after first you pay the €360 own risk. After that your health insurer will pay, depending on your health package, sometimes you have to pay half per session. If you pay high premiums, then its all paid for. But that means a high monthly bill.

So there are private clinics but there is no difference in quality. I want to go to the universities' psychiatric department because they have ADHD speciality there. There is also something called PsyQ, a private organzization with offices across the country that does ADHD.

But I don't like them and heard bad things. They really press you to take medicine. They make demands on your cooperation for group sessions. They force you into a treatment regime. They are sloppy with actually giving you the paperwork, like official diagnosis black on white. They need to make a profit and the only way they can do it is by offering a strictly regulated treatment plan and if you need more help or extras it will come at their expense. Thanks privatization! Thanks america for providing the example. So basically they have a DBC or Diagnostic Treatment Combination.

I suspect in america the people know more about actual costs of meds and treatments because they pay for it themselves. It is more open. All we see is a bill deducting money from the €350,- and since our health insurance covers most anything all you see is your monthly premium and whatever you have to pitch in on the treatment. So it is more or less a bit covered unless you are a hawk and wanna know everything. Because here, no one will have to mortgage their house twice for medical help.

There are other health bureaus or businesses that offer it, maybe smaller practices but I need expertise because I also have serious other issues, like emotional neglect as a child, StPD, maybe Asperger Syndrome, thatw as never really made clear and then the ADHD. On top of that an INTP personality, that overlaps a lot with ADHD as well as some Asperger traits. As MBTI has a 'functional stack' I have a 'dysfunctional stack'.

I need a reliable and through research on me done. Because I don't think in 10 years I wanna go through this again. I have an identity crisis, I barely know who I am, what I am or how to live some sort of meaningful life and have some peace of mind and self-esteem or self-worth. I am not doing anything, going nowhere and am just as functional as a god damned schizophrenic in an institution and I don't wanna grow old this way.

So I hope they can assure me it is indeed ADD I have and then I can get meds and they will be paid for by my insurance company. And it is my hope that these will improve my motivation, working memory, my attention, so I can actually do things without them feeling like sanding a block of rubber.

And it almost seems that the universe is preventing me from getting there. I mean, a doctor behaving like a jackass and a lying assistant elsewhere.... Wtf?!?

 

[Red myst]

Have you thought about getting some ADHD meds on the underground market? I only suggest it because of all the red tape you have to go through. Not a long term solution, but you could try it out for a week or two and you will know if it has any positive effect on you. I'm not sure it will help because you speak often of lack of motivation. The meds do not help me with motivation at all, but they do keep my mind from wandering off course when doing boring task. Mainly desk type work. How would you test yourself to see how the meds effect you? What are you going to try to do that you feel you can't do now? What would you consider a successful outcome?

 

[Variform]

I have no contacts at all anywhere. Maybe if you are a kid these days in school some guy knows a guy. But not me. Besides, if I had such liaisons, there are many other yummy things to get. :-)

But I have good news!

Today I received the invitation. It will still take 5 weeks before they see me. But I got forms to fill out online and a form for hereto-anamnese. Since my mother has vascular dementia, it remains to be seen what she can cough up. But my brother might assist. I don't expect much, but receiving all this made me write a letter and I copied the forms and send it to my mother.

But even if medication won't help with motivation, if I could concentrate better on certain tasks, that would greatly improve my life.

How would I test myself? By trying to write my stories. But also garden work. You know what garden work is like? I'll sketch it.

I start weeding a field where we have some vegetable. I find it boring and get distracted because in another patch I see more weed and then I wanna go there too. So I get up and go there, forgetting my tool. I am all over the place. Then I get irritated.

But I persist. But then it becomes repetitive. When that happens, my mind goes off into violent thoughts. As I tear up weed, I am talking to the police, a judge, all sorts of people. I kill and maim. And I don't like this at all. So I stop.

I get a broom and sweep the terrace, make heaps of the stuff I sweep. But then lose interest or attention and find myself staring at some other task that I can or should do. At that point I am doing three or more things and I get overload.

So I sit down to unwind. But then between my feet there is a blade of grass that needs ripping out between the tiles. I can't relax. So I get up, stroll around.

When I finally weeded the patch I am dead tired and not satisfied with anything I did or accomplished. That too is apparently a dopamine issue.

And that is just the garden. Think about my thoughts when I do the dishes, vacuum or do any of that sort of thing.

I hope meds will alleviate this so I can be quicker and more effective, if only for some hours. So that would be a succesful outcome, more focus, therefore quicker, and more satisfaction because it doesn't feel like climbing Everest without sherpa's.

 

[Variform]

Yesterday I received the invite finally.

I spend 5 hours filling in questionnaires on a secure website. Some of these tests I recognized.

 

[Red myst]

I have no contacts at all anywhere. Maybe if you are a kid these days in school some guy knows a guy. But not me. Besides, if I had such liaisons, there are many other yummy things to get. :-)

But I have good news!

Today I received the invitation. It will still take 5 weeks before they see me. But I got forms to fill out online and a form for hereto-anamnese. Since my mother has vascular dementia, it remains to be seen what she can cough up. But my brother might assist. I don't expect much, but receiving all this made me write a letter and I copied the forms and send it to my mother.

But even if medication won't help with motivation, if I could concentrate better on certain tasks, that would greatly improve my life.

How would I test myself? By trying to write my stories. But also garden work. You know what garden work is like? I'll sketch it.

I start weeding a field where we have some vegetable. I find it boring and get distracted because in another patch I see more weed and then I wanna go there too. So I get up and go there, forgetting my tool. I am all over the place. Then I get irritated.

But I persist. But then it becomes repetitive. When that happens, my mind goes off into violent thoughts. As I tear up weed, I am talking to the police, a judge, all sorts of people. I kill and maim. And I don't like this at all. So I stop.

I get a broom and sweep the terrace, make heaps of the stuff I sweep. But then lose interest or attention and find myself staring at some other task that I can or should do. At that point I am doing three or more things and I get overload.

So I sit down to unwind. But then between my feet there is a blade of grass that needs ripping out between the tiles. I can't relax. So I get up, stroll around.

When I finally weeded the patch I am dead tired and not satisfied with anything I did or accomplished. That too is apparently a dopamine issue.

And that is just the garden. Think about my thoughts when I do the dishes, vacuum or do any of that sort of thing.

I hope meds will alleviate this so I can be quicker and more effective, if only for some hours. So that would be a succesful outcome, more focus, therefore quicker, and more satisfaction because it doesn't feel like climbing Everest without sherpa's.

Yes, I think the meds will help you so you don't feel like you are climbing Everest without sherpa's. That has been my experience anyway. And while it doesn't motivate me, I do no longer feel anxiety about spending all day in a cubical studying over government specifications. These cubical episodes are not frequent. But they can be lengthy. Like from a week to a month. Mostly I am on the shop floor tinkering away with some sort of electromechanical or computer equipment. Don't need meds for that. But when work gets slow, and my company is on the hunt for government contracts to bid on, I get drafted into the front office to help out with that process. I am happy to be versatile enough to do this, it means higher pay and job security. When work is plentiful I have gone for years without leaving the shop floor. But when work dries up, and they start laying off, they want to keep me so they find other work for me to do. I can dread this at first, but the meds help me plow through it. I only take them when I have to do these things, and I feel more accomplished and productive at the end of the day.
I hope the best for you on this endeavor. I know someone who was diagnosed with ADHD and when he started medication, it changed his life. His performance was like night and day. I hope this is the same for you.

 

[Variform]

Promising anecdotes are what keep me going. Yours, accounts on YT. All I have to do is wait 5 weeks. Weeks have flown by fast, waiting. I should try to relax for now.

Thanks for your continual interest, I appreciate it.

 

[BigApplePi]

This is a general statement. Incompetence is one word. But other people make mistakes, misinterpret, are disinterested or don't know how important things are to you when they aren't to them.

It is largely up to you to press your case for results. "The squeaky wheel gets the oil."

I am facing an optional operation on my right shoulder (torn rotator cuff). I've had the MRI but an facing uncertain conversations with the surgeon who doesn't understand my "INTPness." He talks at me and gives me promises without addressing my need for details. I don't want my shoulder to be out of commission for 6-8 weeks and have it fail. It's up to me to pursue my needs and wishes further. My responsibility.