I need to find a new PCP – soon. My doctor, who I really liked a lot, and who worked with me better than anyone else I’ve ever met, passed away last September. I am still on the books with the practice, and I was seen by the doc who runs the practice, who I do not like at all. When I was trying to get clearance for neuropsychological testing, I had to be seen by a neurologist, and the doc who runs the practice is the local “gatekeeper” for referrals.
My insurance at the time was terrible for mental health/neuro things, so I had to get special permission from my hospital system — and that gatekeeper tried to stop me from finding a specialist in a nearby city. They wanted me to stay within their provider network. It’s great requirement for the business side of the hospital system (they nearly went bankrupt, 10 years ago), but it is a terrible idea for patients who need specialized help that can be found quite easily at locations less than an hour away.
So, I’m not a fan of that doctor. I’m not sure if they realize how much I detest them — I didn’t let it show, when they gave me my annual physical last fall — but I hope I never need to explain that to them.
I just need to move on.
Additionally, I have to find a new neuropsychologist, as my current one is retiring in a few months. I’m pretty anxious about this, because I completely lucked out that I connected with them at all. They have offered to help me find someone new, but in the past, they’ve been pretty unreliable, and they’ve also steered me towards people who just weren’t good matches for me.
So, I’ve got to start that process again. The last time I went through it, it was stressful and somewhat traumatic. Insulting. Humiliating. Depressing.
But that was over 8 years ago, when I was still in a pretty dense fog from my TBI in 2004. That’s changed. I’ve changed. I can do this… I have to keep reminding myself.
Because I sometimes forget.
Anyway, it’s turning out to be a decent day. Time to get out in it and have some fun!
Onward.
Broken Brain - Brilliant Mind 
I can still hear the founder of the National Head Injury Foundation (NHIF) (whose daughter has a brain injury) when a group of advocates with brain injuries were discussing how demeaning and offensive the word “client” was at NHIF annual meeting in 1988. She was defending her position by giving us examples of her being a client of hair dresser and her insurance agent. She said she had the ability to go to another hair dresser or insurance agent if she didn’t like how she was being treated. “I’m a client of theirs, but I have the power because I can go to someone else with my business”. The main difference in this argument is “choice”. Most people with brain injuries don’t have any choice because of our disability – we are already clients within the system. We don’t have any choice in the matter. We didn’t choose to have a brain injury – we are clients whether we like it or not. This is especially true for people with brain injuries who are not working and are receiving SSI, Medicaid, food stamps or other forms of public assistance.
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Thanks for writing this. You make some excellent points. The whole concept of “client/provider” relationship in healthcare is demeaning and offensive — in my opinion, because it reduces the relationship to a couple of roles, which completely relieve the “provider” of their obligation to be human and treat the other person as more than a transaction. The “consumer” language of the healthcare industry drives me absolutely NUTS, because it boils us down to a set of behaviors or “consumer choices”, rather than living, breathing, vulnerable human beings in need of assistance in both subtle and obvious ways. The fact that the mental health industry, as well as the brain injury rehab industry uses this terminology, tells me that something is terribly, terribly wrong with how they think about brain injury and mental illness, and how they treat it. To be unscientific, it’s just a very stupid way to look at things. I would think they’d know better.
Calling us “clients” also completely misses the fundamental hallmark(s) of brain injury in a number of ways. As you said, we don’t have the choice about whether or not we need treatment. Also, client choice implies the capacity to A) identify what you need, B) see that you are/are not getting your needs met, C) go somewhere else. Brain injury can disqualify us on so many levels in each way. Again, treating us as clients is a very stupid way to look at things, and no right-minded individual who actually understands the impact of brain injury on person’s ability to assess, evaluate, and choose, is going to spout out that nonsense.
And now that I’m all riled up, I’m feeling much more awake this morning 😉 It’s time for a long walk in the woods.
Thanks for writing and raising this issue. It’s been on my mind, intermittently for the past number of years (ever since being told by several therapists on several different occasions, that they expected me to be a “good consumer” in my relationship with them). Augh! It’s just maddening, when professionally conditioned people’s brains stop working, and they act like their robotic repetition of industry jargon contains any thoughts worth considering — and entitles them to special treatment.
Ugh. Idiots. Onward.
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Going through your posts in reverse chronological order, so now I get why you can’t just ask those providers for a referral. Maybe some of the ancillary staff can make a recommendation though…they are often in the know. Maybe someone can give you a good lead. Or possibly a nearby university research center knows of some good physicians and neuropsychologists to recommend.
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Yeah… work in progress, definitely.
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