Politics, Politics… Should I Stay or Should I Go Now?

In my February 17th Blog Entry (Back-Breaking Miracles), I talked about how during my latest PT evaluation, I threw out my back. I rejoiced in the fact that after being bed-ridden for 4 days, I was up and walking and almost back to normal. Almost…

Six weeks later, I was still almost back to normal. Now, as you know, normal to me is not normal to the typical 31-year-old. My normal consists of daily pain, daily medical treatments and extreme limitations regarding any sort of “normal” activity of daily living (aka: things that you do every day without thinking and that cause you no pain).

Six weeks later, I was frustrated. I was in severe pain and it wasn’t getting better. More than that, trouble was brewing at The PT Facility. Six weeks had gone by and every visit, every week, I was given excuse after excuse as to why the Team had not met to review my reevaluation. What was going on? I was told that one week, the Evaluator was on vacation. Another week, my exercise PT had taken off of work. Another week, one of the PTs openly admitted to me that the Team had “started talking about my results, but got distracted…” Another week, my Case Manager was, also, on vacation. I listened to excuse after excuse, nodding my head and accepting the apologies, but what about the pain? There was no excuse for that…

During week six, my Case Manager encouraged me to contact my Pain Management Doctor. When I did, I was asked, “What did the PT evaluation results show?” I wish I could answer that… One thing led to another and I eventually had to contact the PT Facility for answers; answers which were supposed to have been given to me at least a month prior.

If you have read any of my previous entries, you are well aware that I have grown VERY fond of this particular PT Facility and the entourage of PTs and Specialists who work with me on a regular basis. I have tried applying grace and patience to my given situation, for I thought of several of these professionals on a personal, even friendly, level. What happens, then, when one thing leads to another and no one is held accountable for a patient in need?

Before I knew it, my Pain Doctor was requesting necessary information from the PT Facility. The PT Facility looked bad. It looked very bad. I tried to explain to my Pain Doctor the excuses that were given to me by the PT Team, but he asked, “Were they just going to let you remain in pain for over a month without altering your treatment or making changes to help you?” Frankly, I did not have an answer for him. And I also found myself feeling cheated. Why weren’t the PTs making more of an effort? Why didn’t they have the promised Team meeting? Was it acceptable for them to delay such results and treatments?

My Pain Doctor did not think so and he directed me to speak to my liaison, the Office Manager at The Facility. As politely as I could, I explained the situation, specifically that I was concerned regarding the severe pain that I had been in since the reevaluation and the confusion that I saw between the PTs when it came to communication. When I had first started attending The Facility, the Team decided to be a Team – to have a Team Approach – with my Treatment. The President suggested that she conduct every-other-month reevaluations for data-driven treatment purposes and the Vice President then suggested that the Team reconvene within two weeks after the reevaluation to review the data, make appropriate changes to my program and provide necessary information to assisting physicians.

After several months, we decided that neither Gage nor I needed to attend these meetings. The Team could review the data when they had the time, and I could discuss my concerns and thoughts with my Case Manager, who I saw weekly, during our scheduled visits. This plan sounded amazing, didn’t it?

Unfortunately, at the Round Table, when we all had our first Team Meeting, not even the President nor Vice President thought about the non-billable time that it would take to gather anywhere from three to six Team Members together for a non-paid Team meeting…

Does this all boil down to money or what is best for the patient?

Today, when I attended my first visit at The Facility since the stand-off between The Facility and the Pain Doctor, I learned that it came down to the money. My Case Manager was told that the PT President did not “warrant” the need for Team Meetings, because they were un-billable; therefore, unjustified.

Tears in my eyes, I left feeling defeated. My Pain Counselor reminded me that I have a choice: I can leave The PT Facility. I can try to find a new PT or Team of PTs to help. I can find a new Pain Doctor…. I do have choices…

But why do I feel so trapped?

It has taken about two years for me to build the relationship that I have had with the PT Facility. I thoroughly enjoy most of those relationships! Most importantly, for six months, we all saw progress, REAL progress in my recovery. Then, the progress stopped. It reached a “plateau” as they explained it. They "needed the evaluation results to base the next phase of Treatment," they said. They had excuses for waiting to review the reevaluation results – I mean, everyone deserves a vacation, right? Right?

What now?

What would you do?

Would you stay at a place where you have hit the inevitable, political “bump” in the road (it all boils down to money in the end) or would you ask for your chart and go down the street to another PT facility, starting from scratch and praying that it would be different, knowing that every PT has a boss and every boss has a deadline or a budget or a designated number of billable hours in which every PT much fulfill?

Would you stay or would you go?