My first appointment – with the Guru – went amazingly well! She used the results from the reeval to alter some of my exercises, she took notes and asked relevant questions the entire time and we actually had a little fun together. Even though the exercises are difficult for me, The Guru is amazing at making her patients laugh to distract them from the physical pain. This is quite a talent that she has!
My second appointment with my CM went as expected – emotional. She started by saying that she did not want to spend too much time discussing everything, but that she needed to "clear-up" a few things… She told me that she talked to the VP and President (she did not read the email herself) and was confused about the term “miscommunication.” I asked her to be specific and she asked me for specific examples of miscommunication – which I shared with her as I shared with you all in the last blog. My jaw dropped as she admitted that she did not “remember” many of those conversations with me… She also denied a few of the things that she said to me – which hurt more than anything because I felt her responses were not just inconsiderate, but negligent as well! I always considered she and I “friendly” – and I told her that, because of our friendly relationship, she often told me things that I did not believe were in my best interest to hear. For example, when she told me that the team “started talking about me then got distracted…” that was NOT in my best interest for me to hear. I told her that. She nodded her head, understanding.
After about a 30 minute conversation, we started treatment and then I burst into tears. Picture a massage table, I’m lying on it flat and my head it sticking through the face hole – and tears start dripping from my eyes.
“I really want to stay here, CM,” I sobbed.
“Steph, don’t cry!” her voice cracked and she grabbed the tissue box, but I couldn’t stop crying. I could not.
“CM, I’m not trying to fight you or anyone at The Facility – I just do NOT want to feel nervous when I walk into these doors. And, I need to feel like I want to be treated here. I don’t feel that way…”
“Steph, we want to treat you! It is just confusing because if all you want is treatment, then why did you send that email and talk to the VP?” she asked.
“I wouldn’t send the emails if I thought that I was getting the treatment that was promised or that I believe is needed,” I responded. “And, CM, this is my life. I only have four months before the Disability Company reviews my case and will likely force me to quit my job and drop me from any Disability Compensation. I feel like when I fight for better treatment, I am fighting for my life!”
“Okay,” she said, as if it hit her for the first time that because of my complicated case, I had more on my mind than just a weekly visit to the PT.
“What treatments do you think that you are not getting?” she asked, moving forward.
“Well, I threw out my back AT The Facility and no one did anything different to treat me! Then, the President told me, six weeks later at that, that I should have been coming in more than once a week if I had hurt myself, as if she were blaming ME for being in pain for that long” I said.
“I agree,” CM started, “If you are hurt, you should have come in more.” I was getting upset - she still was not taking responsibility for the miscommunication.
“Then why didn’t anyone,” I paused and looked at her, “Why didn’t you, my Case Manager, tell me that I needed to come in more often?” I asked.
“I didn’t think that you could given your financial situation,” she said.
“I appreciate you taking that into consideration, but shouldn’t that be my choice?” I asked, “And if no one tells me that I need to come in, then I don’t see it as treatment.”
“I can see that” she responded, “In the future, if you have a flare-up, I think you should try to come in twice a week to see if that helps,” she said.
“I can do that,” I responded. We both sighed, then CM spoke again.
“What do you expect from us, Steph?” she asked.
“Well, I want to come in here, exercise with The Guru, then come into this little room, lay on this table, get pain management treatment from you and, when you need to, you can tell me what changes or updates are happening with my rehabilitation or treatment.”
“That’s understandable…" she paused, "But I thought you wanted the Team Meetings.”
“I only wanted them because VP told me to have them. I worked as a Special Ed teacher for five years where all we did was have Team Meetings for high needs students. That was the ONLY way we got to all be on the same page about a kid. When it was brought up TO ME, I thought – hey, I get this! I may not understand my body or PT or why the surgery works for 85% of patients and did not work for me, but I GET THIS!” CM nodded her head in understanding.
“CM,” I continued, “Do you remember when I asked you months ago if you get time in your work day to fill out patient paperwork, review charts, make phone calls, or talk to other PTs?”
“Yes,” she recalled.
“You told me that you do NOT get that time. If you want to do any of those things, you have to stay late, keeping your husband and four kids waiting to eat dinner with you every night. I don’t think that is fair. CM, I am not just looking out for my best interests here, I am looking out for yours and for The Facilities, too. If these Team Meetings and Team approaches are not working, then I don’t want them.” She stopped working on my back and sat in thought.
“So you don’t want Team Meetings or goals or any of that?”
“If they don’t help anyone, then NO, I do not want them,” I emphasized.
“Oh….” She sat for a while in thought, then continued, “So I am hearing that you are comfortable with us talking about your treatment and results in-passing if we cannot have an official Team Meeting about your case,” I nodded in agreement, “I am hearing that you are not requesting goals or official Team Meetings after reevals as long as we find ways to still discuss everything and alter your Program to reflect the reeval results,” I nodded my head, “And I agree with you that we can have the President take better notes during the reevals and make sure to get those notes to the Team within a week. Is that okay for you?” I agreed.
“Okay,” CM continued, “well I think that the Team wanted to have a quick, 15 minute meeting with you to go over expectations.” I cringed. Like I said, I do NOT want those meetings. Why can’t I just talk to CM and she can talk to the Team? But I listened as she went on, “If we can’t meet this week or next, then I’ll just tell them what you and I talked about and we’ll go from there.” (It is week 2 and no word of a meeting, so I pray that I am in the clear...) ‘Thank God!’ I thought, but nodded my head, again.
“Are you okay?” CM asked me, truly wanting to know.
“Yes,” I said, “Are you?”
“Yeah,” she said and smiled.
There was more to the conversation than that. Finances were discussed. The “miscommunications” were deeper dissected. The apparent disapproval from The Team regarding my email was disclosed – with my rebuttal of “then why did EVERY Team Member give me his or her PERSONAL email address and have emailed me back and forth for the past year if they did not want me to email them?” CM's personal frustrations were revealed, about the Team, the Facility and my personal reactions. It was threatened that I should go to a new PT Facility. I called her bluff and asked if The Facility wanted me to take my business somewhere else and made it clear that if I was not “wanted” or if they couldn’t treat me, I did not want to be there. Then she told me she wanted me to stay... The CM explained that since the President has the most experience, she wants her to still reevaluate me so that she can get an outside opinion about my treatment. I agreed, as long as they discussed my appointments with the President within a timely manner. Eventually, all of those “kinks” got worked out…
Additionally, I knew that my insurance company pays a great deal of money YEARLY to The Facility. Based on my calculations, my business alone covers the entire salary of one of their Physical Therapists... If they like me as a person, that is great (and what I hope for)! But if the bottom line is money, then they would be fools to let a patient like me walk out their doors...
After talking to MANY other people about what would be best for me, I keep hearing the same thing:
- Every Health Care Provider will eventually have limits due to budget, management, insurance – you name it…
- Just because a Treatment is "promised" to you with good intentions, it may not always be carried through...
- Usually, Health Care Providers only like to be contacted (via email) when it is in regards to a Thank You letter or quick question; “long” letters are seen as threatening, even if you “fluff” them with appreciation…
- No matter how great a place is, there will always be something wrong with it; it’s up to the Patient to determine if that something wrong is worth staying or time to leave…
- No one – no matter how great of a support system you have – will ever fight for your health like you will…
What do you think? Did I make the right decision by trying to stay?
Upcoming blogs: I found an AMAZING letter written by a woman with an Invisible Disease who wrote to her family and friends what SHE needs from her loved ones – AND – I finally got the results of my reeval from February… Keep Reading!
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