Thursday, May 17, 2012
Medical Overbilling and Abuse
Wealthy private equity investors, the poor, the government and medical practice. It's not a beautiful thing.
Sunday, May 13, 2012
Information Asymmetry
PsychVictim in the UK tweeted about this article on the patient's right to see his NHS medical records.
Sadly, it does very little good if you're a psych victim like Mary and me because it contains this one little escape hatch for psychiatrists:
I've had experience with this sort of thing in the US.
The last time I got ensnarled with the bureaucracy that is psychiatry they got me hooked up with the SSI gravy train. I guess they want a person to be as dependent as possible on their largesse.
I went through an interminable appeals process.
One time I was sitting with my lawyer to go into a hearing. I looked down at my file as he was leafing through it and I was absolutely astounded at some of the things the drug peddler had written about me.
In one note, he had written "patient shows no response to medication" and that this was a historic and ongoing issue with my case. Of course, he had been continually telling me, like a broken record, that I needed to take his drugs for the rest of my life.
He had also placed a personality disorder on my Axis Diagnosis that he had never bothered to share with me. I immediately have to raise me hand and ask, "How can I know what you think my problems are if you don't talk about them?"
I got the SSI, but I also went back to school and got a job.
I told the Social Security Administration that I had got a job, but they sent a couple more checks and then stopped. Nothing more was said about it and I assumed everything was OK, but a year or so later I got a repayment notice. I appealed pro se and asked to see all the files in my case. I was given a very thin sheaf of papers that was nothing like the thick filing that had been used to get my SSI. The thin sheaf of papers had very little detail whatsoever.
What the shrink had said in the thick file was in no way damaging to me. I'd figured out the stuff he said years ago.
However, if he had more open and honest about my diagnosis and what he actually thought, we might have shaken hands and agreed that I never had to darken his door step again. I might have parted ways with psychiatry on good terms with a clean break. I might not have hung around him as long as I did, taking delight in punching his buttons and watching him squirm and mocking him as he reacted.
But all he wanted to do was engage in a game of informational asymmetry, to be less than candid and to withhold information. And as the wikipedia entry points out, transactions based on asymmetrical information tend to end badly.
As long as psychiatry maintains this paternalistic attitude that only it knows what's in the patient's best interests, I am sure psychiatry will continue to have problems with its victims.
...The exceptions [to receiving your complete medical records] are if it is believed information in the records would cause serious harm to your physical or mental health...So even if you want to see all of your medical records, you can't if the shrink "believes" the records would cause harm. The patient's problems began with what the shrink "believed". And even after surviving and wanting a full accounting of the experience, the patient is still going to be victim to what the shrink "believes." What a patently unfair situation.
I've had experience with this sort of thing in the US.
The last time I got ensnarled with the bureaucracy that is psychiatry they got me hooked up with the SSI gravy train. I guess they want a person to be as dependent as possible on their largesse.
I went through an interminable appeals process.
One time I was sitting with my lawyer to go into a hearing. I looked down at my file as he was leafing through it and I was absolutely astounded at some of the things the drug peddler had written about me.
In one note, he had written "patient shows no response to medication" and that this was a historic and ongoing issue with my case. Of course, he had been continually telling me, like a broken record, that I needed to take his drugs for the rest of my life.
He had also placed a personality disorder on my Axis Diagnosis that he had never bothered to share with me. I immediately have to raise me hand and ask, "How can I know what you think my problems are if you don't talk about them?"
I got the SSI, but I also went back to school and got a job.
I told the Social Security Administration that I had got a job, but they sent a couple more checks and then stopped. Nothing more was said about it and I assumed everything was OK, but a year or so later I got a repayment notice. I appealed pro se and asked to see all the files in my case. I was given a very thin sheaf of papers that was nothing like the thick filing that had been used to get my SSI. The thin sheaf of papers had very little detail whatsoever.
What the shrink had said in the thick file was in no way damaging to me. I'd figured out the stuff he said years ago.
However, if he had more open and honest about my diagnosis and what he actually thought, we might have shaken hands and agreed that I never had to darken his door step again. I might have parted ways with psychiatry on good terms with a clean break. I might not have hung around him as long as I did, taking delight in punching his buttons and watching him squirm and mocking him as he reacted.
But all he wanted to do was engage in a game of informational asymmetry, to be less than candid and to withhold information. And as the wikipedia entry points out, transactions based on asymmetrical information tend to end badly.
As long as psychiatry maintains this paternalistic attitude that only it knows what's in the patient's best interests, I am sure psychiatry will continue to have problems with its victims.
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