Thursday, May 20, 2010

The Stressed Out Shrink Rapper

Yes, shrinks get stressed out, too. Can I tell you about it?

I hate paperwork, in case I never mentioned it. And I hate dumb things that are mandated by institutions and don't make sense. So I'm getting ready to go to APA this weekend ( see you there?) and I'm trying to tie things up. It's not going so well. Here's my list:

Remember I told you that I moved and tried to change my address with Medicare? Ah, 221 downloadable forms on the Medicare website, and not one of them is a change of address form. To change my address, I had to re-enroll. 27 pages. Then they wanted my office utility bills. But I don't have utility bills, they are included in my rent. I faxed my rent invoice--it has my address, and it says "office rent" on it. It's a very nice office. I figured I was done.
Two days ago, I got a letter from Medicare. I've been denied my application as a Doctor of Medicine. I can appeal. Why? I didn't send in three things: 1) Downloadable form 558 giving access to my bank account so they could pay me. Only I'm not an in-network doc. They don't pay me. Ever. 2) my participating agreement. I'm non par and wish to stay that way. 3) my utility bills as proof of address. Am I the only doctor who rents space with utilities included?
I called. Twice. If I won't give them my bank account numbers and routing information, I'm out. Which means I have to leave my clinic job where I've been for 12 years. I don't have to fill out a participating agreement. And they'll take another copy of my rent invoice. I have 30 days to appeal. From the date on the letter which came 2 days ago. The letter is dated in April (it's now May 20th). And I'm really not happy about giving them my bank account information---what happens when they pay me for patients I see at the clinic? I'm salaried there, I don't get paid by the patient, the clinic does. If I do nothing, I'm quickly opted out, and that's a good thing...unless you're my Medicare patient and you no longer can get reimbursement or you're the clinic that wants me there. Have other people had to give their bank account info to change their address? Never done this before. Time expended: who knows. Hours. If you're a non-par provider could you offer some words of wisdom here/?

Next problem:
Clinic says I need to be tested for TB along with all the other employees. So I get a ppd placed, no big deal. Only I work there one morning a week, and in the past, I've read it myself or had a dr. friend sign off on it, because it's a hassle to get to the hospital, park, and take off work for this. Now I'm told I can't read it myself or have another doctor read it, unless it's an internist, pediatrician, or pulmonologist. Okay, found a friend, still have to get the form faxed in. Time expended: 2 hours.

Next problem:
My cell phone blitzed last night. I called. They said I needed updates and they'd push them through. Whatever. The phone worked, I thanked them, and half an hour later, I was on my merry way. Only then the phone didn't work. And my kid's phone didn't work. I called back I held. I powered off, I powered on, I removed the sim cards, I read the numbers, I switched the sim cards, I powered on and off and ate the batteries and prayed for ducks to come. The phones aren't reading the sim cards. I need to get new ones. Okay. Hours. I got to work today. The phone works fine. I called AT&T. Can't be the sim card. Husband's phone works fine. Must be the degrading tower. What's a degrading tower? Does it crumble? Why does husband's phone work? Very strange, no explanation, but tonight, all the phones work. Time expended: 2.5 hours.

I suppose the last thing is the book. Time expended 4,237 hours. Our editor wants it in Mid May. I think that happened. It's almost there. We still need a little polish on the last few chapters and a table of contents and Suggested Reading . If you know a shrink book that's been helpful to you, please let us know in the comments===we'll try to stick it in.

Hanging on for:

Thank you for humoring me tonight, please send a bill


Mindful said...

My shrink charges $175 (Australian) for 30 mins so I am happy to take that from you. He is in fact coming from down under to APA and was very impressed when I knew what is was, courtesy of Shrink Rap. So if you meet an Aussie shrink by the name of George, say g'day.

Alison Cummins said...

Don't know what a "shrink book" is, but this is one that was helpful to me"

Anonymous said...

Quick, call the Whambulance! A doctor has been hurt by paperwork and it isn't as easy for her as she wants to get her money, money, money. And a cell phone broke!

Dinah said...

Thank you, Alison, it will go into the Suggested Reading section.

Anon: as a non-par medicare provider, they set my fees, but the patients pay me up front. The issue is whether the patients can get reimbursed at all. And the cell phone is fine, apparently I spend a lot of time on this because the tower was having an issue.

Mindful: will look for George!

Thanks, everyone, for listening. Sometimes it's nice to have a blog to vent on!

Rachel Cooper said...

Dinah, after your cellphone-washing machine debacle I learned my lesson - ie: to check for small electronic devices both in pockets and on my person - before starting a load.

So, thanks (i guess)!

Sunny CA said...

My favorite shrink book is:

"Should You Leave?"

By Peter D. Kramer


Sunny CA said...

"The Man Who Mistook His Wife For A Hat"

by Oliver Sacks

is another favorite shrink book.

Paula said...

Ah ... overwhelming hastle ... know it well. My advice, send Medicare an invoice for the time expended, follow this by sending each page of their form to them (that is after you have taken the time to fold it into a paper aeroplane), then send them an invoice for the time it took you to make the aeroplanes. As for the phone, throw it at the degrading tower (if it's in close proximity), if not, throw it from a great height, (just as satisfying). My theory is, if it's not working anyway ... then go and purchase a new and improved phone, and bill the phone company for the hours spend achieving these tasks and for the new phones you were forced to purchase. Not helpful in any way shape or form, but hopefully the thought of carrying out these acts makes you smile.

d'Zhuoy said...

Noonday Demon -- yes, yes, yes! What an incredible book. Even better than William Styron's Darkness Visible (which you might consider).

Then there's A. Alvarez's books Night (1996) and The Savage God: A Study of Suicide (date?).

I'm sure you've already added these three by Kay Redfield Jamison: Night Falls Fast, Touched with Fire, and An Unquiet Mind.

Emile Durkheim's classic On Suicide.

In a more literary vein there's Ted Hughes's The Birthday Letters, poems on the suicide of his wife, Sylvia Plath. Fascinating look into the mind of one who was left behind. The Plath-Hughes marriage is a rich vein for primary and secondary texts, from Plath's correspondence to feminist psychiatric critiques.

I would encourage you to include some books that offer critiques of psychiatry. I'm not talking about the silly antipsychiatry spoutings of Scientology and the like; I'm talking about reasonable, rational critics like Thomas Szasz.

But maybe I'm way off base.

d'Zhuoy said...

Oh, and also... your ducky reminded me of my favorite-ever episode of The Ze Frank Show:

The best use of 3 minutes I can think of.

Sarebear said...

*hugs* Dinah (carefully w/armcrutch(es) on.

Anonymous said...

Hurricanes are the best. I love drinking either that or a margarita (strawberry or raspberry, frozen) after an especially trying day of either parental or bureaucratic b.s.

P.S. I'm sure you know this, but if you are going out to order a hurricane, make sure you go inside the bar. Much better glass quality (glass vs plastic), much more alcohol (almost 2x as much), and more people to hold you up when you slide down the wall (do I even need to say anything?)