[AncientMelody]

So for the past 6 months my therapist/psychiatrist has been splitting her time between two offices, the regular outpatient office I see her at and a low income federally funded clinic. We received letters that as of June she will be leaving the private office and only working in the clinic.

I work with a similar patient population. 80% of my patients are Medicaid. I could refer any one of them now and they would be able to see her. Now there might be a wait, but they can see her. BUT I CAN'T. I don't have the right insurance (that I pay every dime for because for some reason a ***** medical practitioner can't even get decent medical benefits coverage. They don't accept private payments which I'd be willing to do! And a large reason I SEE a psychiatrist is because my mental health has suffered from the pressures of the occupation.

As I mentioned over on the bipolar section; my husband and I suspect I might be having hypomanias. I was going to discuss this with her tomoarrow. I don't really want to now. What's the point. I'm not interested in seeing another psychiatrist right now. actually what I really want to do is mention it in passing at the end of the session, after I am done having to sit and listen to her canned speech about transfer of care and how she enjoyed working with me, yada yada.

At the end of session I'd like to just drop it in her lap, my self assessment, the detailed letter where I tried to concisely explain my concerns. Oh by the way at the end of the session and walk out

I'm tired of being strong. I'm tired of being just well enough to go in to work only to be met with patients who forget that I am a human too. I have limits to my strength and abilities too. But hell I'm too "well" to do anything but trudge along as I am.

[Hopelesspoppy]

You have 2+ months. Clearly she has been good for you. I understand the anger at the injustice of it all, do I ever! But be careful not to bite off your nose to spite your face....take the best advantage of the time you have and let her ease you into transition.

[Chummy]

I can understand your anger. And wanting to tell your feelings/thoughts in a letter and just give it at the end of a session.
I have done something similair. Last month my T told me she's pregnant and will go on leave from the start of April. She will be gone for about 5 months (she said, but what if she decides to not come back). And I'm getting a replacement T.
Your situation is even more unfair. She's going to only work at that other practise and just leaves all those other patients to look for another psychiatrist. And you're willing to pay for therapy out of your own pocket, but they don't accept that (which I think is weird).
My t actually changed to another workplace a year ago, but I could go with her, which I did. But if it would have been a clinic that wouldn't take insurrence, then I wouldn't have been able to keep seeing her. So at least I didn't had to leave her then.
But now she's going on leave for a long time. And I feel a lot of anger about it.

I have send her an angry email. I wrote that I think it would be better if I quit, because this is giving me a lot of extra worries and something about that leaving a client in the middle of treatment is one of the worst things a T can do (abuse being the worst).
I send it, I think the day after me session. I got an email back. It seemed like my email did got to her.
I kind of wanted to make her feel a fraction of what she make me feel. Mean, I know. But sometimes T's...
I send her an email back explaining some of the things from the other email. And at the next session we talked about it. I don't feel better.

Sorry for bothering you with my stuff. But I can understand how you feel. Though if I would be in your shoes, I would be even more angry than I'now with my T.

I think it would be good to give her a letter with whatever you want to tell her. Even if there's a lot of anger in it. And if you want to give it at the end of the session, do it. But do go back next week to talk about it. I don't think it would be good for you to keep all your anger or concerns for yourself. You've only about three months left with her.

For me it would be very hard to work on the things why I started therapy if I know that my T would be gone in a few months and it wasn't by my choice.
I feel this too. Why would I talk about my upcoming exams or starting college if she won't be there for me when those things will be happening. Since her ''news'' I only worry about what I will do when she's on leave and how I'll miss her and I feel abandeoned and I feel like I'm only work, that won't even cross her mind for a seconded when she's on leave.

I wish you all the best. I hope you can work something out and that you can keep seeing her. Maybe if you talk to her about it, she can talk to her boss or whatever?

[Lauliza]

I understand your anger. This didn't happen to me with a T, but my ObGyn did the same thing. She worked out of a major hospital and delivered two of my three kids and was the only gynocologist I'd ever had (I saw her other times outside of having kids). I got a letter she was leaving the hospital to practice at a low income clinic and was not taking any patients that didn't use this clinic. I was devastated that even if I could pay another way I could still not see her. I understood what she was but I still thought it was very unfair. I know it sounds weird to be so loyal to a gyno, but he had quite a following of patients.

In your case it's worse since she could still see private pay patients on the side but is choosing not to, which is odd. I'd write everything you want to but refrain from actually giving it to her. She may change her mind and see private patients in the future so you might want to end on less hostile terms. I definitely see the value in getting it all off your chest, however.

[ListenMoreTalkLess]

Originally Posted by AncientMelody

As I mentioned over on the bipolar section; my husband and I suspect I might be having hypomanias. I was going to discuss this with her tomoarrow. I don't really want to now. What's the point. I'm not interested in seeing another psychiatrist right now. actually what I really want to do is mention it in passing at the end of the session, after I am done having to sit and listen to her canned speech about transfer of care and how she enjoyed working with me, yada yada.

At the end of session I'd like to just drop it in her lap, my self assessment, the detailed letter where I tried to concisely explain my concerns. Oh by the way at the end of the session and walk out

I respect a T or anyone else for choosing a different job that is more in line with her values. I can understand why any health provider or professional makes a choice to work with indigent clients. The desire to work and help those with the fewest resources is a laudable one, especially when it's rarely the highest paying way to go.

I had one therapist who I had to end early with because he changed jobs to where he was only going to be supervising students and not seeing clients any more. I was very attached and had very little time, less than 2 weeks, to make a switch and we did focus on me finding someone else for the time that we had left. I don't really remember much of it, but I was very pissed off.

I don't know if this is true for you, but my experience was that I wasn't just angry and sad that he was leaving before I was ready too. I was angry and sad at everyone in the past who had let me down, who weren't there for me when I needed them to be, and having to lose my T just brought all those unresolved losses to the forefront-- along with my having to acknowledge that I hadn't done well for myself in building a support network of people nor was I in the right job for me.

So the thing isn't about just thing. I sense that there is more going on with you than just the impulses you're having about saying goodbye in a way that doesn't seem to really honor the work you've done or point towards a positive future for yourself. I think if you can tune into understanding what your T leaving is symbolizing or bringing up for you, you may be able to turn this unfortunate event into something that moves you forward in your own life.

[AncientMelody]

well I think the big reason she made the switch was for family reasons, but I respect that too. She should go wherever she feels she needs to, I don't argue that. My issue is with a health care system that won't allow for an established patient to continue seeing her current provider even though she is willing to pay out of pocket to do so. My issue is that for a medical provider to work with the indigent population it requires enormous personal resources to make that system work. There should be appropriate medical and mental support to allow these providers to maintain their own health while helping their patients maximize their own health.

I did see her today, but I am too tired to go into more detail; I'll update tomorrow. I didn't pull the crap I suggested earlier, I don't think that was ever the intent. I did need to let out some hurt and anger last night so the forum helped with that. lol

[ListenMoreTalkLess]

Originally Posted by AncientMelody

My issue is with a health care system that won't allow for an established patient to continue seeing her current provider even though she is willing to pay out of pocket to do so.

The problem is that for every hour that a private pay client takes up, there is one less hour for a client who cannot pay and must rely on said health care system. A private pay client has the resources to use any of multiple providers, an indigent client can only go to the free clinic. I don't see why you should be entitled to use the services of an indigent clinic, whether you pay or not, as you are taking care away from somebody who has no other place to go.

Some T's make this work by having a private practice on top of a job at a clinic, but your T has chosen not to do so.

It is not always desirable to change therapists, but as the cliche goes, there are definitely more fish in the sea.

[AncientMelody]

Thank you for your compassion.... I DON'T have a ton of resources. There is the notion because someone can afford to pay for a session that they have "Resources". That is a fallacy. There is more to resources than finances. Some people just do not get that. My limited resources are that of time and location. There are very few private practicing therapists in the area because they work in the CMH offices primarily

This post does not need to be about championing the cause for the destitute. There are many avenues for that. THIS POST should be allowed to be about me and my personal loss.

[ListenMoreTalkLess]

Posters on this board are not required to buy into anyone's personal beliefs about the problems with "the health care system." If you don't want people to comment on what appears to be distorted beliefs, then make your post about just your personal loss and leave the entitled statements about the system out. Or better yet, state that you are only seeking brainless support from people who agree with you. Now I know.

I'm sure that you have the resources to find another private therapist. I do not believe that you have fewer resources of any type than the indigent folks who only have the choice to use community mental health centers. Many of them would gladly switch places with you.

I may lose my psychiatrist too. I see mine where his offices are at the local teaching hopital. He is on the faculty as a professor and instructor. I have been given notice that they are restructuring the university medical college and he will have his practise cut back to a 1/4 time. He will be having to cut back on his patient numbers as a result. So now I play the waiting game to find out if I have 'won the lottery' and am chosen to remain one of his patients. Sigh. I don't like this as I have done well under his care. I don't do well with change - especially when it is unknown what will happen.

Agree with Listenmoretalkless. I don't have a choice. I cannot pick and choose my healthcare team. I make do with who I am assigned to.

(((AncientMelody))). I'm sorry this is happening to you. I feel for you. You should have every right to continuity of care.

Is there a possibility of bartering with her? Your professional skills volunteering in a project that is dear to her, for your continuing with her. Even, if it's off the books?

Good luck to you.

[stopdog]

I am sorry this is happening to you. It is hard to find professionals one can work with and it is a loss.

[clairelisbeth]

Originally Posted by ListenMoreTalkLess

Posters on this board are not required to buy into anyone's personal beliefs about the problems with "the health care system." If you don't want people to comment on what appears to be distorted beliefs, then make your post about just your personal loss and leave the entitled statements about the system out. Or better yet, state that you are only seeking brainless support from people who agree with you. Now I know.

I'm sure that you have the resources to find another private therapist. I do not believe that you have fewer resources of any type than the indigent folks who only have the choice to use community mental health centers. Many of them would gladly switch places with you.

Geez, that's kind of harsh and uncalled for.

AncientMelody-it's totally understandable that you are upset. I would be too.

Sent from my iPhone using Tapatalk

[AncientMelody]

Thanks guys.

She was kind enough to offer after-hours appointments for me a brief while; my office is about an hour from hers. It was not really a sustainable situation for either of us. Like myself she has small children and she needs to be available to them. So I can understand that.

All that raging in my first post was me needing to let out frustration. The imagined scenario did not come to pass...it never would with me, really. To be sure it was an awkward session.....a lot more dead air than usual. Her last day at the office is June 30th. I do have a couple more sessions set up with her. We did talk about my concerns about possible bipolar symptoms. She thinks it's non diagnostic, but to keep an eye on it, which more or less coincides with what I felt.

[AncientMelody]

Originally Posted by ListenMoreTalkLess

I respect a T or anyone else for choosing a different job that is more in line with her values. I can understand why any health provider or professional makes a choice to work with indigent clients. The desire to work and help those with the fewest resources is a laudable one, especially when it's rarely the highest paying way to go.

I had one therapist who I had to end early with because he changed jobs to where he was only going to be supervising students and not seeing clients any more. I was very attached and had very little time, less than 2 weeks, to make a switch and we did focus on me finding someone else for the time that we had left. I don't really remember much of it, but I was very pissed off.

I don't know if this is true for you, but my experience was that I wasn't just angry and sad that he was leaving before I was ready too. I was angry and sad at everyone in the past who had let me down, who weren't there for me when I needed them to be, and having to lose my T just brought all those unresolved losses to the forefront-- along with my having to acknowledge that I hadn't done well for myself in building a support network of people nor was I in the right job for me.

So the thing isn't about just thing. I sense that there is more going on with you than just the impulses you're having about saying goodbye in a way that doesn't seem to really honor the work you've done or point towards a positive future for yourself. I think if you can tune into understanding what your T leaving is symbolizing or bringing up for you, you may be able to turn this unfortunate event into something that moves you forward in your own life.

Well I would like to focus on this bit here because I do appreciate what you have written here. Yes it's about more...it's about a loss of control. I have been pushed into my last couple of life transitsions due to circumstance rather than active choice. They've worked fine, but I am tired of not having control.

I've worried for awhile that she'd be leaving completely. Although she says this was a recent decision, I've seen pattern in her availability dip every 6 months or so. I regret not making an active choice when I saw this to start drawing our time to a close. To make it my decision and not happenstance.

[AncientMelody]

Originally Posted by ListenMoreTalkLess

Posters on this board are not required to buy into anyone's personal beliefs about the problems with "the health care system." If you don't want people to comment on what appears to be distorted beliefs, then make your post about just your personal loss and leave the entitled statements about the system out. Or better yet, state that you are only seeking brainless support from people who agree with you. Now I know.

I'm sure that you have the resources to find another private therapist. I do not believe that you have fewer resources of any type than the indigent folks who only have the choice to use community mental health centers. Many of them would gladly switch places with you.

I don't believe I have any distorted beliefs about the health care system. I have re-read my post after I have been emotionally distant from the original post and I don't see anything inherently flawed in what I said. Frustration in spades yes. I was very frustrated. I've been dealing with a severe sleep disorder which has been close to costing me my job. So yeah, I was a bit overwhelmed when I learned I was losing my psychiatrist to boot. But nothing I said was incorrect or offensive in any way.