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RE: A Question Of Balance And Discretion - 2/24/2009 5:39:58 PM   
hizgeorgiapeach


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Not to mention that it's a violation of Doctor Patient Confidentiality, if you haven't specifically given him Permission to do so.
 
Camille, you are NOT Obligated to allow him to send a transcript of your psycho-therapy sessions to ANYONE.  Not even to the GP on staff at the clinic where you're being treated.  If they tell you that you Are obligated to do so - they're Lying, and attempting to coerce you into disregarding your Legal Rights under the HIPPA laws to Privacy and Confidentiality between yourself and your doctor or treatment specialist.  If they raise a stink about it - threaten to bring in a lawyer, that'll change their tune Real quick.

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RE: A Question Of Balance And Discretion - 2/24/2009 5:44:31 PM   
camille65


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He told me it was standard practice.. I have never seen a therapist before so its a learn-as-I-go thing and I don't like what I'm learning. Argh. Yeah he sends the info when I leave each time, am going to ask to read what he sends. Do more research (yay more questions for ya all) and um.. decide next step.

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RE: A Question Of Balance And Discretion - 2/24/2009 5:55:30 PM   
hopelessfool


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cam, next time you go in, ask to see the supervisor or higher up on the floor, say you feel your rights for phi have been violated. and youd like to have the steps to file a formal complaint against the shrink in question. if they deny it conact your states hippa compliant investigator. i think thats what hes called. im not really remembering the 3 hour hippa lecture, except dont do it dont do it and for fucks sakes dont do it

The ONLY information a doctor can release with out your autherization is your dates of service (when you go in) and a very basic reason why hes treating you like therapy and only therapy.  I believe the wonderful hippa packet said.

IF you revoke your consent in writing (the only way to really do it) and he releases it threaten to sue the clinic for violation of your hippa rights, its 10 years in a federal prision and fines up to 250k as well as money to you due to being violated..

He does not have the right to release your info to any doctors unless you consent or its considered medically necessary to treat you,  or its needed for billing processes, like to get insurances to pay but since your considered and SP clinent (self pay) this part isnt necessary. Also i would ask the clinic if they have a self pay discount for patients that pay their bills in full in a set number of days, to try to save you some costs ... However your strink doesnt need to send your records because head and body espically with these diseases arent corilated. If he says he needs them due to medical necessity, ask for proof of it, ask why does the RH doc need it?



< Message edited by hopelessfool -- 2/24/2009 5:58:32 PM >


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RE: A Question Of Balance And Discretion - 2/24/2009 7:20:10 PM   
Crush


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Camille and  GaPeach,

You two have my sympathies and empathies.   SLE is a difficult disease to live with and to treat, from what I know.  (We though my wife had lupus at one time, but it turned out to be a different autoimmune disorder...still sucks)

Sleep...just relax...you are getting sleepy.....sleepy...you are feeling very relaxed, almost as if..... ;)

Sure hope something works for you beyond our "endorphin rush" moments.  

And yeah, I'd be concerned about my records being typed in that way.  But on the other hand, the doc will know what's up and if confidentiality is broken, well.....email me and I'll give you the new fake IDs site link ;)




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RE: A Question Of Balance And Discretion - 2/24/2009 8:11:37 PM   
Vendaval


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camille,
 
Every profession has various ethical and legal responsibilities and boards that over see liscencing requirements.  A great resource for you to start with is the American Psychological Association.

 
"Mental Health Patient's Bill of Rights"
 
Confidentiality -
 
"Individuals have the right to be guaranteed the protection of the confidentiality of their relationship with their mental health and substance abuse professional, except when laws or ethics dictate otherwise. Any disclosure to another party will be time limited and made with the full written, informed consent of the individuals.
Individuals shall not be required to disclose confidential, privileged, or other information other than diagnosis, prognosis, type of treatment, time and length of treatment, and cost.
 
Entities receiving information for the purposes of benefits determination, public agencies receiving information for health care planning, or any other organization with legitimate right to information will maintain clinical information in confidence with the same rigor and be subject to the same penalties for violation as is the direct provider of care."
 
http://www.apa.org/topics/rights/

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RE: A Question Of Balance And Discretion - 2/25/2009 4:22:07 AM   
camille65


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From: Austin Texas
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quote:

ORIGINAL: Crush


Sleep...just relax...you are getting sleepy.....sleepy...you are feeling very relaxed, almost as if..... ;)

Sure hope something works for you beyond our "endorphin rush" moments.  

l.....email me and I'll give you the new fake IDs site link ;)





Dang you are good! I fell asleep about 3 minutes after reading your post, so will this be a nightly thang between us?
And on the new ID, may I pick out my own name please? It could be the slight rum hangover talking but I like Camille Peacepipe Moonpie......

Vendaval, I thank you for that link. This is the sort of information I need, solidly back stuff that I can read and use. I am beginning to gather a nice assortment of links, thanks to the various folks here and I truly appreciate it.

Hopefully todays appointment with the PA will result is some sort of positive change in my prescriptions, although I am a wee bit stressed out. Apprehensive. Phobic of doctors. In a general bad mood due to the anxiety etc etc etc and just not sure how assertive I can pretend to be. Am going to try though because I have to.

Crapola I wish so badly I didn't have this stupid stupid unmanageable (repeat stupid a few more times too) fear of doctors that just paralyzes me, silences me. Hah. Had hoped that the therapist was going to help with it, told him on the first session and... well its all about 'breathing the pain away'. Sorry that I sound bitchy, its the scaredness talking.


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RE: A Question Of Balance And Discretion - 2/25/2009 4:29:47 AM   
Vendaval


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Just imagine them in their underwear since they see you in one of those paper doilies. Makes them seem far less threatening.   Take notes on a steno pad and casually drop words like lawyer and HIPPA and patient advocate into the conversation. 

_____________________________

"Beware, the woods at night, beware the lunar light.
So in this gray haze we'll be meating again, and on that
great day, I will tease you all the same."
"WOLF MOON", OCTOBER RUST, TYPE O NEGATIVE


http://KinkMeet.co.uk

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RE: A Question Of Balance And Discretion - 2/25/2009 4:57:56 AM   
camille65


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Good morning Vendaval.

I hesitate to do that. They can fire me as a patient and from what I've heard at physical therapy, that kind of news spreads fast.

The more I research and read, the angrier I get. The more trapped feeling I get too. Hopefully I will be able to communicate properly thru the cognitive difficulties of this yet another flare up. Ohboy I wish I could type to her rather than speak!


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RE: A Question Of Balance And Discretion - 2/25/2009 7:44:10 AM   
GreedyTop


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Camille.. get her email address... then you can compose an email addressing all your concerns and send it to her. If she asks why you want it TELL her.  Let her know you have concerns and questions but would prefer to give them to her in writing.

OR

Just sit down with pen and paper and do it, then hand it to her and ask her if she would be willing to discuss it with you


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RE: A Question Of Balance And Discretion - 2/25/2009 8:31:10 AM   
Lockit


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Mo is where I am and I wouldn't suggest anyone move here with what I have been through!  We may have a law that says that even if they think you are an addict they cannot deny you pain medication, but they find a way around it.  Unfortunatly for me... and for the doctor...if I ever get this thing I am putting together, together... he denied me without an examination, no test, no reading even one page of my medical records... but offered me a medication that could cause me serious damage that I refused to allow.  So he can stand on... we offered to treat her pain.. she refused it.  But what he doesn't know about my rare illness is what I told him in front of a witness... my daughter... and I have found proof that I was in the right to refuse the medication and it isn't something I said, but medical professionals.

Everyone I spoke to in trying to get a doctor and help said it would be difficult to get here. 

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RE: A Question Of Balance And Discretion - 2/25/2009 9:17:51 AM   
Crush


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I'll send a podcast, Camille ;)

One of my lectures that guarantees at least 50% of my students will nod off in class...hmmm...how about "The inner workings of a transistor" or "Chaos Theory...or why things don't ever go they way they are supposed to" Both guaranteed to be snoozers without the powerpoint!



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"In religion and politics, people's beliefs and convictions are in almost every case gotten at second hand, and without examination." -- Mark Twain

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RE: A Question Of Balance And Discretion - 2/25/2009 10:45:41 AM   
camille65


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It ended up being a pretty messed up appointment IMO, but I think I have to stick it out for 6 months. I am documenting everything and unless things change drastically, I am going to end up having to take action.

My frustration level.. is off the scale. My pain level is right next to it. I'm kinda of stunned that this is all happening and I am going to take my breakthrough Morphine that I saved... drug tests be damned, I have to have a few hours of relief.

They did agree to drop the Lyrica level (but not eliminate it..sigh) to my beginning level. However there won't be any tapering off. So it is going to be a rocky week for me. I can't handle the side effects of the higher dosage and once past the crap of dropping the dosage minus the proper tapering I hope to have some improvement.

I cannot believe the depths of my anger right now, with no outlet. I am not an angry person, really I'm not. 'Nuff, I've for once run out of words.


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RE: A Question Of Balance And Discretion - 2/25/2009 11:01:13 AM   
sirsholly


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quote:

Is is okay that this therapist guy, types every word I say then sends that on to the doctor? Because that is what he does, he told me I am free to read over what he types but I've been reluctant to do so.

it is a standard practice to give a brief paragraph or two to the recommending MD. However...word for word is a new one on me. You can request that he stop with the details.

Camille...i am a licensed therapist. If i received a referal from a pain clinic for a patient with fibro and TMJ i would write the doctor a not so sweet note suggesting he stop
pushing his patients off to therapists and write the damn scripts already. If i had the chance to talk to the patient i would be very much tempted to suggest they locate another pain clinic. Tempted, but not able to do so...ethics et al.

One thing i am not is trained in Bio-Feedback, which might be of help to you, I have heard good things as far as pain control. Perhaps this is something you can suggest?




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RE: A Question Of Balance And Discretion - 2/25/2009 11:52:05 AM   
sirsholly


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Also...i have read here that there is a possibility of the HIPPA laws. If you think there is Camille then you have every right to complain. However...before you do so, might i suggest you ask for a copy of the admission (or new patient) paperwork you filled out on or prior to your first visit to the clinic? You may find that you did in fact authorize a release of information.

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RE: A Question Of Balance And Discretion - 2/25/2009 12:30:16 PM   
kdsub


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If you need this...if it is a last resort...or it gives hope...Then be brutally honest in every detail. Why go throught the process to lie? What do you care what he thinks of you...You are there for you.

Is it you will be embarrassed?...are you afraid of being outed? What it important to you... your fear of the truth or the fear of pain.

I hope you make the right choice for YOU.

Butch

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RE: A Question Of Balance And Discretion - 2/25/2009 1:36:47 PM   
camille65


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Hi kdsub,
Naw I don't care what he thinks about me (much), nor worry about being outed, however I do have to be careful with what I reveal. If he were a therapist with no connection to anyone else? Then I would tell all, but if there is a chance that he completely misunderstands and sees it as a sick co-dependent relationship then I am putting my entire standing at this pain clinic at risk. If that happens it is likely that if I leave that clinic it will follow me with negative results.

He is not a therapist I chose, he works in conjunction with the pain clinic and reports to them. Not me. I have limited options when it comes to doctors in this area and I take medication that cannot be interrupted.

That is why I am asking advice although as time goes on I am finding that I am running into more questions.

Holly hihi. I am trying to figure out what paperwork you refer to. They'd lost my consent forms and I resigned them today, there was no mention of privacy in those 2 pages. It was about "...goal may be to also mean eventual withdrawl from all medication." and stuff about making sure I alert about pregnancy, potential problems with long term medication use, firing me as a patient if I abuse prescriptions or take street drugs.

It is possible I signed other stuff, I am having a tough time remembering things. Today I wrote down every word that passed.

HIPAA isn't really the biggest issue for me, its the inability to get the medication needed to return me to 3 months ago. Ugh I feel like I've actually slid back 3 years progress but they have their own agenda. Which is "goal will mean eventual withdrawl from all medication" (hah, I copied that from the informed consent thingie I had to resign today). They believe, truly believe that CBT can conquer auto immune diseases.

So I am stuck for now. A lot happened today that displeased and angered me.



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RE: A Question Of Balance And Discretion - 2/25/2009 3:00:00 PM   
hopelessfool


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Cam, they cant fire you as a patient for complaining about privacy issues, if they do you could sue them big time, as well as the clinic being fined or  be shut down for not following FEDERAL mandated laws.  IF your near any of the borders of TX I would look into seeing if you can find one of the Catholic Health Initivies Hospitals. They tend to be really great on actually helping people instead of this, "your making it up your not REALLY in pain" type of deal.

_____________________________

" I have nothing left to give, I have found the perfect end, You remain to make it hurt, disappear in to the dirt, carry me to heavens arms.....Dear Agony Just let go of me, suffer slowly, is this the way its gotta be, Dear Agony...."

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RE: A Question Of Balance And Discretion - 2/25/2009 4:04:12 PM   
camille65


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Thank you, added to my list of Stuff To Look Up!

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RE: A Question Of Balance And Discretion - 2/25/2009 5:01:19 PM   
SavageFaerie


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Camille

This is one reason I dislike Texas, especially in the bigger cities.

While I dont have fibro or any long term illness, I did have an accident back in 97 that caused permenant all soft tissue damage.  I always have problems when I move. With my mental disabilities I have to play the I know what works game and often just labeled without even touching or looking at my history as a drug seeker, its so damn belittling. The mention of the only muscle relaxer which prevents me from seeking pain killers is the oh drug seeking kind Soma

Then on the other side when I tell them the ONLY antianxiety that has ever worked is xanax, Im often doomed.

Hell I have run across MHMR offices that said they dont treat anxiety (its mhmr for gawds sake) and its policy not to prescribe that medication which is xanax.  Its the only think that ever allowed me to even leave my house. I have been through the gammit of those type drugs they do not work, only xanax

I found a good combo in NYC fairly easily...funny how the big city listens.

Now that I have found my home down in FL I have to dance the dance again soon.

poenkitten saw a new pcp that she likes and she is taking patients and accept medicare. She seemed to actually understand the mental aspect of things.  I have found so many physical doctors that just dont have a clue how difficult it is for someone with severe anxiety disorder.

I tried the therapy route, but it didnt solve the brain chemical issues, nor did anything for past events, I still remember and it still effects me.

So when I mention these two drugs its you jsut want it for receational purposes despite before even seeing my past medical and mental records.

Gads its not like I want to add Vico to it to make the damn Las Vegas cocktail...I just know those work and keep my neck from locking solid and allowing me the ability to move around outside where I live.

Doctors its call quality of life not drug seeking and I get so angry when most just assume.

Camille your in austin now if I remember, I am very familiar with Texas and at least the mental health side.  Let me see what I can drum up...although I would look at local MHMR facilities, allthough I was gobsmacked with the last one saying they dont treat anxiety....still shake my head on that one.

I will also see if my family can recommend anything as I have family near Austin and works in Austin.

I am also dumbfounded that they avoid a cash patient, they arent restricted to ins or medicare limits...but you need to be aware they arent over padding.

Im more than happy to help on the flip side.

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