1y ago

What is a well known 'public secret' in the industry you work in that the majority of outsiders are unaware of?

You're viewing a single thread.

661 comments

This pertains to the US:
A lot of people are unaware of cancelation lists, and a lot of providers don't really advertise that. When I was a casemanager for adults with severe mental illness, I would always ask to have my clients added to the cancelation list, and this would often get them in much sooner.
Also butted heads with a receptionist last year when my client was literally experiencing congestive heartfailure and she wanted to schedule him like 1.5 months out to see his specialist about having a defibrillator implanted. I said it was unacceptable and said he needed to be added to the emergency openings I know the providers reserve. She got a look on her face and said "But I need to get provider approval for that.." I told her "I think you better talk to the doctor then."
Specialist eventually came over to scheduling and asked what was going on. The receptionist said what we wanted and asked if she would approve it, with a real dismissing inflection. The specialist said "Oh my god, yeah of course he's approved for the emergency list.."
Some of these things are just so overlooked/unknown by the general public. And sometimes you've got to be assertive and stick with your guns to be treated fairly and get the attention you deserve. Especially now more than ever. Our healthcare system was bad before, but it's been so strained ever since covid...
The healthcare system can be a nightmare for average people functioning well. It is so much worse for the population experiencing severe mental illness/with cognitive disability. This barrier for care plays a significant role in the reduced life expectancy in the disadvantaged population I worked with.
Patients suffering from severe mental disorders, including schizophrenia, major depression and bipolar disorders, have a reduced life expectancy compared to the general population of up to 10–25 years. This mortality gap requires urgent actions from a public health perspective in order to be reduced. Source
If anyone reading this has family or friends with severe mental illness or trouble with intellectual functioning, you may want to offer some support for doctors appointments. Honestly, everyone would benefit from having another person in their appointments for support and as a second set of ears.
Anyone reading this with severe mental illness, don't be afraid to reach out for support. If you don't have a social support system, there are services out there to help. Try to find social services in your area to get some help navigating thru all the bullshit. And don't give up hope.
Always like to share this website with free evidence-based resources that I used all the time with my clients. I personally benefitted from the material as well.
- Also butted heads with a receptionist last year when my client was literally experiencing congestive heartfailure and she wanted to schedule him like 1.5 months out to see his specialist about having a defibrillator implanted. I said it was unacceptable and said he needed to be added to the emergency openings I know the providers reserve. She got a look on her face and said "But I need to get provider approval for that.." I told her "I think you better talk to the doctor then."
  Specialist eventually came over to scheduling and asked what was going on. The receptionist said what we wanted and asked if she would approve it, with a real dismissing inflection. The specialist said "Oh my god, yeah of course he's approved for the emergency list.."
  I'm not sure I understand what happened here. Was this all just because the receptionist didn't want to ask for approval because it seemed like a hassle?
  
  Yep.. at least that was my guess. Didn't want to pull the specialist back out of what she was then doing/didn't want the hassle. But I was adamant that we weren't going anywhere until she checked.
  Some people are just finicky and I can't really say for sure what her deal was, but her demeanor was just rude and like she didn't have the time of day to give us...
  
  What a fucking bizarre attitude to have when working in healthcare. Laziness in that area can cause deaths.
  
  It's more prevalent in the industry than you'd like to think.. Burnout is often linked with lack of empathy.
  I worked exclusively with adults whose illness was severe enough that they were residing in various residential care facilities (RCFs) and assisted living facilities (ALFs) in my region.
  I was a 3rd party and a mandated reporter and I can't tell you how many times I hotlined facilities and did internal/DMH/DHSS reporting/assistance with investigations. Misallocation of Client funds was a common problem (especially at specific RCFs), medication errors/stealing Residents' meds, neglect of facilities/cleaning, improper nutrition, and abuse and neglect were all too common...
  At first I thought the same thing when I started that position, wondering why someone like that would even take those positions. But people are complicated and often shitty. Some people like to power trip, some people want to take advantage of the disadvantaged, some people's self-care is so neglected by being over-worked that they no longer have the capacity, and some people are just assholes...
  
  This just makes me sad. :(
  
  There's so much wrong with the system and so much that could done to improve it, but I don't want to frame it here in a hopeless sort of way. Our treatment options and accessibility continue to improve, social stigma of mental illness has improved tremously in the last decade or two, and there's no reason to think further advancement won't continue. But acknowledging the current shortcomings and feeling sad and angry about it are important to drive that positive change.
  
  I'm in total agreement. What we need is fully nationalised healthcare, with direct political participation from the people.
- Reduced mental function definitely includes dementia; my mom had Parkinson's disease and definitely needed my help and advocacy and memory.

661 comments