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My difficult child's appointment with pediatrician. Psychologist
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<blockquote data-quote="Marguerite" data-source="post: 23733" data-attributes="member: 1991"><p>MWM, I didn't mean to disparage hospital procedures, it was more a comparison. There are advantages and disadvantages to each method. In our experience, our hospital clinics tend to be more overloaded and to deal with this, often hand out initial screening appointments to junior staff. The aim of this exercise is to give experience (which is always useful) and to also quickly sort through the enormous scope of the caseloads. It sounds like in this situation a private clinic is doing the same thing. The good things about this - it can cut through the cr*p fast, help you get answers faster than you have been. it provides early and intensive training to the right people. It can assess and assign patients more appropriately en mass. </p><p>The disadvantages - sometimes these people are given too much leeway, too much credence and they make mistakes that can follow the patient for a long time. And even if the first consult with the health professional whose name is on the practice sorts out any misunderstandings, you still have the annoyance and frustration to deal with. Too often, though, the reason these interns (I'm using the term loosely here) HAVE the confidence to make these snap assessments is because their employer and supervisor doesn't challenge their initial assessment often enough. So be aware of this - you may have to work hard to set the record straight.</p><p></p><p>Several things then come to mind here - </p><p></p><p>1) The practice sounds like it could be overloaded, if initial consults are handled by a subordinate.</p><p></p><p>2) You could also have a 'revolving door' practice here, where everybody comes out with the same diagnosis.</p><p></p><p>3) Or this could work out well if the psychologist herself goes through the files thoroughly, takes on board the concerns of the neurologist and your recollections about his history, and isn't swayed by preconceptions. My main concern - if this is likely, then why would she farm you out to an intern?</p><p></p><p>We went through a similar process with difficult child 3 while waiting for 'urgent speech pathology intervention". The first hoop we had to jump through, after an initial assessment to determine difficult child 3's receptive and expressive language status, was to attend a class for parents with kids who had a language delay. There were at least a dozen of us who had to meet on a weekly basis for ten weeks, two hour sessions. For the first half the kids were minded downstairs while we were lectured to about how to talk to our children. Then we spent the next hour playing with our kids according to rules we'd been given and while the therapists prowled around to make sure we did what we were told. To me it felt like fiddling while Rome burned - I knew difficult child 3 needed urgent therapy, I didn't need to be taught how to talk to him because I knew what was getting results and what wasn't. A lot of the things they told me to do clearly were a backward step for difficult child 3 but they made me do it anyway. To refuse would have had us kicked out of the program and we would have lost our chance at the eventual therapy.</p><p>Because we spent so much time together I got to know the other mums (there were no dads in this lot) and I knew what the therapists were trying to do - they were trying to cut back on the number of clients needing/wanting therapy. Of the dozen kids, there would have been at least 8 who benefited sufficiently from this to be shunted elsewhere in the system.</p><p>difficult child 3's autistic friend never got his therapy because his mother couldn't get herself to these sessions every week. She dropped out after three weeks, and so they dropped him even though he needed the therapy. She always played with him according to the rules they gave me - I remember how much stimulation this boy got - but she had no way to get to the clinic regularly.</p><p></p><p>So hang in there, see how the next appointment goes and make your decision then. But in the meantime, can you book another appointment with someone else, on the assumption that this pediatric psychologist may not work out? Then when you know for sure either way, you can either cancel or keep the appointment with the new person.</p><p>And when you make the appointment, make it clear that your husband wants to attend (as is his right - a lot of these clinics forget that) and if they are likely to be running late to please let you know so you can make arrangements. he is rearranging his schedule to fit in with the time they specified - they need to be accomodating also. You are clients, not supplicants.</p><p></p><p>When we were trying to get difficult child 3 assessed I ended up making appointments with specialists all around Sydney (which is really saying something! This place is huge in area) and would cancel appointments if we got in to see an equivalent person sooner. I also asked each time to be put on a cancellation list, which meant a few times we had to rush because we'd get a phone call saying "Dr so-and-so has had a last minute cancellation - can you get here in two hours?" Sydney is three hours' drive across, but most of the time we could get there because we had a day's notice. And as happened with the pediatrician we settled with, he has other rooms closer to where we live so he's really quite convenient.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 23733, member: 1991"] MWM, I didn't mean to disparage hospital procedures, it was more a comparison. There are advantages and disadvantages to each method. In our experience, our hospital clinics tend to be more overloaded and to deal with this, often hand out initial screening appointments to junior staff. The aim of this exercise is to give experience (which is always useful) and to also quickly sort through the enormous scope of the caseloads. It sounds like in this situation a private clinic is doing the same thing. The good things about this - it can cut through the cr*p fast, help you get answers faster than you have been. it provides early and intensive training to the right people. It can assess and assign patients more appropriately en mass. The disadvantages - sometimes these people are given too much leeway, too much credence and they make mistakes that can follow the patient for a long time. And even if the first consult with the health professional whose name is on the practice sorts out any misunderstandings, you still have the annoyance and frustration to deal with. Too often, though, the reason these interns (I'm using the term loosely here) HAVE the confidence to make these snap assessments is because their employer and supervisor doesn't challenge their initial assessment often enough. So be aware of this - you may have to work hard to set the record straight. Several things then come to mind here - 1) The practice sounds like it could be overloaded, if initial consults are handled by a subordinate. 2) You could also have a 'revolving door' practice here, where everybody comes out with the same diagnosis. 3) Or this could work out well if the psychologist herself goes through the files thoroughly, takes on board the concerns of the neurologist and your recollections about his history, and isn't swayed by preconceptions. My main concern - if this is likely, then why would she farm you out to an intern? We went through a similar process with difficult child 3 while waiting for 'urgent speech pathology intervention". The first hoop we had to jump through, after an initial assessment to determine difficult child 3's receptive and expressive language status, was to attend a class for parents with kids who had a language delay. There were at least a dozen of us who had to meet on a weekly basis for ten weeks, two hour sessions. For the first half the kids were minded downstairs while we were lectured to about how to talk to our children. Then we spent the next hour playing with our kids according to rules we'd been given and while the therapists prowled around to make sure we did what we were told. To me it felt like fiddling while Rome burned - I knew difficult child 3 needed urgent therapy, I didn't need to be taught how to talk to him because I knew what was getting results and what wasn't. A lot of the things they told me to do clearly were a backward step for difficult child 3 but they made me do it anyway. To refuse would have had us kicked out of the program and we would have lost our chance at the eventual therapy. Because we spent so much time together I got to know the other mums (there were no dads in this lot) and I knew what the therapists were trying to do - they were trying to cut back on the number of clients needing/wanting therapy. Of the dozen kids, there would have been at least 8 who benefited sufficiently from this to be shunted elsewhere in the system. difficult child 3's autistic friend never got his therapy because his mother couldn't get herself to these sessions every week. She dropped out after three weeks, and so they dropped him even though he needed the therapy. She always played with him according to the rules they gave me - I remember how much stimulation this boy got - but she had no way to get to the clinic regularly. So hang in there, see how the next appointment goes and make your decision then. But in the meantime, can you book another appointment with someone else, on the assumption that this pediatric psychologist may not work out? Then when you know for sure either way, you can either cancel or keep the appointment with the new person. And when you make the appointment, make it clear that your husband wants to attend (as is his right - a lot of these clinics forget that) and if they are likely to be running late to please let you know so you can make arrangements. he is rearranging his schedule to fit in with the time they specified - they need to be accomodating also. You are clients, not supplicants. When we were trying to get difficult child 3 assessed I ended up making appointments with specialists all around Sydney (which is really saying something! This place is huge in area) and would cancel appointments if we got in to see an equivalent person sooner. I also asked each time to be put on a cancellation list, which meant a few times we had to rush because we'd get a phone call saying "Dr so-and-so has had a last minute cancellation - can you get here in two hours?" Sydney is three hours' drive across, but most of the time we could get there because we had a day's notice. And as happened with the pediatrician we settled with, he has other rooms closer to where we live so he's really quite convenient. Marg [/QUOTE]
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