I wrote this letter to my doctor regarding a disability form I needed to have signed. A simple extension form, one page, maybe 5 lines of text to be filled in, half dates.

I wrote the letter in a blind rage over the fact that it took more than 10 days to get someone to sign the thing, and I had been depending on it for my rent. I wrote several drafts, and it still came out to just over 4 pages, typed.

I won't bore y'all with the whole letter, but here's a sizable excerpt.

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Dear Dr. X,

I am writing this because I am unhappy with the treatment I have received. As you are the head of my treatment "team," I am addressing it to you and cc:ing other interested parties in hopes that some changes might be made to avoid similar situations in the future.

My complaint is with the treatment of administrative issues in the your department, specifically with a very difficult time I had getting a simple and routine disability form delivered to you and filled out in a timely manner. I tried several times and ways to get this form to you, and due to what I see as a lack of care for the process or documents involved, the result has been a fiasco, delaying the form's delivery to the EDD by more than 8 days... 8 days needed to process the form so that I could have a payment in time to pay my rent.

I will state that the story below is from my perspective alone, and there may be several mitigating factors of which I am not aware. For instance the fact that the winter holiday was approaching and several people involved were working toward days off during that holiday. I understand this and have sympathy for the stress that it brings and understand there may be other issues I don’t know about.

On Sunday, December 16th I received a final check for my disability and a note explaining that I'd need my doctor to sign the enclosed form to extend the disability coverage. This was a concern because I was traveling that night to the small town of McArthur, California, a remote town in the northeastern corner of California. I was worried that, if I waited until my return, it wouldn't get to the EDD in time to get a check before the end of the month.

Instead of waiting, on Wednesday December 19th at 12:08pm I wrote an e-mail using the "e-mail your doctor" system telling you the form was coming via fax. I used a fax machine in my parents' home to send the form to the Psychiatry department with a cover letter with a request to cc: your nurse in hopes that it might be expedited in the event you were away.

On Thursday, December 20, 2007 I was traveling back to San Francisco via car, and I received a phone message from you at 2:28pm. You said you had received the e-mail, and the cover letter, but that the form was missing (you seemed to believe that I hadn't sent a form). I immediately returned the call, explaining that I had sent the form, and I believe I also called your nurse, explaining status in hopes she might have gotten a copy of it all (as I had requested the cc:).

Shortly you called back, explaining that someone at the front desk remembered seeing the form, but that it had now disappeared and could not be found. This put us both in a dilemma, as you were leaving for a short holiday vacation and would not be around when I returned to San Francisco, and I was on the road, unable to fax the form to you. I asked that you work with your nurse to find out what needed to be done to have another doctor sign it, and to have her call me once she had the information. Hours later, at around 5pm, I called her, and she said I needed to get the form to Mr. Y and that he would have to take care of it. Your nurse sounded annoyed in this conversation, as if it was a bother to have to give me this information. Although this was my 3rd call to her that day, she did not acknowledge the previous calls in any way.

I immediately wrote Mr. Y 2 e-mails, explaining the situation, and that I'd be dropping the form by the next day. On the 21st I called Mr Y. at around 10 to doubly verify, and then dropped the forms at the front desk at Noon. At the front desk I asked the receptionist to a) staple the form to the cover note, b) put both in Mr. Y’s box, and c) call him and let him know they were there. I stood there as she called and spoke to Mr. Y.

At this point I thought all was handled and that the form was taken care of. I still had hopes that I'd be able to receive a check in time.

On, December 28, 2007, I received a call from Mr. Y at 10:30am, stating that he had just received the form, and that I had not dropped it off when he had expected me to. I explained that this was not correct and that I had watched while the receptionist called and told him that it was there. He seemed surprised, and went on to tell me that you, were back and that he'd be having you sign it, and that if I wanted to further expedite it I could deliver it to the EDD myself rather than mailing it. During this conversation I told him that he had not yet read my e-mail of the 20th, and had a lengthy discussion about the fact that I was upset and why.

At first he was defensive, for himself but more for the department. On listening to me and reading my e-mail he became more sympathetic, I think realizing that I really had been putting forth a great deal of effort to get this done properly. He did apologize at the end of our conversation and stated that he'd call me once you had signed the form so I could pick it up at the front desk to take it to the EDD. This was the first moment that I felt that someone there really cared whether or not the form was signed and that I was taken care of.

There are some real, physical changes that I think can and should be implemented if your office wants to work smoothly with clients and insure a continued flow toward health. Not fixing these things could cause patients to stop seeking altogether for feeling that they really aren't being cared for. I will admit that in this case I do not feel properly cared for. I am angry, and feel betrayed by those I trust with my care.

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The letter goes on to talk about things they specifically need to improve... like the fact that it is inexcusable for a document to enter the facility, be seen and recognized, and then be "oops" lost.

Mostly I went on to say, though, that what needs to be changed, is the attitude. That I was made to feel by medical personnel that I was a nuisance and a bother, and I had to take into account how busy the doctors are (as if their business is more important than mine, or their other business is more important than my care). If one person there had stood up and made me feel like they thought it was important to have it signed, one person to take responsibility, like it was their job or something, I don't think I'd have been nearly as mad... even if it had taken longer! As it is, my stomach tightens up horribly just thinking about talking to them at all, now.

I did, somehow, get it into EDD in time to get a check and pay my rent (though I went there in person to do it). The rage over it all still simmers a bit, and I'm still waiting a full response (I did get a letter of apology saying they do care about me and my care... but somehow it falls flat with the appended excuse of "I still think we could have done a better job of it before the holidays"). I'll post more if I get more.