Diary: The Health System

DIARY: A short while ago, I had decided to apply for sickness benefits at Centrelink whilst I sort out some medical issues. This is because I wouldn’t be able to work for a few months and a regular income is essential. Sounds easy doesn’t it.

I have previously been on unemployment benefits for a few short periods and the only long period was when I was 17 and living away from home. The last time was about 8 years ago and after a few months I found a full time job which was a relief because Centrelink is HELL! I vowed never to return.

I thought the sickness allowance would be different though but there was a new problem ... my doctor! I like my doctor but his administration skills are poorly lacking. Problems usually involve his holidays where it is impossible to contact him or he doesn’t think through the needs of his patients.

Last time he went on holidays, he told me that another doctor would see me whilst he was away. When I turned up, the doctor knew nothing about it. Asking the doctor to ring the health department to authorise a permit for a month’s supply of morphine to a heroin addict was problematic enough but my 6 monthly authority had ran out as well. It finally was approved but it took an hour and the doctor was not happy. In a busy clinic, an hour for one patient means the other patients had to wait that extra time as well. As you can imagine, there were a few complaints.

 So now my doctor was going away again so I explained to him what happened last time. He said he had a better idea and told me to pick up a script in 3 weeks time which he would leave at reception for me. I did as I was told and went to the chemist as usual with the script he had pre-written. Easy. Then it all started again.

To avoid having to apply for a 30 day permit, my doctor had written 3 separate scripts for a lesser quantity to get me by until he returned in 13 days. The pharmacist (who I deal with every week) said the scripts didn’t say weekly pick up so I had to come in every day and pick up one days worth of medication at a time. He told me he knew what the doctor meant and it had always been a weekly pick up but there was nothing he could do. He suggested I ring the doctor’s clinic and get a letter authorising me to pick up weekly and until then I had to come in every day. I paid and left very unhappy.

Luckily the next day, another pharmacist told me that because we had been doing a weekly pick up for so long that he would use his discretion and allow me weekly pick ups. I asked why my regular pharmacist didn’t do the same and I was told that my regular pharmacist wasn’t sure because he wasn’t used to dealing with me. What could I say? He had ONLY been my regular pharmacist for 4 months.

But the worse was yet to come. I then had to pay for another 2 scripts as well. WTF?! So what was normally about $33 per month had to be paid 3 times ... for 13 days supply. Then when I next saw my doctor, I had to pay for another script. In total, I had to pay for 4 scripts for the month, 4 x $33. BTW, When I asked my doctor why the hell he wrote 3 separate scripts and thus 3 separate payments as well as the new script, he just shrugged and said, “oh well”.

 Back to sickness benefits. I had to resupply another medical certificate to replace an older certificate my doctor gave me, which had expired on Feb 10. I went to the doctor and he wrote another certificate. I then went to Centrelink a few days later and there were 60 people in the queue at 4.00pm. I was not going to be seen that day so I came back the next morning. After waiting 45 minutes in the queue I finally was attended to. After 15 minutes of phone calls and talking to other Centrelink employees, the person serving me said that my doctor had not filled out the dates properly so I would need to go back to him, get another medical certificate and return to Centrelink.

Oh dear god! I remembered why I vowed never to rely on Centrelink for income. Maybe I should have vowed never to return to my doctor?

Centrelink was surprisingly good without too many mistakes. It did take 3 months to get the right ID and forms filled out and they forgot to photocopy the back of some document. I wasn’t desperate for cash so it wasn’t too much of a worry. The problem is that I had to go to Centrelink 6 times so far and waiting in a queue for at least 30 minutes each visit. The other complaint is being told different things by different people. All this for $250 a week and a healthcare card. I suppose the healthcare card saves a bit considering all the medication I am on. Over all, I was happy with Centrelink. My real complaint is aimed at my doctor and the chemist. I have written about them before and I think somehow I will write about them again.

When you step back and compare the system I am complaining about to the US health and welfare system, I should count myself lucky. If I had been in the US, I would be homeless and a desperate junkie. Because of my drug history, I would be unemployable and not eligible for welfare housing. I would receive no income support and have to rely on charities for food. My SROM treatment would never had happened and I would not be able to afford methadone. A bleak picture indeed. The US mindset of avoiding “socialised medicine” at any cost is just unworkable ideology from the conservative elite. Leaving health to the business sector, insurance companies and big pharma has not worked out well for the US. For all the faults of our system, the main perpetrators that affected me were private businesses. The Medicare levy now seems like a very small price to pay.

Diary: Is My Pharmacist Committed?

DIARY: Some chemists are notorious for the treatment of methadone patients. And I have had my share of run ins with arrogant pharmacists who feel methadone patients are somehow less important than other customers. But the switch to another medication meant I was a normal customer again, away from the stigma of being just another junkie on methadone. Well, I was wrong...

I am guessing most methadone patients have had the frustrating experience of waiting in line for service only to be overlooked when a regular customer comes to the counter. I am also guessing that many methadone patients have found themselves at odds with the pharmacist on at least one occasion. If you happen to pick the wrong chemist, it can cause methadone patients much, unneeded grief which often erupts into an outburst of frustration and anger. The chemist gladly informs their 2nd rate customer that they are off the program. The ex customer has to then find another chemist, which is usually for the best in the long run.

That all changed for me when I switched to SROM ... well I thought it did. Not having to go to the special counter for methadone patients was a big bonus and I was treated as regular customer who was just receiving a normal prescription. So I thought at first.

My script is presented monthly and I pick up weekly. I had some extra medication at the start so I could come in a few days late if I was unable to get to the chemist on time. I usually pick up Thursday evenings for the following week but sometimes I would leave it until Friday or Saturday and I would just receive a week’s worth of medication. One day that all changed with a different pharmacist. The pharmacist decided that my weekly pick up started on the day I came in and since I was one day late, I would be short a day. She explained the script said “pickup dose every 7 days”. She knew it was a technicality and since my doctor was on holidays, she couldn’t ring him. I finally sorted it out with the owner and I agreed to come in every Thursday to keep it simple. My doctor also changed my script to say “weekly pickup” so I could come in any day within the week.

I stuck to the Thursday agreement but this week I was at a funeral and I forgot to pick up my dose. I came in the next morning as soon as the chemist opened but agian was told that my week now started on Friday instead of Thursday. I was furious and stormed out. I came back to point out the new script but the pharmacist just casually flopped over to the counter sucking on a lollipop and slapped the prescription down without saying a word. I showed her the new wording but she didn’t even respond. I was a customer for fuck’s sake but a junkie is a junkie and I wasn’t worthy of customer status.

I rang the owner but he couldn’t get his head around the days. He said that if i got my medication on Friday, next Thursday would only be 6 days. I said that shouldn’t matter as we had been through this before all I wanted was to pick up my meds on Thursdays like usual. He got mixed up with days and numbers and kept repeating the same illogical outcomes even though he agreed he was wrong only 30 seconds before. His final solution was come in on Thursday as normal and he will just give me 6 days worth to get it back in line. WTF? One mixed up chemist!

It was so simple. I have a one day buffer which means I have my last dose Thursday morning, pickup my script that night and start the next morning, Friday. I have the buffer because I take my dose before 7am so it kicks in by 9am otherwise I am in massive pain and start withdrawal. If I have to wait until the chemist opens at 9am, I am not getting my meds working until 11am-12pm.

I asked them to ring my doctor but somehow this was not an option anymore. Can you picture an insulin patient having to miss a day because they came in a day late? What about someone on medication for a heart attack? A day early is different but this is after the due date. Originally they stated that the script specifically said that medication was every 7 days but when I purposely had the script changed to clear this problem up it wasn’t the issue anymore. They conveniently changed their mind that this was the reason.

Funny enough, I used to come in late one or two days for the first few months and nothing was even mentioned, until I got the pharmacist from hell. Why was I treated with suspicion but they still wouldn’t ring my doctor? I was doing fine coming in every Thursday but one day I come in Friday morning and my medication gets pushed back a day. The pharmacist treated me like shit and this just would not happen with other customers.

I approached another chemist near by and they said they would be happy to treat me as a customer regardless of when I came in. As long as my script said “weekly pickup” and I didn’t come in earlier than the due day, it was up to me when I picked up my medication. I asked them to ring my doctor to make sure but they said it wasn’t necessary because they understood the logic of “weekly pickup”. I wonder what a customer of 10 years has to do to get treated like I was. It all came down to one junior pharmacist and the owner who couldn’t do the maths in his head. One phone call to my doctor would have cleared it all up.

Just as I was getting my life together, I get let down by my doctors and then the chemist. I have enough problems to deal with! It seems that addiction warrants others to put you through extra misery without consideration for being a person with needs and feelings. There are very few positive experiences being an addict with depression and it is extremely upsetting when your only relief, your medication is unnecessarily interfered with. It is easy to become cynical when it happens regularly whilst having the public consider you less than human as well.

Many methadone patients (including myself) have become loud and angry when obvious discrimination occurs and usually it results in punitive action which only inflames the patient even more. I’ve seen it dozens of times at pharmacies especially certain ones that seem to thrive on acting superior to the patient. No one can really understand until they have been through it and I don’t wish it on anyone. I have never heard one single methadone patient ever ask for anything more than being treated the same as everyone else. Is that too much to ask? ... and people wonder why there are relapses.

For more horror stories, visit A.T. Watchdog. If you think we have it bad in Australia, try the US.