Workshops From Hell

In over 30 years of attending continuing education presentations in order to, well, continue her education, Doc Righteous really thought she had seen it all. But today’s experience took the cake. She now has new things to add to her list of Things Presenters Should Never, Ever Do–and this morning’s presenter committed three of them in his first three sentences.

The Top Ten Things Presenters Should Never, Ever Do

10. Read from your notes

9. Ignore your notes

8. Digress from your notes

7. Fail to give a break halfway through, thereby denying attendees a chance to exit early and gracefully.

6. Download all your handouts directly from the public domain.

5. Put your entire presentation word for word on slides.

4. Allow attendees to ask questions throughout your presentation.

3. Announce at the outset that this is a completely new subject area for you and that you really don’t know anything about it.

2. Announce at the outset that you not only have no expertise in the subject matter at hand, but that you are counting on the very workshop attendees whom you are supposed to be instructing to help you out.

1. Announce at the outset that you are not going to talk about the very thing you were hired to talk about.

Facebook

Dr. Righteous has been more than patient.

Over the years, she has acquired some Facebook friends who are not, of course, really friends. They are friends of friends, or old classmates, or simply people (suggested by Facebook’s deeply weird algorithms) who share a common interest. All told, the good doctor has about 200 “friends,” of whom she probably actually knows less than 50.

And now it is time for some serious housekeeping. Some of these people simply must go. So Doc R today began a rigorous pruning of some of the farthest-out fringe-dwellers on her Friends list.

First to go was the birther who today posted what was, for Doc R, the last straw: A photoshopped pic of President Obama resigning from office, with a really offensive tag-line to the effect that he did not deserve the job. So, off with her head!

Next was the tea-bagger who seems to believe not only that his government is hiding evidence of visitors from outer space (including, perhaps, himself? One wonders.) but also that feminist lawyers support pedophilia via the pornulating of young girls for commercial purposes. What the fuck?

Next is the pet-person who was arrested recently for hoarding animals. Doc of course understands and sympathizes with mental illnesses like this: It’s the continued cheery “collecting”–a truly unfortunate choice of words if ever there was one–of virtual animals for her virtual Facebook zoo in all this benighted person’s Updates that turns Doc R.’s stomach. Off with her head!

Facebook is supposed to be a social network, after all, not a soapbox for the most bizarre and offensive political stances that people can conjure up in the wee, sleepless hours.

Doc, not normally a patient woman under the best of circumstances, has far exceeded her limit. No more tea-baggers. No more birthers. No more of those sickening Sept. 11th conspiracy theories. You post one of those, your ass is out! Anti-Semitic? You’re history! Hate women? People of color? Gays, lesbians, bisexuals, queer, or questioning folk? transgendered or intersex persons? Buh-bye!

She expects to be down to two dozen people by the end of the week.

Duty Calls

Fig. 1: Dr. Righteous has the last word

Who, me?

Here’s the thing. Dr. Righteous wasn’t even being self-righteous at the time. No, she wasn’t on her high horse about anything, wasn’t telling anyone how they should live their own lives, and damned if that’s not exactly what she’s  in trouble for.

Oh, well.

Life is ironic, isn’t it?

The good Doc will probably blog it one day, in all its hairy details, but her best friend says it’s not a good idea, even anonymously. (Her best friend thinks it’s better to write a novel, and publish it under her own name. Dr. Righteous doesn’t understand that logic. But never mind.)

Briefly, Doc R. stepped on someone’s (un)ethical toes at work, entirely by accident. Now their toes are all bruised and they’re acting like it’s her fault. This is not the first time in her professional career that this has happened, but usually when she steps into the shit, it is with malice aforethought.

Once she got in trouble for calling a sexual-harasser — well , not to put too fine a point on it, a sexual harasser. She was told that was libel and she could get in trouble. She could get in trouble?? What about Sex-Boy? What about the admin for allowing a hostile work environment to persist?

On another occasion, a colleague got all pissed off at the Doc for saying, “you can’t do that” (bill one marital therapy session as two, separate individual sessions). OK, let’s rephrase that: Honey, you can do whatever you want, but it’s insurance fraud. That better?

It never ceases to amaze Dr. Righteous that people are not happy to have the error of their ways pointed out to them. Even accidentally.

I had no fucking idea

Prof. Susurro nails it

If you can get past the gratuitous slap at sex workers. . .

. . . then Dan Carlat has a pretty good post up over at his place.

Depending upon your personal situation, it may be “good”, and on your line of work. Me? I’m a psychologist in a large group practice which includes a psychiatrist whom I rather like but whose über-conservative politics drive me crazy. Oh. And did I mention? He gives paid talks for a drug company, disguised as CMEs. So Carlat’s blog post reminds me of something I prefer not to think about but which makes me sick when I do. To wit: This is, IMHO, tots unethical behavior. What can I, should I do about it? Fuck if I know.

I’m happier when Dr. Carlat refers to these guys as “hired guns” rather than the “whores” in the title, as follows:

…Schering-Plough is already poised to make aggressive use of hired guns to get psychiatrists to prescribe its new antipsychotic.

In his post, Dr. Carlat references his NYT Magazine article on his own experiences as a hired gun, which I wish were required reading at my office. I am having fantasies, as I write this, of printing off several dozen copies and putting one in every mailbox.

I asked our good doc about it casually one day and he admitted that his activities were “supported” by the drug company, that he wasn’t teaching about a disorder or even a class of medications but about one brand-name medication in particular, and that he used materials supplied by the drug company. He says he “enjoys getting out” into the countryside. Hmm. I think I see a pattern here. Do these companies target nonspecialists in rural areas in an attempt to control that market by brainwashing generalists out of the mainstream who lack the experience/training/exposure to know any better?

Here’s what Carlat says the new guys flogging Schering-Plough’s new antipsychotic will be getting paid:

–$1,600 for a 45 minute power point presentation or informal “peer discussion group.”
–$1,000 for a 45 minute web-based live presentation (you get $600 less because you don’t have to leave the comfort of your office)
–Total maximum (called “contract total aggregate”) amount that you may receive over the course of the year is $170,000.

Dang. That’s good money if you can get it. I have taught part-time at the local Cow College and I figured, by dividing all the hours I spent prepping, grading, meeting with students, and actually teaching into my salary that on an hour-for-hour basis I could make more working closing at a local burger joint. Seriously: They were hiring, and I saw the hourly wage posted on the sign. Closers make more than adjunct professors. And we have to make our own PowerPoints!

The injustice of it all.

My doc friend, on the other hand. . . well. Those are some serious bucks.

Certainly serious enough bucks to cloud his judgment, if not those of his “students”. Be interesting to know how much of the stuff he flogs gets prescribed at our practice. I know one thing: I find excuses to send my clients to other docs. I am afraid that whether it was the best drug for my client or not, he might prescribe it. And with the best of intentions! I think he honestly sees himself as an ethical physician who genuinely cares about his patients.

So whaddya think? I am tots not in a strong position here, above and beyond the psychiatrist/psychologist power differential. Should I ‘front him at a staff meeting? In private? Talk to the other docs and build up a consensus that we shouldn’t do this at this practice? Ignore it? Just start whittling away at it bit by bit, expressing a concern or two in an offhand way whenever it comes up?

Doc

Lou Dobbs is a prick.

And another thing

that chaps the Righteous hide is that Doc Righteous, who really likes to teach, can’t get a raise.

The Uni is building a new football stadium but can’t afford faculty raises.

Uh-huh.

WTF?!

Seems there’s a dood goin’ around a certain metropolitan area making intake appointments with female therapists and then exposing himself.

On the phone, he says he has a problem with work stress. When he gets there, he describes using masturbating to relieve his anxiety–and then proceeds to demonstrate his technique.

Eew.

Read My Lips

1. Payment is due at time of service, unless other arrangements have been made in advance.
2. A minimum of 24 hours is required for cancellations, otherwise full charge will be made.
3. You are responsible for any fees not covered by insurance.

You all signed an agreement to these three points before we ever sat down to talk for the first time.

I love what a do for a living, but peeps, the operative words here are “for a living.” This is my job. It’s not a hobby. I don’t get paid, I don’t eat. And I do like to eat.

#1. “In advance” does not mean after you sit down for your session, or worse, at the end of your session.

How would you like it if, on payday, your employer announced that he forgot to bring his checkbook? Or asked you to hold the check until Friday/the end of the month/Doomsday? How would you like it if he asked if he could pay you “next time”?

And what would you say if your employer asked you, after telling you he’s not going to pay you, “Is that all right?” What am I supposed to say? It’s not all right. If you called ahead and said, “I can’t pay you this week, Dr. Righteous,” then I’d have a choice. I could, if we have worked together for awhile and I know you’re good for it, tell you to come on in and we’ll worry about payment later. Or I have the opportunity to suggest that we reschedule. But if you ask me that at the beginning of the session, do you really think you are going to get an honest answer? What am I gonna do, say “No, it’s not ok, get out of my office!”? You tell me after we’ve already had our session, what am I supposed to do? Repossess the hour?

#2. If you don’t give me at least 24 hours notice, I haven’t a chance of a snowball in hell of scheduling someone else into that hour. And once again, if I don’t get paid, I don’t eat.

How would you like it if you arrived at work one day to find a “Closed” sign on the door? Same thing. I arrive at work, but you, my employer of the hour, do not.

How would you like it if your boss called while you were in the shower and left you a message saying the business will be closed for an  hour today? A little late for you to make other plans, isn’t it?

Late cancellations are bad, but no-shows are a pain in the ass. I can’t start anything else, because you might be here any minute. If not showing up seems out of character for you, then I spend the time worrying that you’ve had an accident or something. If you are suicidal, then of course I wonder if you are swinging from the rafters at this very moment, and maybe I should be dialing 911 instead of sitting here with my thumb up my ass waiting to see if you are going to show up. And speaking of dialing, I can’t get on the phone (other than to check for a message from you), or even walk away from the phone, in case you are just running late and might be trying to call the office. Do you think I don’t care? I worry about you if you don’t turn up when you are supposed to!

Imagine, if you can, how I feel when I call my answering service 20 minutes into your hour, to find you’ve left a message within the last few minutes to say you can’t afford it today (it’s a $20 copay, for chrissakes, you spent more than that yesterday getting your nails done) or that you overslept, or you forgot, or whatever.

Apparently your personal growth and happiness has become more important to me than it is to you. After all, I’m here and ready to work. What’s wrong with that picture??

#3. I did the work. I need to be paid. So I can eat.

How would you like it if you never knew whether or when or how much you would get paid at your job? Maybe some days you would, some days you wouldn’t. Some days you’d get paid, but only  14.81% of your salary.  That’s exactly what happens to me if your insurance company denies the claim and all I ever collect for that hour is your lousy copay. How would you like that?

How would you like it if, willy-nilly, your employer decided not to pay you for the work you did between, say, two o’clock and three o’clock for the last couple of Wednesdays? A little late to make alternative arrangements to produce income those days, isn’t it?

Take another little piece of my heart now, baby
You know you got it, if it makes you feel good! –Janis Joplin

The worst experience for me though is when you run up a bill and then just stop showing up.  I call. I send a letter. I send a statement every month. You ignore me.

Psychotherapy is a pretty personal experience on my side of the couch, too, toots. When we are working, I give something of myself. So it hurts personally as well as financially when you stiff me for the bill. It feels as if you are giving me the finger. Which of course, in a way, you are.

Analyze that.