Why would this be a conflict of interest?

[Justmehere]

Things are not working with my therapist. She states as much. She thinks I need more support.

She had a very part-time private practice, works part-time at a big clinic very close to me (and oddly far from her city of residence and her private practice) that takes my insurance. She also works at a third clinic as a part-time researcher and in grad school for her Ph.D. (She is probably spread a bit too thin.)

The big clinic in my city turned me away many years ago, right as my symptoms burst through after lost of trauma. This was long before they had a trauma-specific program. They don’t have the records of anything other than they declined to treat and thus won’t do a new intake now. At the first intake, they accused me of one traumatic event not being real, and thus not really needing help... that nearly wrecked me. The perp was convicted and sentenced and now everyone believes what he said he did to me.

They hired her as part of their new and robust trauma center over a year ago. When I found out, she had a new part-time job and worked there, that was hard for me. I wasn’t wanting care there at the big clinic time, and I wondered why she would work at a terrible place. She said if I ever got care there, it would be a conflict of interest to even indicate she knows anything about me, even if I signed a release form. She said she couldn’t help me get care there, it would put her private practice in jeopardy. I didn’t understand why, and I didn’t ask... it didn’t matter to me then. I didn’t want to pay for her time to explain it. She was extremely adamant though.

Since then, I’ve heard great things about the trauma program, and I’m needing help they can provide that my therapist can’t provide. They have many therapists. The whole clinic system has over 400 employees in a large multi-city area. I don’t know how many counselors in the trauma program, but she's one of quite a few. They take my insurance. I could save so much money seeing anyone there that I really need to save right now. They have locations in multiple cities near me, and I could go to a location where she doesn't work.

Why couldn’t she advocate for them to do a new intake and consider me as a client from transferring from her private practice to her or any other therapist? Why can’t she speak to them even if I signed a release? What is the conflict of interest?

 

[Chris-duck]

Why couldn’t she advocate for them to do a new intake and consider me as a client from transferring from her private practice to her or any other therapist? Why can’t she admit I even exist to her if they did? What is the conflict of interest?

I'm UK so it might be different, but I don't see a conflict of interest here. But I've read your other posts about your T and maybe she doesn't want to admit she can't help you in private practice while also working for this place, like in case they begin to doubt if she can help people there? I don't see why they wouldn't be able to take a new referral when their program has changed if nothing else, is there anyone else involved in your care that could help you get support there?

 

[Teamwork]

If you can’t self refer, and she won’t then someone else needs to. But, I may have read it wrong. Did you not say they won’t look at you again for some reason and you need her help to do so? If so, then yes that is a conflict as she would be in a client privilege situation of saying I know this person and they need this help. I’m probably not saying it right, but she can’t know you in private practice and advocate for you in her other job? Is that about it?

 

[Justmehere]

I don't see why they wouldn't be able to take a new referral when their program has changed if nothing else, is there anyone else involved in your care that could help you get support there?

No. That's part of what makes this extra hard.

I’m probably not saying it right, but she can’t know you in private practice and advocate for you in her other job? Is that about it?

Yes.

 

[joeylittle]

it would be a conflict of interest to even indicate she knows anything about me, even if I signed a release form. She said she couldn’t help me get care there, it would put her private practice in jeopardy.

She probably signed a non-compete clause as part of her contract at the clinic.

If you were seeing her in private practice before she contracted with them, the non-compete wouldn't apply - but it's also possible (likely) that she signed a document stating she did not have a private practice.

I could be wrong - I don't know a great deal about non-compete clauses. They're generally meant to keep a doc from taking clients with them when they leave a clinic and go into a private practice. In that sense, she would be breaking the terms of a non-compete if you were to go to the clinic where she works, get help in her department (even if you weren't her patient, I don't think it matters either way), and also be seeing her in private practice. That would be a problem for her, yes.

But her problem doesn't need to be your problem. In other words - she's doing something she should not be doing, probably in operating a private practice without disclosing it. Maybe you're the only client who has asked about the clinic, maybe there are others....but it strikes me as seriously unethical for her to put pressure on you to not seek care from an available resource because it would jeopardize her own income stream. Telling you that her practice would be in jeopardy sounds to me like she's not only telling you she souldn't help you out with/at the clinic, she's encouraging you to stay away from it. Certainly, she's asking you to lie if you went there, and not disclose that she's your therapist. Not cool at all.

I suppose it's possible it could have something to do with the terms around any funding she's getting for her PhD...

Whatever it is - I don't think it's good ethics, the way she's framing this.

 

[Justmehere]

Oh shoot, you are probably right.

It made sense to me that she can’t have patients leave her clinic practice and see her in private practice... Those ethics make sense to me.

And now it makes more sense why it can’t be the other way around. She didn’t tell me she was working at the clinic, so I imagine other patients in her private practice 30 miles away don’t even know. I found out in a professional setting, because the clinic is where I live, not where she lives or where her private practice has been. I asked her about it. That’s when she explained she had already considered how she would handle it if I was ever a client there and how she would have to act like she didn’t know me.

A non-complete clause makes perfect sense now. They probably don’t know she has a private practice. It’s no where online. No where. It says she’s a clinical trainer for this private practice. She doesn’t do that training anymore, just takes clients. Has an agreement to use someone else’s office when they are not scheduled there. Lots of therapists around here do that. Office rent is high.

But after no disclosure forms, no release forms, apparently no treatment plan of late, and now this... she probably needs to figure herself and her professional life out.

 

[joeylittle]

But after no disclosure forms, no release forms, apparently no treatment plan of late, and now this... she probably needs to figure herself and her professional life out.

Yes.

 

[hithere]

boy that sounds terrible. !

 

[Abstract]

Good grief is all I can say. It does sound like the only logical explanation.
But I agree with Joeylittle. Her problem is not not your problem. This is your life we are speaking about. So that comes back to looking at someone else who can get you into the program. I'm a firm believer in when there is a will there is a way.

It sounds like you need proof of why they turned you down last time. And proof of his conviction. Can you get these? Which other medical professional could approach them for you? Do you have any way of accessing the person right at the top.

 

[user27357]

if this isn't helpful please dismiss it and don't take it as criticism- it isn't.

So many times in a doctor patient relationship we forget that they work for us

Right from the start we are forced into a school setting where we are taught to respect the educators and that carries over to the police and government and we get used to being submissive in any dealings with people that come to us from positions of authority. I respect my therapists but I try to remember that they are far from being my customer and I dont have to try to please them. in fact the relationship is quite the opposite.

you are a buyer of their services, they are selling what they have. Unless you have done something to give them legal cause to ban you from their business, I think you are entitled to treatment. Maybe even legally in a position to demand it with the threat of legal action or bringing the state board into play.

no matter how much you like and trust your therapist, you are their employer and they have sworn an oath to serve your best interests. If you think they are keeping you from getting the best care, something is wrong and needs to be addressed.

please don't take it as a slam on you for not being as pragmatic as I am. I am probably too willing to cast people aside if they don't see things in the same light that I do, i will fire an employee if necessary with only a few warnings, and I may miss out on the potential that was there if I had been more patient and waited for the good stuff. When I enter into a relationship that involves cash for services I try to go in with eyes wide open and I try to remember that without the cash, my favorite therapist probably won't be sending me christmas cards or joining me for lunch even if we happen to be at the same restaraunt eating alone at the same time.

expect professionalism and terminate anything else is my approach.

Hope you are helped by this opinion

 

[Abstract]

If you think they are keeping you from getting the best care, something is wrong and needs to be addressed.

 

[theshadowoftheliving]

I’m so sorry you are going through this.

One thing I’ve learned through my own experiences of jumping through hoops to just get a little bit of help is that you can be creative.

So your current therapist won’t do a referral. Will your primary care physician help? Or a different doctor? Sometimes those people can help be an advocate when therapists fail at their jobs.

Or, if you call enough times and talk to the right people, you might be able to get what you want. I’m constantly surprised by how great a kind attitude and praise goes towards getting what you want. And if it’s a large enough organization, that means there are several people who work in any given department - call back on a different day and try speaking to someone else.