we punish ourselves in o so many ways

we punish ourselves in o so many ways

fiction
edward w pritchard

Dr Roberta had been managing two offices for over a year now. She was a psychologist and the two offices were about 15 miles apart. She had bought the second office when Dr. Myers, the psychologist had passed on and since she knew his wife and Dr. Myers client records weren't all that good she had got a good deal on the practice.

Dr. Roberta had been a psychologist for 8 years and worked hard and diligently to grow her practice. Fortunately she had a good office assistant at the first office and both her and the assistant were traveling back and fourth between the new office and the old to instill the old office procedures and philosophies on the two employees of the new office and the 300 or so patients she had bought with the new office. After some discussion with some of her peers she decided that she would have to manage both offices herself if she was to not lose too many precious clients at the new office; because Dr. Myers didn't have all that good of a hold on his patients because of his style of interacting with his patients prior to his death. Since Dr. Roberta was the only professional psychologist she would have to see all the patients at her appointments at both offices. The two support staff, two each at each office, would assist her with clerical work, medical record keeping and most importantly billing, but she would see all the patients herself.

Running a psychology practice and managing the patients is always challenging. Often because of urgent problems a patient will require extra time or unscheduled time in the middle of the day and that is disruptive to the Doctor's schedule and peace of mind. In time running between the two offices Dr. Roberta began to subtly change her philosophies and because of time constraints her clients became more of patients and charts and less and less of people with problems, usually temporarily problems that they needed her help with. Often she had patients in two places stacked up to see her and in time she often would be with one client while the next client waited; sometimes at the other office.

Dr. Roberta had a large loan to pay with the new purchase of the second practice and she would be paying on it if things went as planned for the next 60 months. Because of the looming loan payment every month, billing became more and more pressing because sometimes for no reason at all there would be a shortage of clients this month. Still, however the loan and expenses of running both offices were due the next month, come what may.

Dr. Roberta had been meeting with a young woman and the appointment ran over 35 minutes because of pressing problems in the young woman's life, two clients were waiting at her original office to see her, one who was new, which meant a long initial appointment; when Dr. Roberta decided thereafter to have written billing procedures at both offices. One of the new written procedures was that if she, the Doctor was with one patient, and that patient ran over the scheduled time, that patient and the next patient would be billed in full from the top of the next coming up billing period. Although this was double billing it was approved by most of the insurance companies they worked with, as long as it was within reason. Self billed clients would be dealt with one situation at a time.

Patients often objected to the new billing arrangement, but as they were often in down periods of their life when they came too see her, and needed to see her badly, usually, they were fairly compliant. However often someone would need to see her about a particular billing issue and usually it was because of the new double billing procedure, which often caused the second client to pay for time they didn't get, since if they stayed over their normal appointment time they would be again double billed with the next person. When pressed on the matter, after the first few discussions, the Doctor began fall back on that it was office policy. In time the written office policy began to be a thing apart, larger than any of the office staff, even than Dr Roberta, the owner.

After about two years of running both offices and the pressure to meet payroll and expenses each month the Doctor had began to call herself Dr. Roberta at the old office and Dr. Fitz, her last name at the new office. One day while driving home late one evening after work she was stopped by a highway patrol officer, who was young and very polite and formal. As he walked up to her car, to discuss with her her burnt out taillight on her newer car, he asked her her name before he asked for her license and registration. For a moment, just a long pause really, totally in her own mind, she had a panicky sensation of not remembering who she was; because, she was between offices, and didn't now momentary remember what to call herself. Later, at the end of her conversation with the officer, using the skills of her profession to stand up for her rights and try not to accrue the $89.00 ticket, asking for a warning instead; the officer politely told her that it wasn't up to him, it was policy.