Monday, August 11, 2014

The HMO Shuffle

Several years ago I sought out specific guidance on parenting issues, I was feeling quite overwhelmed as a single mother.  I turned to the designated counselors within my HMO;  month after month of meetings and observations of myself, my parenting style and my interactions with Raphaela, they refused to help me.  No explanations, they quite simply abandoned me.

I got over the rejection, and yet to this day I fail to understand why I was not deserving of their assistance.

This past year in Gan, I had several dealings with Raphaela's stubbornness and performance anxiety:  the refusal to participate in swimming lessons, the fear of the plays and parties which all the parents attended, the willingness to dance only when no one is watching and throwing a massive fit when we tried a ballet class, etc. I am also aware of certain basic speech issues which I would like to be corrected before Raphaela enters first grade:  she has inconsistency issues with the letters "R" and "Sh", resulting in a barely noticeable lisp.

Many of my friends with older children told me that the Israeli HMO will not deal with these "common" problems until a child turns seven years old, but I - as a parent and as a Doctor - see no reason to wait, especially because Raphaela is also bilingual.

Thus started the run-around.  First I had to fill out a complete developmental form, as well as asking her Gan teacher to provide her assessment, and our GP to give us a formal prescription for the Childhood Developmental Center.

Then you send in the forms and wait for the center to call you, which they did two months later, recommending that a Physical Therapist check Raphaela for gross motor functions.  Huh?

They also requested a hearing test, something that makes slightly more sense given the context.

And of course, it takes at least one month before there is an opening for an appointment, for anything, and many health professionals are currently on summer break.

So we did the hearing test, the results were inconclusive, and the next appointment takes place at the end of the month.  This morning the PT watched as Raphaela ran and jumped and climbed and attempted to play basketball, and came to the conclusion that there is a strong emotional component present, and that I should attend several sessions with a parenting advisor/therapist. Together we can compile a list of strategies when Raphaela's fear overcomes her ability.

The physical therapist also recommended that I play more ball with Raphaela, not one of my favorite sports or past-times, I must admit.  If she had a father in the house, he would play with her, and then she would be able to dribble a ball and catch it better, right?  (One more thing to add to the guilt list...)

When I asked why I hadn't yet heard from the speech therapist to arrange testing and sessions, the PT laughed and said, "We don't handle that at all, you need to go to an entirely different department and start over with them."

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