Making complaints against a Kaiser Permanente Child and Adult Psychiatrist and a LCSW (the LCSW has since
left for another position)  - to the Medical Board and the National Association of Social Workers.....what
did I really expect?  I mean, this is like Joe six pack who got run over by his own attorney in a divorce
complaining to the state bar.  This is like complaining to the state Judicial Qualifications Commission about a judge who does not follow the law but his own prejudices.  But I felt it had to be done. I willingly put hundreds of hours and my own $$ into
it.  I wanted to follow the complaint procedure which exists for citizens.  I wanted to see what the true
state of social work/psychiatry was and is.  I am saddened, but will continue to work for reform despite
the strong grip of the managed care/pharmaceutical industry.....on basic mental health of patients.

THE MEDICAL BOARD

The medical board just sent me a form letter stating they cannot do anything, there was no violation.  I
don't even think the signature from the executive director was personally signed, I think it is a stamp.
I was just hoping through an investigation they would look at the charts/etc over the last year and see that
Paxil was not warranted....by the time the KP psychiatrist saw her she was receiving counseling less
than once a month and her crying was directly related to not seeing her mother, not from PTSD or a chemical
imbalance. How do you prove a chemical imbalance anyway? I thought the board would see perhaps at a
minimum, 20 mg of paxil (pill splitting as mentioned before they came in 40 mg pills) was too much for a 14
year old in the middle of a custody dispute.  After all, adults are often given 10mg...due to a loved one
dying.  20 mg was too strong.  And the brochure from the medical board, (now I receive it) states what they
do investigate:

--prescribing drugs in excessive amounts or without legitimate reason--

In my opinion, she never should have been prescribed paxil because the chief cause of any depression was
not going to be addressed - her seeing her mother.  Again, for a child in the middle of a custody dispute,
professing their love to their counselor for that parent, crying to be with that parent....you do not
drug the child.  You find other options that can help an alienated child.

What I will do now is continue to work with an advocate assigned to me by a professional association
the KP doctor belongs to in making a request for a ethics review.

Most important I will continue to learn and grow from the experience.  I just believe that with the state of
managed care psychiatry, doctors are not talking to patients (especially children) enough and are just
trying to treat them with drugs that do not come close to solving their basic problems.
 

THE NATIONAL ASSOCIATION OF SOCIAL WORKERS
 

Gawd, this complaint process was very stretched out.  I was pleased at one point my request for professional
review was defered pemding more information.  Much like the medical board complaint, I studied the ethics
code books and offered no personal opinion/commentary. I studied the ethics codes and studied the charts
from the intake form all the way to the end where the KP psychiatrist said since (and thank goodness) the
child was coming to live with us he would no longer be her psychiatrist.  Still, he managed to have one last
medication management session with the child and stepmother, (KP policyholder) and wrote a new
prespription for paxil with 2 refills...but I digress.

My contention against the LCSW with the NASW was that she was lacked competence and failed to refer her out
for services she herself could not or would not render.  My contention was that the gap in sessions
(sometimes 5 weeks between sessions) dictated a psych eval (prescription for anti depressants) was not
warranted.  The NASW was given a lot of relevant documentation.  I was assigned an advocate and
utilized his services.  I failed to see how a LCSW who has a child in front of them crying to see their other
parent (when there is no court order barring it) decides against a custody evaluation but rather opts
for sporadic sessions and a psyche eval.

So once the complaint was defered, all they wanted to know was what was my relationship to the patient and
how was I personally affected.  They knew I was the legal stepdad.  I had every right to make the
complaint.  I said I was personally affected because her violations prevented her from seeing her mother
and myself.  I provided documentation which shows the bio dad saying because of KP treatment - me and my
wife can't see the child. 

And again, what treatment?  Sporadic sessions?  Paxil? The LCSW admiting Kaiser doesn't do custody or PAS
evals despite the child being so unlawfully alienated? Therapy is a relationship and there is nothing wrong
with seeing a counselor to work out problems.  My point is a LCSW has an ethical obligation to treat the
patient for what the chief problem is, to be competent, to refer patients out when needed.  To see
the patient more or less.  Not be a "figurehead" for the policy holder, this being my complaint also in
regard to the KP psychiatrist for the medical board. Proof of same was everywhere in written documentation
form.

So, the NASW turned down my request for professional review not because I failed to point out legitimate
ethical violations covered in the Code book, but because I failed to show, me being the complaintant,
 

---was directly affected personally or professionally by the alleged violation or has direct knowledge of
the violation--
 

They say I can appeal but I'm not going to bother because then confidentiality rules apply.  I would
rather go public to the media.  Look at what the catholic church has done in covering up and
transfering priests around.  Oh, now they will have a review board.  The public needs to know citizens don't
have a chance in making legitimate complaints regarding doctors, lawyers, judges.  Something like 1
or 2 percent of complaints are even acted on.  So why have the review boards?

What I have learned is the state of managed care/KP Behavorial Health/social work/psychiatry is in sad
shape.  Patients are seen sporadically, not treated for chief and obvious basic problems, but rather
refered for medication.  If KP behavorial protocol and the medical board/NASW thinks no violation occured
when a child in the middle of a custody dispute was medicated rather than refered out for a custody
evaluation, (admist sporadic sessions) I think something is wrong.

We need to get back to social workers/psychiatrists talking problems out with their patients, rather than
acting like a figurehead for the policy holder and lining them up for anti depressant medication -
medication which patients themselves give up on 50 percent of the time and medication which is given out
without a....LEGITIMATE REASON.  But hey, prescribe anti depressants no matter, because it's good for your
pharmaceutical stock portfolio.

Life goes on....and thanks for listening.

---Tony