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My new psychiatrist just got out of school, wasn't taught proper compassion skills

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I haven't posted here in a long while, but I knew this would be the board to write this at. I kinda need some suggestions and ideas for me, but also for my new psychiatrist.

My psychiatrist of four years, retired in January and he was the best doc I ever had (other than my current psychologist). He was older and had decades upon decades of experience. He could read your emotions and was very kind and understanding. I think he was better in the compassion/bedside manner department than he was with meds, though he was smart there too. I was lucky he was my doctor. He helped me trust doctors.

When he retired we all were assigned one of two new doctors. The other long term doc left last summer, hence why they'd hired two new doctors. And they are new. Less than a year experience, just out of school new. I was given the doctor that looks like Patrick Dempsey. Not necessarily a bad thing.... Though I've heard rumors chicks are actually making extra appointments to see this guy more...totally knew that would happen lol...

Anyhow, this guy, he's very smart, very book smart. I guess he went to school to be a surgeon first. The problem is, he acts like a surgeon. He has great intentions but comes off insulting, too pushy, disrespectful, too much ego? He really lacks the other half of being a psychiatrist. Not to say they should all be really nice or anything, but he gets frustrated and yells at patients and talks down to them. He doesn't really listen to what you are saying, makes up his mind before you've said anything and just....well, comes off as a jerk.

I was lucky I had my caseworker with me. The first two visits he was just as nice as, but the third visit he pulled all this. It made me so uncomfortable (years of childhood abuse in my past) when he got loud that I froze. I couldn't even leave. I did my old school age trick of "hiding in plain sight" where I just withdrew until the appointment was over. Wasn't seeing, wasn't listening, didn't even feel my body anymore. It was there but I wasn't.

I fired him the next day. Both myself and my caseworker filed complaints and she made a lot of noise to the healthcare system in my area that employs him. It took a week but my caseworker ended up in a meeting with the president of the system. And he had a lot to say. This new doc has had many complaints for the same thing, so he knew about the issues. Both of the new docs were trained at the same university medical center, they have been pumping out new psychiatrists like an assembly line and they do not teach them this part of their job. At all. He said even the new doctors know it's an issue and they are trying to learn. He said they are trying to break this doc out of the harsh training he had and get him down to a more talk able level, ect.

I guess the board is going to call me this afternoon to talk to me directly, but the president wants me to give him one more try. They appreciated that I've been a long term patient and that, other than this, I like their staff, ect very much. I've gotten apologies from different levels in administration as well.

So now I'm stuck. Do I make an appointment or not. I don't normally give anyone second chances if they make me so upset, so this would be an exception. Maybe this doc won't figure it all out, but what if he does and ends up helping a lot of people? Can someone learn how to be more empathetic? I'm not going to decide until next week, I need more time to think.

I'm writing this here, because if I do decide to see him, I'm going to have a few things I need to say to him and with that, maybe some suggestions. What do you suggest to a doctor? It's normally the other way around. But they tell me he's open to learning and suggestions and self improvement. And he knows he needs to work on it.

If you were able to talk to a shiny brand new psychiatrist, what would your advice be, based on being a long term patient? I might make a list to take with me, if I go. Not in a mean way or anything, but just like, these might help?

-Misty

(Sorry for any typos, did this on an IPad using the fine technique of two finger typist)

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I expect different things from different doctors. I have an endocrinologist, for example, who's not going to win any points for charm. He's direct and goes fast. But he's really good, and he's always professional, and ensures he answers all your questions regardless of how long it takes.

 

I'd expect a lot different from a psychiatrist. But even if all he's doing is managing your meds, you still have the right to expect professional behavior and courtesy. Which, if his demeanor caused you to disassociate in such a way, you didn't get anything of the sort.

 

I don't think I'd see him as a patient again, especially if there are other options. He sounds like a bully or an ass. Maybe both. Life is too short, and MI too hard, to put up with that kind of behavior from any kind of a medical provider. If you want to meet with him to talk about how he made you feel, that might be fine. He might be capable of learning something.

 

My two cents. Good luck.

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he sounds awful, handsome but awful

 

I would not go back to him unless I felt confident that I would successfully inform him

how I felt in the appointment.

and I would write it down on paper so help focus

maybe write him a letter

 

if he YELLED at you, totally inappropriate

and you disassociated and totally shut down

you need to tell him that, and tell him how you felt

 

but, I am not sure you should go back to him at all

I agree that a nice person would be nice regardless of whether the caseworker was there

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You are under NO obligation to help train this person.

 

You have to do what works best for you and your needs. He needs to learn compassion and empathy. If you feel like you have the ability to tolerate therapeutic errors, or at least let him know from your perspective how his actions affect you as his patient, have another chat.

 

But it's not your job to teach him stuff he needs to do his job. 

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If you do decide to give this guy another chance, I would bring your caseworker with you again.

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Thanks for the responses. I need to clarify that my caseworker was at all three visits, maybe I forgot to say that in the first post. I'd brought her with because I forget things I need to say while in there (my memory sucks) and I'm glad I did. She became a great advocate because she witnessed and remembered all of it when I didn't remember much.

I just don't know yet, but your comments are helping give me a lot to think on. I appreciate it.

-M

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Who's Patrick Dempsey?

I wouldn't go back to a doctor who had been so abusive. As Woo said, it is not your job to train him. And I'd make sure he knew why I wasn't returning, too.

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From your description this doesn't sound like a training problem or something that can be fixed by a come-to-Jesus meeting with management. It sounds like he's just an asshole. Would you really want to trust an asshole with your mental health even if they're trying hard to rein it in? If there's any doctor that you need to be a basically decent person, it's a psychiatrist. I can't imagine working with one who wasn't.

What's a mystery to me is why he left surgery he sounds better suited.

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My psychiatrist is not the best and can at times be abrasive, but he never once yelled at me, and I see him only once ever two or three months and then only for 10 minutes.

 

Personally, I would not tolerate a doctor who disrespected me if there were any other options. I have more self-respect than that. As has been said, it is not your job to train him. That is what a residency is for. Honestly, I wonder why some people become doctors and especially psychiatrists if they are unable to be empathetic.

 

I can't tell you what to do - just what I would do.

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You deserve to be treated with compassion and dignity.  You are not a guinea pig for this doctor to practice his "bedside manner" on.  If you have another option, I would take it.

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You hire your docs. Is it fair (or appropriate) for you to hire a subpar pdoc for yourself? I think it is a totally valid question whether you should be putting yourself in a potentially damaging position again because the head of the hospital asked you to. I feel like if if the pdoc did it once, he'll do it again. It's not okay for you to be a guinea pig for untrained staff.

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They can ask until the cows come home, doesn't make you obligated to do him any favors.  And this WOULD be a HUGE favor, and I don't choose my psychiatrist based on people who owe me favors.

 

Two years ago, I would've done it, thinking that I had to or that I needed to or that they needed me or whatever.  Now?  Hell no.  In fact, I'd bring StJ (my partner) with me and have him ream the guy a new one.

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You all have given me a LOT to think about. I've discussed this with friends and family as well, but I knew I would get more constructive opinions here because of experience with psychiatrists. I still don't know for sure what I'm going to do. I feel like I've been pushed into a corner with this. I live in such a rural area, we only have 3 psychiatrists around here. The one I was seeing, the other young new one from the same university and a woman who is based forty miles away who does video conference appointments through a clinic up here. That's all we have. I don't drive and am on a tight budget, so traveling the forty miles to see someone down there would be extremely difficult to do. I'd worry about having to depend on others to get there and if there is something that came up and I had to go in sooner, it would be an issue.

 

So I feel stuck. They normally don't, but are giving me the option to see the other new guy if I don't want to go back to this one. I know nothing about him but know he's had complaints too, though I don't know what for. I have enough meds until the 19th and I feel like I can't sit too much longer on it or I won't get an appointment in time. I have so much crap going on with depression, severe anxiety, fighting my borderline impulses and this isn't helping because it's just going round and round in my head. It's got me too stressed out.

 

Starting to think at this point my best option would be to switch doctors but to who? I thought about well, maybe at least go in and tell him how it affected me, but I think if I did, writing it might be better. My stress level would be just amped if I had to actually sit down and talk to him. You all are right, it isn't worth the risk and I do deserve someone better. I know my case is very complicated and I need someone who's dealt with complicated before. Out of the three, only the lady by video has that experience. But do I want to have a doc by video? Is that even a good thing?

 

All I know is I'm tired of worrying about it and tired of it making me so stressed. I just want to get my meds sorted and be treated better during the process....

-M

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I find writing things down helps me too ... like if I have something complicated to say to someone, I'll write it down so I have time to think about it all and make sure I write all that I want to say, without forgetting anything.

 

About the DR by video, I would think that she would want to see you for the initial evaluation, then you could do the video calls after that.  Just my thoughts.  Maybe if you saw the lady you could have regular appts with her (with help getting there), and if you needed an in-between visit, you could do the video call?

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I see a psychiatriac resident at a student clinic.  At this point, I have seen 3 different docs.  One was a complete jerk, while the other two have been pretty good.  So, I don't think it's the training program they came from that made the one totally uncompassionate, just his personality.  It might be similar for you seeing the other new doc.  He could be just fine for you. 

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Well, I've had a lot of time to mull things over. With limited resources in my area I didn't want to make a rash decision. Thank you so much for the opinions because I really needed to take a good look at every angle.

 

I decided to actually give this doctor another go. It's an appointment by appointment thing for now, if he upsets me, I'm gone. I was told when I tried to make an appointment that I was being put on a waiting list (maybe because I technically wasn't his patient anymore?) and panicked because I was going to be out of meds in two weeks. I called my pharmacy and they said sometimes sending over a request works, so they did. It must have gotten to him because my meds were refilled without seeing him.

 

In the meantime I thought, well, I WILL sit down and type out some of the stuff I'm dealing with right now, I have so many symptoms and everything is aggrivated. I also wanted to write out what he did that made me uncomfortable and upset, my reactions to it, how it can't happen again and I wrote why. That I'm a really triggery type borderline who stays quiet but then goes home and takes everything out on myself, etc. I said in it that I'll walk right out the door if he gets pissy at me again, I don't care how frustrating it is, he can't be a jerk. It started out as one page, a week later, was seven.... In the end, it was actually pretty theraputic for me. I ditched at least some of the pent up anger and frustration from the last month but I also gave a lot of backround on my symptoms and abuse I went through and just caught him up to date in a way.

 

Then I mailed it to his office. It took me a couple days to have the guts to do it, but I thought, if I'm going to try this again, he needs to read it before I come in. By the next morning, his office called and booked me into a late afternoon slot for today, after a group I have in the same building. So, that is that. I'm stressed already this morning but trying to take it in stride. Going to go have coffee with a friend and spin a load of laundry and just keep mildly busy so I don't ruminate over and over and over all morning. It will be fine. If it's not, then I chose someone else.

 

If he can be more patient, then it might actually help. He's young, excited about his profession and I'm starting to hear he's very good at meds. Just needs to curb his patience level. Even if we can just find a way to tone down my anxiety some, because it's maaaaaaaaaaaad out of control right now (along with impulses and depression, etc). I'm so sick of my symptoms and spring is here and my photography will pick up soon and I don't want to be hiding in the house doing nothing.

 

I'm really nervous, not so much for going into his office, but because I sorta dumped thirty years of crap down on paper and was more honest than I normally am, I'm not good at all at admitting I'm struggling. I generally wait until I'm falling off the mental cliff before I say anything. But after a lot of thinking, I thought, what good does that do? Nobody can help if I don't do my part and say something. I don't like it, even in writing, it makes me feel super exposed for some reason. But hey, at least I don't have to sit and try to give a backstory, it's all in there.

 

I'll probably post later this evening, depending on how it goes.

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thinking of you.  I hope the appointment goes well.

It went really well. I built it up so much worse in my mind that I was a wreck by the time group was done. The therapist who runs the group is a really lovely and compassion person who has been through social anxiety, ect. She offered to come with me to see the doctor and I was grateful. First thing he did was apologize. He said he didn't mean to make me react that way and it wouldn't happen again. He said he was happy I came back, that he didn't think I would. We talked about all the impulse stuff I've been doing and my anxiety being bad, especially the social phobia.

He started me on Gabapentin 300mg twice a day. I need to do some reading up on it yet. I don't see him for like six weeks, unless something comes up before then. He wants to just test it out for a while. They also sucked me into another group, for DBT, so they will be keeping me busy. I'm glad it went well.

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That is great you wrote a letter to him!  I think that was a really helpful thing to do.  And as you saw, he did react to it in a positive way, so it did work out and was worth it, at least IMO.  And it helped you vent at the same time.  I'm glad he got you an appt so quick and I'm glad it went well!

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Writing and posting that letter was incredibly brave - well done to you, and I'm so glad to read that it triggered a positive, open and honest appointment with the pdoc.  I hope the relationship continues to improve.  

 

(I also hope this thread will serve as encouragement to those of us who need, but have been afraid to have, a frank conversation with our care providers.)

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