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Hi everyone. So, I've kind of been bouncing around doctors this year. I've gotten burned bad. It's kind of almost like a breakup - you pour your heart out and start all over every time...People don't seem to understand what a big deal and how emotionally uprooting shopping around for doctors can be.

A problem I've had often is that doctors act like they know me better than myself after 2 sessions and start passing judgment and advice that is unwarranted. I'm not going to go into this argument right here, but statisically speaking, therapy has done nothing for me. I did a year of group therapy in DBT while seeing a private therapist weekly. Since I was 16, I've had a different therapist on and off every year, going to them semi-regularly. Nothing. I understand it works for some people. I understand that some people are hesitant to start therapy. I'm not in that position. I know it isn't worth my time. But I know that I respond well to certain medications. Today I felt awful when my current doc basically told me I was lying or psychotic or something when I said therapy doesn't work for me. I have outside evidence from friends and family who have watched my mood go up and down over the years. The times when I was doing better always corresponded to different medication changes. I don't want to get in an argument here on this board, and please don't try to judge me or convince me otherwise, just take at face value that this is what I am looking for.

I don't really have any recommendations and don't trust people I've seen to give decent recommendations. Due to this therapy issue, I either need someone who does therapy as well as dispenses meds (I'm not totally against it if it comes with the bargain, but I don't have time or money to seek it out otherwise) or someone who will actually respect my not wanting to have outside therapy.

Thanks, I'd love to hear about some doctors personally!

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Names removed by CB Mgt to protect the good, bad, and ugly.

question Why do you want a new doctor?

Today I felt awful when my current doc basically told me I was lying or psychotic or something when I said therapy doesn't work for me.

Is THIS why you want a new psychiatrist?? Because if it is please take a deep breath and step back from this. It is hard to find a good psychiatrist. EVERYONE on this board knows how hard it is. Unless you checked it out, I doubt that he thought you were lying or psychotic. That is a huge assumption.

If you are satisfied that this doctor has your medications in good order then I advise you not to run away. You are not doing therapy right? And you still have this doctor?

Did the doctor fire you or are you just upset?

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I was seeing her out of convenience mostly. She really screwed up a while back and I delayed seeing her for a month because it was so awkward.

:Trigger:I had a self harm episode :Trigger: and put in an urgent call to her over the weekend. I knew that she isn't in on Mondays, but the next business day, Tuesday, she didn't call me back. I left a very upset message with her, saying that it showed lack of concern for her patients not to return an urgent call. She called back on Wednesday morning with a message that sounded like she hadn't even listened to the one I left last night, basically saying, "Call the front desk to make an appointment." I avoided her for a month, after which she called asking why she hadn't seen me. I reminded her of the episode and told her I was still upset. She tried to play the, "Oh well I'm not in on Monday" thing, but I told her she didn't call on Tuesday either, to which she replied something like, "I had a lot of meetings" and then told me that if I wanted someone who would call me back at all that I should get another doctor or a therapist I could call. After this I should have just dropped her but I just didn't have the time. Now I'm pissed off enough to go through the process again.

Today I saw her and she basically just told me a bunch of judgmental stuff and refused to make any medication changes. When I tried to explain about therapy not working for me, she said that I was setting too high standards for people. Um, if I'm paying someone 100s of dollars I am going to have a high standard, I'm sorry! When she heard that, she told me that part of therapy is the relationship with the therapist...effectively implying that having a crappy therapist and dealing with it as well as dropping tons of money into the deal is "therapy".

So no, she's not good otherwise.

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If you want to know, know that you will always get a call back, nights, weekends, then chose a clinic with many doctors. Such a clinic will have policies and someone on call every weekend. This type of clinic will always call you back. There is one in Kirkland whose name starts with the name of a tree. Lots of doctors. It is easy to look online and find the psychiatric clinics with multiple doctors.

Also, and this is my generalization, but sometimes psychiatric clinics like that have very short appointment times. It is all about the business model. So the psychiatrist only has ten mins to talk about your meds. Little to no psycho social. I don't think this is actually in your best interest but there is no time for the MD to be in your face about therapy. There is also a ARNP in Bellevue who only, ONLY talks about meds. PM me and I will give you her contact info. I did not like her but she has a busy practice. She might work out for you.

Many sole practice doctors do not want to return calls on the weekend. Nor do they want high maintenance patients. If you are still practicing self harm then you NEED to be in therapy.

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It is not easy finding someone who works for what you are looking for, it's trying and it sucks trying to switch when you are established, I have been there many times too. People who have had to go through the experience of trying to find and establish a relationship with a new doctor totally understand. I have had to do it for myself, and my kids, with a variety of different kids of specialists...I have a son with autism and it takes people a long time to really "get" him...trying to switch sucks, a lot!

I am seeing a good psychiatrist in Seattle right now for myself. I have also had a lot of issues with psychs, doctors, and therapists since I started seeing a therapist when I was 14. I know the frustration of not getting calls back, and I haven't had that problem with him, I am more pleased with him than anyone I have ever seen and he is good at listening to my opinion on what works and what doesn't when he is thinking about changes and such. As far as therapy goes, I have seen lots of different therapists, and I don't nessecarily think I don't need it right now, but I am not seeing a seperate therapist right now. During one particulalry rambling cry session I had talking to him, he did ask if I was seeing a therapist also, but he didn't make a big deal about it, and he said that if I ever wanted to schedule a longer session with him to talk more, I was welcome to... and that was the only time it ever came up. He listens well, and gives appropriate feedback. He doesn't do drama like saying "you are crazy for this..." or whatever was said to you, he responds honestly but is not rude like that.

The only caveat is what was mentioned before me, I haven't tried to self harm for several years, and doctors take that very seriously, and I don't imagine there would be too many psychs that just do meds and would feel that there wasn't any other help needed. I don't know how he would deal with that obviously. When I started seeing him I desperately wanted help and to be able to be functional again, and he was very receptive to trying to find new solutions as quickly as possible.

I specifically started seeing him because I needed a new Suboxone doctor and they aren't easy to find, but as luck would have it, he's been tremendously helpful with my depression, bi-polar, ADD, and sleep issues too. He is more soft spoken and doesn't really get excited or opinionated about stuff...there isn't much of a personal connection like there might be with a really outgoing or chatty person, but his honesty and competence is more reassuring.

:)

Anyway enough babbling...That's just my experience~ I can give you his name and number, if you want PM me.

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If you want to know, know that you will always get a call back, nights, weekends, then chose a clinic with many doctors. Such a clinic will have policies and someone on call every weekend. This type of clinic will always call you back. There is one in Kirkland whose name starts with the name of a tree. Lots of doctors.

Whoa, sounds like we go to the same place!

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If you want to know, know that you will always get a call back, nights, weekends, then chose a clinic with many doctors. Such a clinic will have policies and someone on call every weekend. This type of clinic will always call you back. There is one in Kirkland whose name starts with the name of a tree. Lots of doctors.

Whoa, sounds like we go to the same place!

ha ha I don't go there. Well I did for three sessions but decided it was not for me. The Psychiatrist, female, who name is german for mountain. I go to a little solo practice doctor in the Madison Valley, who is several times a year on vacation and unavailable. He does take my emails and I like him so much. But he is not the kind of doctor you call at night when in an episode.

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I go to a little solo practice doctor in the Madison Valley, who is several times a year on vacation and unavailable. He does take my emails and I like him so much. But he is not the kind of doctor you call at night when in an episode.

I love my solo practice pdoc, she is amazingly quick with emails, and takes urgent calls on her cell phone. She is so much more responsive than any big clinic I have ever worked with (pediatric, adult medical, psychiatric, or veterinary for that matter). I don't know how she does it, to be honest. Yes, if it is a true emergency and she is not available, you are stuck with the ER or 911, but that is the same with any medical group where you must wait for a call back.

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I looked at online reviews for my place and they are just awful. Not so much about the practitioners, but more about the friendliness/competence of the office staff and financial aspects. It's too bad because I really like my pdoc and tdoc and haven't really had many problems with the staff or payment aspects. I'm sure it scares people away from going there, but those are the perils of allowing online reviews of doctors and therapists. Not that I'm opposed to that.

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  • 2 months later...

Boy there's nothing that feels worse than a pdoc who judges you unkindly after therapy. I don't even go to therapy because: a) I don't have the insurance; and b) I'm unwilling - unless the person comes highly recommended - to spill my guts to someone who may not care and will act bored or unkind, thereby worsening my condition. I could sure use it though.

Just today, my pdoc, who has known me for a grand total of 1 1/2 hours of my life over a year (based on our six 15 minute meetings) said something to the effect that I was my own worst enemy. WTF??

I didn't know what he meant, but given that my 15 minutes were over, I didn't have time to ask. He said it after I asked whether the dosage he prescribed would be accepted by my insurance, which had partially declined coverage previously. He hates discussing insurance coverage, so I should have known what was a sore spot.

He also prescribed cymbalta today without much explanation. He gave me about 6 boxes of free sample cymbaltas to "try out." He didn't describe the side effects. I later checked how awful the side effects could be, and particularly how bad the withdrawals would be, and I am amazed that he did not say anything. Even if it worked great, the withdrawal could make me useless for days, maybe weeks. I'd get fired. Oh well. Not really his problem.

I also sometimes question the motives of pdocs. Pharmaceutical companies come around and try to sell them all these new meds. How much of that pressure effects their practice? I wonder if they are directly paid by them? I have no idea.

Please be extremely careful who you pick, because there are major assholes out there (as there are in all professions), and always double-check with crazyboards and other sources before taking anything because you need to know all the side effects and risks.

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always double-check with crazyboards and other sources before taking anything because you need to know all the side effects and risks.

You are going the hear the worst case scenarios on mental health boards. Not a fair sampling. People for whom the meds work and don't have side effects (the majority of people who take psyco meds) have no motivation on post about it on the Internet.

nf

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Of course you have to remember that in any office visit there is typically two people in the room.

One of them is well educated, trained, and performing their life's work.

The other is mentally ill, unstable, with less than reliable perceptions.

*I too have had more than a few visits where I was upset by the pdoc/therapists comments, or enraged, or felt slighted.

But after talking it out with them, having time pass, and become more stable, I usually realize that it's my misperception and overly emotional state. sigh.

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and always double-check with crazyboards and other sources before taking anything because you need to know all the side effects and risks.

Actually, other sources are better than CB. Sources such as the Prescribing Information Sheet rock. Drugs.com is a good source. Definitely, check their med interaction site if you take other meds, supplements or even OTCs. Crazyboards is info posted by your average mentally ill Internet dweeb who may or may not know what he's talking about. Some good info can surely be gained here, but it is often anecdotal personal accounts. Personal accounts certainly have value, but they always are one offs. I'm not saying there aren't links to good sources and that there aren't some very knowledgeable people here. Just saying that poking around here should not be a necessity before starting a med. Not at all. Other sources are more important.

As for side effects, all medications have them, including OTCs. Whether you experience one or more is a crap shoot. If you look in the Prescribing Information Sheet, you'll see that most people do not experience the long list of potential side effects. Generally, you should not plan on getting side effects when you start a med. Instead, you should be informed. You should be informed by your doc about significant side effects and seek immediate medical help if you have signs or symptoms. You should inform yourself, too, because sometimes docs fail and be real, it is your personal responsibility. This becomes more important if you have other conditions which may more likely be effected by how the med works in your body. Anyway, the first line of info is that Prescribing Info Sheet, the one that the pharmacist gives with each and every medicine dispensed. Often a more simplistic version is given, too. Most manufacturers websites include a sheet for patients which is pretty easy reading. Drugs.com and other similar sites have the PI info but can be a little easier to read.If you can't investigate, try to find someone who can sit down and do it with you. And, yes, of course you can ask here. Just, use discretion. You don't know who is on the other end of the Internet talking to you.

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Of course you have to remember that in any office visit there is typically two people in the room.

One of them is well educated, trained, and performing their life's work.

The other is mentally ill, unstable, with less than reliable perceptions.

*I too have had more than a few visits where I was upset by the pdoc/therapists comments, or enraged, or felt slighted.

But after talking it out with them, having time pass, and become more stable, I usually realize that it's my misperception and overly emotional state. sigh.

You make some generalizations here that aren't always true and miss some important points.

Yes, they are obviously very educated and trained. That is all the more reason they should know their comments (and non-verbal cues) can have tremendous impact and should be thought of carefully, fully explained, with knowledge of the repercussions. Providing information, opinions, or suggestions - stated with an empathetic tone, fully engaged and in response to the patient's needs - should not typically result in he/she feeling slighted, hurt, or enraged (I acknowledge that some patients are probably just too unstable to ever not feel defensive). Part of their extensive training is designed to allow the patient to understand their own pathology without providing comment. They are trained to actively listen in a non-judgmental way and then have the patient discover their own path to understanding by use of various techniques.

Relating to my own post, there is also no excuse for not providing the side effects of medications you are dispensing. These medications are powerful and potentially extremely dangerous. It's also their legal obligation to provide that information. Mine didn't and I"m sure he's not the only one. It's not enough to tell the person to read the box or check drugs.com. The side effects themselves, even "mild" ones such as somnolence, can be enough to get one fired for missing days off.

Some other facts. Psychiatrists are not all mentally stable themselves. In my line of work, I had comprehensive factual information regarding a very successful psychiatrist who had been hospitalized twice for depression, was on several medications, and had a very volatile unstable family background.

Some are not necessarily empathetic or altruistic. It is easier to have a core group of well insured low maintenance clients coming in consistently than to have to advertise/market/network for new clients whose insurance coverage may be limited or non-existent. There may be an underlying financial incentive to continue medication that is unnecessary, to add to dosages, to add unnecessary medications, etc. My current pdoc has no idea why my prior one put me on a certain medication at a very high dosage. The medication did not treat the symptom it was prescribed for. Nevertheless, it took me several weeks to withdraw from it. Not fun. They are also pushed by pharmaceutical representatives to prescribe the newer expensive medications. They may have personal financial interests or business relations with these companies they do not have to disclose.

I don't want to bad mouth pdocs. There is nothing more valuable than a great pdoc or therapist, but there is also almost nothing worse or more dangerous than a bad one.

One should get good recommendations before hiring one. I believe avvo.com has started to provide client reviews for doctors and psychiatrists, and other cites have reviews. Rather than dismiss them as the unreliable judgments of mentally ill, unstable people, I would take them seriously, particularly if there is a pattern of similar complaints by a number of former patients.

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