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Just had the most shitty experience with a new pdoc.  This doc was totally cold, indifferent and didn't read my file so I was cross questioned about my medication history for much of the appointment which was incredibly stressful -all the info required would already be in my file.   Then I was asked to explain all the meds I've tried and made to feel bad for the reasons I stopped taking them (i.e. they didn't work + had intolerable side-effects).   I was given an interrogation about current benzo usage, although again this is on my record and is decreased anyway.  

Then I was told I have 'tried everything' (not true) and I when I asked I was given a flat no to the two therapies I wanted to discuss... oh and I was and patronized too. 

I was told depression isn't severe in a way which felt incredibly dismissive.   OK maybe my depression isn't severe compared to the worst cases, but my low mood it is lasting many years  with persistent suicidal thoughts and ideas.  Inability to function/work/etc.

The this doc said well we could try some anti psychotic and when I paused for thought she then pressured me to make a decision because our time was up.  I then got rushed out the door. Now I'm back at home obsessing over suicide methods again. ugh. 

Mental health care in the UK is screwed up.  There is no choice and no real support.  The doctors I've experienced are either incompetent or disinterested... I do wonder why they bother.  Does psychiatry training accept doctors that have failed in other specialities or something?

 

 

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Sorry to hear you can another (?) crappy experience. Not all doctors are bad, mine, for example, is really good and friendly, I think it's luck of the draw as always. 

 

This makes me think of a group session I had today for getting back to work, we were talking about the need to be assertive in situations where others would take advantage of your or throw their weight around and the implications that has on you in the long run. It really sucks that  you're in a position where it might be beneficial, with a doctor of all people, but it might be something you're going to need to do if future appointments are as bad as this one. 

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That really sucks what you went through.  I would have thought, "Seriously?"  I would have been just as pissed as you were.  Just reading what you wrote makes me angry for you.  It is too bad people can be treated that way by a medical professional.

To answer your question: 

Quote

Does psychiatry training accept doctors that have failed in other specialities or something?

 

I have *heard* that this is true in some cases, but I don't have anything to back it up other than hearing it said.  Actually I think I heard that people go to med school for psychiatry because they can't get in to any other area.  Don't know for a fact though.  Like I've said, I have just heard this talked about over my lifetime.

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2 hours ago, melissaw72 said:

That really sucks what you went through.  I would have thought, "Seriously?"  I would have been just as pissed as you were.  Just reading what you wrote makes me angry for you.  It is too bad people can be treated that way by a medical professional.

I find it hard to be assertive without coming across as confrontational or aggressive.  I also find it hard to verbally articulate my own thoughts and ideas in a sensible way that might persuade them.  I've tried writing letters but they clearly don't read them and what really frustrates me is they want me to stop using the one thing that has helped me a tiny bit and accuse me of being an 'addicted' when I express concerns. 

I have been posting on this forum for a long time now and this is the second or third bad experience I've had with pdcos.   I start to think "is it me?"  but then I realize I speak to other doctors and professionals about MH and physical health and I never have these situations arise other than with certain MH "professionals".    When I express my anxiety and ask my surgeon about the plans for surgery and why this is the best option  he will take time to reassure and explain........  with the pdocs I've met if you ask a similar question about meds they just roll their eyes and imply you are being uncooperative and are wasting their time. 

I wonder if I get their back up and make them defensive because I don't have the "yes doctor" unquestioning attitude they expect from psych patients?   Or maybe it is because I've had years of treatment resistant depression and they think I'm a "heart sink" patient?  

I feel like I'm slowly being converted into an anti-psychiatry nut by all these experiences.  

 

 

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I find it hard to be assertive without coming across as confrontational or aggressive.  

Me too because then (at least with me) I get another diagnosis of something close to being aggressive ... or something in that area (I know what I mean but can't remember the word), but in any case I will be labeled as (whatever) now and that can be used against me by the pdoc.

Quote

I also find it hard to verbally articulate my own thoughts and ideas in a sensible way that might persuade them.

I do too ... I can't have any sort of argument in the moment because all my thoughts just run together.  Although when I get home and have time tho think back on it, the words will come to me and it is like, "I should have said (this/that)."

 

About the writing something down ... have you tried writing stuff down, then bringing it with you to pdoc, and handing it to pdoc and ask to read it before the appt starts?  And if pdoc doesn't actually read it ... You know how some pple (in general) can look like they are reading something you just gave to them and all they are doing is staring at the paper?  And you know this because you ask a question about what was written down and they can't remember it or have never heard of it ... then (at least with me) I say (literally), "Ok, what did you just read?"  to see if they were really paying attention.  (I've done this with my pdoc at times)  And they summarize what they "wanted" it to say ... so what you wrote down could be construed as something totally opposite of what you wrote.  So I always make sure what he reads, he knows exactly the point/s I made in it.  So if you do have pdoc read anything, make sure what he read is what you meant it to say, not what he wants to think.  I hope this makes sense.  (Sorry this is so confusing ... I know what I am trying to say and it is coming out all over the place).

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and accuse me of being an 'addicted' when I express concerns

^^Wasn't sure what this meant?

Quote

with the pdocs I've met if you ask a similar question about meds they just roll their eyes and imply you are being uncooperative and are wasting their time. 

I wonder if I get their back up and make them defensive because I don't have the "yes doctor" unquestioning attitude they expect from psych patients?   Or maybe it is because I've had years of treatment resistant depression and they think I'm a "heart sink" patient?  

I hate when they think I am being uncooperative, when all I really am doing is looking out for myself.  I mean, don't I have a right to question things and ask questions?  It also could be like you said, that maybe most of the patients they have are the, 'yes, DR' unquestioning attitude. 

What does "heart sink" mean?

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Sorry this happened to you. This has happened to me so many times I have pretty much completely given up on the mental health system here. I don't live in the UK, I'm Australian, but nonetheless because Australia is also part of the Commonwealth, we have socialised healthcare (at least in the public system- similar to the NHS there but it has another name and ours seems even less functional at times) 

Personally , I believe these kinds of problems, especially within mental health, are one of the huge disadvantages to public socialised healthcare. It really doesn't seem to be patient driven whatsoever and it is not hard at all to get kicked out because they deem you impossible to treat because you have exhausted their underfunded resources. 

I don't have any advice because ever since I left child mental health services about 2.5 years ago this and other similar problems have happened to me within the adult system. I have now been kicked out completely because I have, according to them, exhausted all if their resources. I am never anything but upfront and honest about my mental illnesses with doctors, to my best ability, and the only time I am "uncooperative" is when I have already tried something that they want me to just to make them look like they are a competent doctor. 

I have had the same problem with therapists here as well. It's a really hard thing to do, accept that I am severely mentally ill but that I apparently will never be anything but because the system that is supposed to help refuses. 

Anyways, I don't want to turn this into my thread, so I will shut up about my own experiences. I was just trying to help you feel not so alone by talking about them. As I said, I have no advice because these problems are largely because of the system, not the patients (in this case, you).

Most of the time we do our best to convey our concerns and get shrugged off. I have very little understanding and capacity to comprehend why this even happens besides knowing that socialised public healthcare systems are often underfunded and lack resources for the more complex and difficult to treat people. 

Again, sorry this happened to you. I know it probably seems rather dismal and impossible, but I hope you find a proper pdoc soon. 

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4 hours ago, melissaw72 said:

I do too ... I can't have any sort of argument in the moment because all my thoughts just run together.  

I hate when they think I am being uncooperative, when all I really am doing is looking out for myself.  I mean, don't I have a right to question things and ask questions?  It also could be like you said, that maybe most of the patients they have are the, 'yes, DR' unquestioning attitude. 

What does "heart sink" mean?

I have the opposite problems - my thoughts don't run together they just stop flowing completely.  I get so overwhelmed with anger/frustration that my brain just shows down, sometimes I physically can't speak any more. 

Believe me I've tried and tried again with the letters - I've sent them ahead of time and taken them to appointments.  The 2 doctors I've met will barely skim read them and then draw incorrect conclusions. I know I write reasonably articulately (although maybe not on internet forums...).  I wouldn't mind but a standard appointment is 30 minutes and a extended one is up to an hour.... if I bring in a 2 page letter there is plenty of time to read it properly and discuss. :cussing:

With the addiction thing - My GP put me on a benzo about a year ago to cope with anxiety, I started on quite a high dose but I have worked down over time.   The pdocs I have seen keep putting pressure on me to stop it completely because benzos are "addicting". My response is that this is the only medication that has worked and has helped me when I'm having a horrific day.  I will stop it if someone is offering me a better alternative... but they are not offering alternatives, just telling me to go back on SSRIs that failed many times already.   I'm not addicted because my usage has gone down over time, not up.    

However the pdocs seem blind to this argument.

"Heart Sink" is literally just that - it is a derogatory term some medical professionals use to describe patients that literally make their 'heart sink' when they see them.  It is often applied to "difficult" patients, like those with personality disorders or unexplained physical symptoms like Fibromyalgia.  Basically the doctor's brain over heats because they can't cope with the patient's needs/demands and have no solutions to offer, so that causes a feeling of frustration, fear and anxiety for the doctor.... they then project their own negative feelings onto the patient.

 

 

 

 

Edited by crazyguy

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1 hour ago, Hopelessly Broken said:

Personally , I believe these kinds of problems, especially within mental health, are one of the huge disadvantages to public socialised healthcare. It really doesn't seem to be patient driven whatsoever and it is not hard at all to get kicked out because they deem you impossible to treat because you have exhausted their underfunded resources. 

I don't have any advice because ever since I left child mental health services about 2.5 years ago this and other similar problems have happened to me within the adult system. I have now been kicked out completely because I have, according to them, exhausted all if their resources. I am never anything but upfront and honest about my mental illnesses with doctors, to my best ability, and the only time I am "uncooperative" is when I have already tried something that they want me to just to make them look like they are a competent doctor. 

I have had the same problem with therapists here as well. It's a really hard thing to do, accept that I am severely mentally ill but that I apparently will never be anything but because the system that is supposed to help refuses. 

Anyways, I don't want to turn this into my thread, so I will shut up about my own experiences. I was just trying to help you feel not so alone by talking about them. As I said, I have no advice because these problems are largely because of the system, not the patients (in this case, you).

Most of the time we do our best to convey our concerns and get shrugged off. I have very little understanding and capacity to comprehend why this even happens besides knowing that socialised public healthcare systems are often underfunded and lack resources for the more complex and difficult to treat people 

 

I'm sorry to hear about your experiences, although I have to admit it is kind of comforting to know I'm not alone.    To be honest it is nice to read about someone else's issues rather than just be stuck in my own.... so thanks for sharing. 

I can identify with so much of what you say -  resources are limited and they are not interested in helping those with complex issues, only drugging those that are violent or socially disruptive .      I've also found they keep suggesting things I have tried already and then imply I am uncooperative for not doing so.   I mean really how pointless is it to try the same med for a 4th time around?  It is a waste of everyone's time!

If I had the money I would go privately for medication advice but also for counselling.  Unfortunately I looked into it and it costs £200 an appointment, plus medication costs... I simply can't afford it.... I've also read it isn't uncommon for private pdocs to milk the patient for cash too, stretching out the assessment over multiple appointments, requiring monthly medication reviews and so on. 

 

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I'm sorry, I don't know what else to say, except that I really hope things change for you.  If I think of anything else, I'll post.

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On 11/11/2015, 15:51:48, melissaw72 said:

I'm sorry, I don't know what else to say, except that I really hope things change for you.  If I think of anything else, I'll post.

Thanks, that is OK I know nobody here is a professional.  I don't expect solutions but it is just good to be able to vent and be 'heard'.  :)

I feel a bit less frustrated today.  I've decided I will not see that doctor again. I'm going to go back to my GP and ask about going back on the last antidepressant I was on........ it kind of stopped working but maybe it will work again after a break.  It has to be better than nothing. 

Edited by crazyguy

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I agree it is a good idea to be able to vent and be heard, not feel alone in the situation.

I'm glad you are doing better today.  I hope it continues and that you find a new pdoc who you can work well with.

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Oh my, when I saw this post... I started to feel less alone I guess. Like you, I have been having troubles when I moved from the US to the UK. Doctors are complacent, don't want me to continue a treatment that has worked so well. question everything, and really don't care. This is so fragmented - you see mullions of doctors just there to assess you, and they make recommendations to the GP without even consulting me first...I am sure this is not true for all of them, but the NHS system is made as such that I have felt seriously misunderstood - which led to rebound depression and panic attacks. My interactions with the GP as she tried to discontinue some of my medications were even worse, and left me feel totally helpless.

Unfortunately, I didn't know how to handle it. So I took an overdose of drugs last week, and then was hospitalized for a week. The truth of it, simply, is that you will find good doctors there, but since you have no choice, it's a terrible game of luck. I found one doctor for my ADHD who supported me and called me when things started to wrong. He didn;t have to do it, since his involvement is pretty much limited to one assignment, and then back into that damn system. Yet he did it. The doctors at the hospital understood my problem, and made very good recommendations involving trying to source some US drugs to the UK. Of course, I will never see them again, so it's too bad. But at least I felt understood, and it was somewhat encouraging.

As for me, I also know that the NHS cannot bring me the support I need. So I will see a private doctor - I need someone that I can reach when things get messy again. Someone that I can trust because he cares and is competent at the same time.

Take good care of yourself...I wish I could bring a solution to your problem. But at least, you're not alone in this. 

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Yeek.   I had a visit like that with a pdoc.  I'm not really good at dealing with doctors who act like goons.  Fortunately my GP is really good at telling me its time to see someone new and handing me a name.  So far this has worked out.   I'm kind of confused how socialized medicine works.  Are you "assigned" a doctor and then stuck with them? 

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I'm sorry that happened to you, crazyguy. I can't imagine how incredibly upset I would be. Wait ... actually I can imagine a little. I had just one really, really, really bad experience with a pdoc. He kept insulting me, said I'm the kind of guy who liked Woody Allen movies (I don't), and dismissed me out of hand. When I gave him a check to pay (this was late and the secretary had gone home), he looked it over very carefully and accused me of writing a check that wasn't good. Needless to say, that was the one and only time I saw that pdoc. I was upset for days and went back to my old pdoc. My old pdoc wasn't the best but at least he wasn't insulting. Now I have a completely different pdoc.

I hope you can find a pdoc that you can at least work with, and better yet, I hope you find a good pdoc.

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4 hours ago, HAL9000 said:

Yeek.   I had a visit like that with a pdoc.  I'm not really good at dealing with doctors who act like goons.  Fortunately my GP is really good at telling me its time to see someone new and handing me a name.  So far this has worked out.   I'm kind of confused how socialized medicine works.  Are you "assigned" a doctor and then stuck with them? 

Not sure what you mean by socialized medicine, but in terms of finding a DR (I see you are from the US ... Minnesota) you can get one who covers you with insurance ... you could call your insurance company for a list to be sent to you, or you could go private and pay on your own.  Some may have sliding scales for payment.  The only time I can think of where you could be "stuck" with a DR is when you find a DR in a clinic, where you are assigned one.  But not all clinics are the same.

What I did before finding my current DRs is I found a DR, then called their office to see if they accepted my insurance or not. If they said no, I moved on to another one.  If they said yes, I gave them a chance.

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Socialised medicine is what most countries in the Commonwealth call their public health system (besides the actual national name for it) It is called socialised because anyone can access it within a set of rules for the particular country. 

It works pretty much the same as any other type of health care, except a GP is usually the base point, meaning without one you usually can't get any referrals outside of a general practice and a GP usually has the most knowledge on how to get into other parts of the health system and will usually make contact with any other professional (or at least their practice) before making any referrals. A GP will usually write out and order any pathology lab testing that a potential doctor asks for as part of the referral, also. 

The GP also receives any notes or reports, results etc, with the person's consent, from other professionals. This is to make sure all of someone's health professionals are on the same page and are aware of any treatment. Although that can fail, depending on how busy the GP is (or other health professionals)

Once you get referred to another health professional, unless you are involuntary, it is between you and that doctor when you leave (or sometimes just yourself and you tell your GP why so they can make another referral if necessary) 

Once referrals run out (for various reasons), unless you can afford private health insurance, you are screwed. Same thing applies if any part of the health system says they can't do anything for you anymore, once you are out it is very difficult to get back in and be treated. 

Coverage within a public socialised health care system is usually dependent on the national universal health insurance and whether or not you are on some kind of government "benefit". This applies to all sectors of public health care, and medicines prescribed under the national health insurance. 

Of course these will vary throughout the Commonwealth (and other countries with a socialised public health system) 

 

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@Hopelessly Broken

That is a pretty accurate representation of the NHS 'socialized' system.  The only thing  is in the UK you can never 'run out' of cover, although effectively the GP is employed indirectly by the state and is always under pressure to 'gate keep' by keeping referrals as low as possible, prescribing the most cost effective medications and so on.  

When you get referred to a specialist you can choose what hospital you go to, but it is often more difficult to request a particular doctor.....Normally you get referred to a hospital's 'team' and that team decides which doctor or health care professional you  to see.   So you might want to see Dr X, but the team decides you will be assessed by Nurse Y first.

Also with mental health there is VERY little choice.  Specialist services are so under resourced that GPs are required to manage most MH problems (as a result many are very good at it though).  To even get to see a psychiatrist you have to be more severely ill or seeking a diagnosis for a complex condition.  In my area the only therapy GPs can refer to is 6 to 8 sessions of CBT, which is useless really. If you want counselling or psychotherapy then you have to go via a psychiatrist and will wait years and might not get it at all. 

Of course the plus side is the cost.  As the system is paid for by everyone out of general taxation it means everyone is always covered even if  they are unemployed. You never pay anything to see any doctor/nurse/visit the hospital and never pay more than £105 a year for medications, even if you are on 10 different expensive drugs. If you are unemployed or retired you get all meds free anyway.......

Unfortunately this is can sometimes be abused by people who see their GP twice a week for no good reason (there are no limits on access at GP level),  or demand their doctor prescribe stuff you can buy at the pharmacy without RX.   

 

 

Edited by crazyguy

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I'm another one who has had shitty experiences. I'm in Australia

In hospital, first pdoc - ''It's your fault you're depressed'' (yes, he actually said that) When I tried to explain about all the other symptoms I was having - paranoia, people stealing my thoughts, the government spying on me by putting cameras on helicopters and people plotting against me he dismissed me with a wave of his hand and made it clear that he wasn't interested in anything I had to say and what was happening to me.

Another pdoc, when I was trying to explain that Seroquel was doing nothing from me he said

''yes it is, it's a good drug''

''Well it's not working for me and since I'm the one who has to take these drugs I think I'd know whether or not something was working''

''No no no it's a good drug''

 

Another one has said to me ''Do you think all this could be in your head and that you're just bored?''

 

I'm sure there have been others that have made ridiculous comments but they are the ones that have stood out.

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7 hours ago, dazed and confused said:

I'm another one who has had shitty experiences. I'm in Australia

In hospital, first pdoc - ''It's your fault you're depressed'' (yes, he actually said that) When I tried to explain about all the other symptoms I was having - paranoia, people stealing my thoughts, the government spying on me by putting cameras on helicopters and people plotting against me he dismissed me with a wave of his hand and made it clear that he wasn't interested in anything I had to say and what was happening to me.

Another pdoc, when I was trying to explain that Seroquel was doing nothing from me he said

''yes it is, it's a good drug''

''Well it's not working for me and since I'm the one who has to take these drugs I think I'd know whether or not something was working''

''No no no it's a good drug''

 

Another one has said to me ''Do you think all this could be in your head and that you're just bored?''

 

I'm sure there have been others that have made ridiculous comments but they are the ones that have stood out.

That is really fucked up.

 

On 11/12/2015, 3:49:36, crazyguy said:

Thanks, that is OK I know nobody here is a professional.  I don't expect solutions but it is just good to be able to vent and be 'heard'.  :)

I feel a bit less frustrated today.  I've decided I will not see that doctor again. I'm going to go back to my GP and ask about going back on the last antidepressant I was on........ it kind of stopped working but maybe it will work again after a break.  It has to be better than nothing. 

Have you talked to your GP again about going back on meds?

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I didn't mean you lose coverage, I mean GPs can lose professionals to refer you to. Coverage stays the same, but its useless once you get deemed untreatable and kicked out of the system. 

Here it seems to be the other way around. The likelihood of getting a referral to a team here is next to zero unless you are an imminent threat to yourself or others. Then most teams only provide short term treatment and you're back at square 1 (trying to find a compotent pdoc via referrals, all the while getting more and more ill) 

It seems if you actually find a compotent pdoc, most of the time they will send back a treatment plan to your GP for them to follow, to reduce cost to the patients (our health insurance isn't very good at covering mental health care in an outpatient setting, and a pdoc can be up to $300 a pop even with our health insurance rebate) 

But then again, most GPs in my area are not comfortable prescribing psych meds and will only do so as a last resort, with clear instructions from a pdoc (contradictory when most pdocs just push someone like myself away) This is why I am not medicated, my GP has extensive mental health training but she is not comfortable prescribing psych meds, especially the few I haven't tried yet. 

Anyways.......

Best of luck to you, crazyguy. I know that is probably extremely dismal, it is for me. 

 

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