View Full Version : Changing doctors


cokoo1
01-14-17, 07:20 PM
If I've been diagnosed by a psychiatrist and have started treatment/medication with them, how complicated is it to find a new psychiatrist to manage my medication? I'm not happy with the care I'm getting from the current psych or their whole practice in general... and am CONSIDERING seeing a new person.

Will a new doctor make me go through the whole entire process of getting evaluated/tested/diagnosed before I get treatment? Or will they continue my treatment from where I'm currently at?

I'm hesitant because the medication has started to improve my quality of life and I'm still new to it/in the titration process, so the thought of having to restart from square 1 feels like a nightmare... Not to mention a waste of time and money (currently unemployed).

Any help/info/advice highly appreciated.

ToneTone
01-15-17, 12:01 AM
it's not a nightmare ... different psychiatrists want different amounts of patient history. Best to just go for it if you really want a change.

In my experience, my new psychiatrists always continued with the previous medication I was on ... That's the safe option apparently ... Then over time, they're willing to make changes. At least that has been my experience.

The new ones seem to want to wait before making a change. Don't know if that is helpful to you.

Tone

cokoo1
01-15-17, 12:25 AM
it's not a nightmare ... different psychiatrists want different amounts of patient history. Best to just go for it if you really want a change.

In my experience, my new psychiatrists always continued with the previous medication I was on ... That's the safe option apparently ... Then over time, they're willing to make changes. At least that has been my experience.

The new ones seem to want to wait before making a change. Don't know if that is helpful to you.

Tone

Hmmm makes sense... Guess it's just about taking a chance with new doc.

sarahsweets
01-15-17, 03:11 AM
I think some of it will depend on how long you have been treated for adhd by your current doc. If it hasnt been that long, a new doc may want to do a little more digging. What is it about your current doc that you dont like?

cokoo1
01-15-17, 03:48 AM
I think some of it will depend on how long you have been treated for adhd by your current doc. If it hasnt been that long, a new doc may want to do a little more digging. What is it about your current doc that you dont like?

She basically just talks at me instead of with me which is incredibly frustrating because I actually am interested in having a conversation about what's happening and how things work. Even when I got my diagnosis, she was like yup your test results are in line with those that have ADHD. So I'm gonna start you on medication. And that was it. Nothing explaining what that means... so I was basically left on my own to scour the web to research the diagnosis, medications, everything really. And of course that caused more problems cuz things online are almost always conflicting but I had no choice cuz how else would I know what medication is and isn't supposed to do.

I also got the impression that her priority was to just get me to visit as often as possible and each time I would leave without really knowing/learning anything. I was very up front that I'm unemployed and broke so I can't really go in once a week like she wanted me to. But she made it sound like there's no other option. When in fact I have read other people's experiences with their psych and how they are open to a quick phone call/email for any medication adjustments and just going in person once a month.

I also had an appointment last week that I had to cancel the morning of because I'm out of the state right now and my trip back was delayed. And now they are wanting me to pay a $250 cancellation fee which is 5x my regular copay had I gone...

Overall it's just felt like their practice has left me with more stress and questions than answers. But on the other hand because of the medication, for the first time in forever I actually have days where I can get up and be active. So yeah idk. Double edged sword I guess.

Hope that makes sense lol. Those are just some of the reasons I can think of right now.

sarahsweets
01-15-17, 08:36 AM
She basically just talks at me instead of with me which is incredibly frustrating because I actually am interested in having a conversation about what's happening and how things work. Even when I got my diagnosis, she was like yup your test results are in line with those that have ADHD. So I'm gonna start you on medication. And that was it. Nothing explaining what that means... so I was basically left on my own to scour the web to research the diagnosis, medications, everything really. And of course that caused more problems cuz things online are almost always conflicting but I had no choice cuz how else would I know what medication is and isn't supposed to do.
Ok, I get it- no feedback or elaboration.
A lot of times doctors are good for diagnosing and medication management but a therapist trained in ADHD is your best bet when it comes to the nuances that affect our lives. So, both would be a safe bet.


I also got the impression that her priority was to just get me to visit as often as possible and each time I would leave without really knowing/learning anything. I was very up front that I'm unemployed and broke so I can't really go in once a week like she wanted me to. But she made it sound like there's no other option. When in fact I have read other people's experiences with their psych and how they are open to a quick phone call/email for any medication adjustments and just going in person once a month.

RED FLAG TERRITORY: The standard is once a month assuming you become stable on meds right away- or maybe twice a month for a month or 6 weeks. Once you are stable, medication management appts are generally every 3 months and you either go in once a month to pick up your script- or have it mailed to you.
Especially if you explained the financial hardship- she should be sensitive to your situation!

I also had an appointment last week that I had to cancel the morning of because I'm out of the state right now and my trip back was delayed. And now they are wanting me to pay a $250 cancellation fee which is 5x my regular copay had I gone...

Is that amount their policy? Is that anywhere in the paperwork or office?
If not I would say dispute it due to financial hardship or at the very least ask to make payment arrangements. If they want their money they will do it. I cant imagine they would want to go to court over it.

Overall it's just felt like their practice has left me with more stress and questions than answers. But on the other hand because of the medication, for the first time in forever I actually have days where I can get up and be active. So yeah idk. Double edged sword I guess.

Hope that makes sense lol. Those are just some of the reasons I can think of right now.

I get it and if possible I would find a new doc, hopefully cheaper or in network. Go to current doc until you have new appt and be up front. Tell the new doc it was a financial burden you couldnt afford and that you wanted additonal input on your disorder. Disclose all the things that happened so the new doc knows whats up.
I feel for you!

cokoo1
01-15-17, 04:33 PM
Ok, I get it- no feedback or elaboration.
A lot of times doctors are good for diagnosing and medication management but a therapist trained in ADHD is your best bet when it comes to the nuances that affect our lives. So, both would be a safe bet.



RED FLAG TERRITORY: The standard is once a month assuming you become stable on meds right away- or maybe twice a month for a month or 6 weeks. Once you are stable, medication management appts are generally every 3 months and you either go in once a month to pick up your script- or have it mailed to you.
Especially if you explained the financial hardship- she should be sensitive to your situation!


Is that amount their policy? Is that anywhere in the paperwork or office?
If not I would say dispute it due to financial hardship or at the very least ask to make payment arrangements. If they want their money they will do it. I cant imagine they would want to go to court over it.



I get it and if possible I would find a new doc, hopefully cheaper or in network. Go to current doc until you have new appt and be up front. Tell the new doc it was a financial burden you couldnt afford and that you wanted additonal input on your disorder. Disclose all the things that happened so the new doc knows whats up.
I feel for you!


Thanks so much! That helps a lot. I definitely found the whole once a week thing strange because their whole script system is electronic and goes directly from them to the pharmacy. I will probably just go once more so there's no gap in my medication while I find the new doc.

ToneTone
01-18-17, 11:59 PM
OK,

Here's my experience with psychiatrists who accept insurance. They give 10 minutes--15 minutes AT MOST!-- to each patient. It's a revolving door and in my experience, they are ALL like that. Rushed is not the word! Super-rushed!
And I read an article saying that they hate this, but if they take insurance, they need to rush through patients to make money.

I'll go further: I'm a little south of you in Philadelphia, and I could not find but one psychiatrist recently who was taking new clients and who took insurance! ... One ... and he was across the line in Jersey ... Actually he was in California, skyping to an office in Jersey.

You're in New York City I see--I'm sure the situation there is the same or worse than the situation here. Frankly, you are lucky to have found someone who takes insurance ... and no, the insurance-takers don't relax and listen easily to patients.

Now I did go for two years to a psychiatrist outside of insurance and he gave me about a half hour a session. Huge difference. Very relaxed, we would explore the effect of the meds in depth. He would listen carefully, reflect, ask me questions. I mean night-and-difference from the guy in network. He was about $135 for half an hour (and repeatedly going up) ... vs $25 for visits to in-network psychiatrists. This guy left town, and I just felt I couldn't afford his rates anymore.

I ended up ultimately at a psychiatric nurse practitioner who accepts insurance ... and she gives me a relaxed half and hour and listens really thoroughly and seems to know as much about the meds as any of the psychiatrists I've seen. She's in network. You might consider the same type of option.

And yes, many psychiatrists (and therapists) have huge cancellation fees. Apparently people flake on them all the time ... and they are under pressure to fill their days with clients. They don't get a dime in reimbursement for a cancellation.

Anyway, I feel your pain.

Tone

ToneTone
01-20-17, 03:26 PM
Here's something I wanted to mention ... When I was with the psychiatrist who took insurance--who rushed me through sessions in 10 minutes or so--here's what I later figured out.

He didn't want any detailed updates for most of my visits. Unless there was a crisis, he didn't want to talk about adjusting medication. But .... every I would say third visit he would listen and be open to adjusting the medication.

Looking back, I can't help but think that this was his plan. I would see him every two months and yeah, about every third visit he would be willing to talk about adjusting the medication. His body language and his demeanor would be different during these visits, and he wouldn't cut me off so quickly as he did the other visits.

Just my experience. Hope it helps.

Tone

Drewbacca
01-21-17, 12:26 AM
Changing doctors is one of the biggest frustrations for any of us... between doctors that have skeptical views of ADHD in the first place and doctors that fear drug-seeking... it's hard to get good care and there's always that anxiety about starting with someone new. My first p-doc was more than happy to try anything (recklessly, I feel, in hindsight). My second refused to listen to me and I ended up going off medication completely until I later completely fell apart. My third (temp) and fourth p-docs were very reasonable and supportive. Then I moved again and got another one that just didn't seem to want to treat ADHD for whatever reason; I wish she would have just been upfront with me instead of wasting my time.

Current doctor is great! I hope that I can keep her for a while, because the anxiety of hunting for a new one isn't much fun. Hope it all works out for you. I think the key is to just have a frank conversation. Any doctor worth his or her salt would understand the situation.