View Full Version : Does Medicaid = Low Quality Psychiatrists?


Obsessive_ADD
04-06-17, 06:05 PM
I am currently on medicaid and live with my parents. Are the psychiatrists who take medicaid likely to be inherently less skilled at treating specific, more difficult treat conditions such as ADD-PI? We could probably afford to pay for a psychiatrist out of pocket if it was worth it but it's not clear to me whether there would be anything to gain. I've been on all the traditional ADHD meds as well as most of the SSRIs indicated for OCD. Any ideas?

Diagnoses: ADD-PI, mild GAD, mild OCD

dvdnvwls
04-06-17, 06:30 PM
With medicaid you can get a great one or a bad one or anything in between. What you do NOT get (not much anyway) is choices.

ToneTone
04-06-17, 06:33 PM
Well I have a friend on Medicaid and she's pretty happy with the doctors she has found, but she doesn't go to a psychiatrist.

But if you live in an area, where you can find and schedule an appointment with a psychiatrist who takes Medicaid, I would say you are fortunate. Where I live (and I live in a big city with multiple major hospital systems and medical schools) I could NOT find a psychiatrist who took insurance ... Forget Medicaid--we're talking private insurance ... They were all filled up ... and there were very few in the first place. Well, I found one who Skyped from California.

I now go to a advanced psychiatric nurse practitioner, who I like a lot.

The general rule is that psychiatrists out of network will give you more time ... Psychiatrists inside insurance networks (and I'm sure it's the same with Medicaid) give you about 10-15 minutes for a visit. They have such large caseloads they cannot spend a lot of time with people. They are much more rushed, in my experience ... I imagine psychiatrists who accept Medicaid might have large caseloads ... and they may not be able to give you a lot of time.

So if you are getting started on treatment and can afford it, I would go to someone who gave me more time ... Getting the right dose ... even getting the diagnosis right isn't easy ... Also, it's very easy to omit key information from a psychiatrist when you are in a rush.

In other words ... go to the best psychiatrist you can afford ... because the difference between an excellent doctor and a mediocre one can be HUGE! ... and hugely consequential. Not all expensive doctors are excellent. Not saying that ... Unfortunately, in psychiatry, I think a large number of the really good ones are expensive and don't Medicaid or private insurance.

Good luck.

Tone

aur462
04-10-17, 04:12 AM
I'm less familiar with Medicaid but my wife tells me that even shrinks that don't take insurance usually accept "caid". My mental health network is complete and utter excrement filled with lots of shrinks with reviews remarking "should lose his license" and other heartwarming sentiments. I go out of network.

oldtimer
07-18-17, 12:20 PM
See if you can find 'Healing ADD' by Amen in your library. After reading it try the survey mentioned in the book. With a preliminary diagnosis, the rest is down hill. Having a better idea what is going on makes it easier on you.

Lunacie
07-18-17, 04:28 PM
See if you can find 'Healing ADD' by Amen in your library. After reading it try the survey mentioned in the book. With a preliminary diagnosis, the rest is down hill. Having a better idea what is going on makes it easier on you.

Daniel Amen is an author of pop psychology and unsubstantiated claims.

There is little to no research to back up any of his ideas or treatments.

His books are basically brochures to promote his clinic.

His methods may be about as successful as any other treatments but cost
thousands of dollars more.


And he does not accept Medicaid, Medicare, or Medi-Cal.

finallyfound10
07-22-17, 11:08 PM
When I had medicaid, I saw to two MD's who were in their Psychiatry Residency. One was really good- maybe she was PGY4 (Post Graduate Year 4, which is the last one in US programs) and the guy was not that great.

There were other factors though, the woman was doing part of her residency at a non-profit mental health organization where everyone involved shared my faith, so from my perspective, she brought more than straight clinical skills.

Look into non-profit mental health organizations. There are secular ones too.