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Old 09-19-18, 07:35 AM
Royce1013 Royce1013 is offline
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Explaining to new Psych

I have a couple other posts about my terrible experience with a recent psychiatrist and my search for a new one. Part of this is venting and part is actual questions. Short summary is my wonderful helpful doctor left the practice and they assigned me someone else. This someone else may be wonderful for other conditions(although I highly doubt it), but she is so clueless about ADD. I have a hard time believing her degree is even real. I am on a few wait lists for other practices, but I really need to start just calling everyone and find someone else. She has me on one pill a day (I was on 3x) which has caused a lot of stress and frustration at work and with relationships. Last appointment her solution was to take no adderall and try some random “free samples!” she had. She seems to think it’s not the fact that I’m taking 1/3 of my effective dose, no, those problems must be from the one pill I do take. I said I would prefer to just stick with what works (adderall or similar) instead of testing random pills. She said I shouldn’t even be on adderall because adults don’t have ADD. I’ve never dealt with a doctor this incompetent.

So, when I do get an appointment with a new psych, what do I say? Do I tell them what this other doctor has been saying or does that make me look like I’m doctor shopping? Also, do I need to get my records sent? I would like my previous doctors records from the same practice to be sent but not hers.
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Old 09-19-18, 10:03 AM
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Re: Explaining to new Psych

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Originally Posted by Royce1013 View Post
I have a couple other posts about my terrible experience with a recent psychiatrist and my search for a new one. Part of this is venting and part is actual questions. Short summary is my wonderful helpful doctor left the practice and they assigned me someone else. This someone else may be wonderful for other conditions(although I highly doubt it), but she is so clueless about ADD. I have a hard time believing her degree is even real. I am on a few wait lists for other practices, but I really need to start just calling everyone and find someone else. She has me on one pill a day (I was on 3x) which has caused a lot of stress and frustration at work and with relationships. Last appointment her solution was to take no adderall and try some random “free samples!” she had. She seems to think it’s not the fact that I’m taking 1/3 of my effective dose, no, those problems must be from the one pill I do take. I said I would prefer to just stick with what works (adderall or similar) instead of testing random pills. She said I shouldn’t even be on adderall because adults don’t have ADD. I’ve never dealt with a doctor this incompetent.

So, when I do get an appointment with a new psych, what do I say? Do I tell them what this other doctor has been saying or does that make me look like I’m doctor shopping? Also, do I need to get my records sent? I would like my previous doctors records from the same practice to be sent but not hers.
OK, so I've had some experience with a terrible psychiatrist, so I will give a little advice and just take it with a grain of salt.

First of all, it's not your fault, and you don't really need to spare anyone's feelings, because you hired this psychiatrist to help you and they didn't do an adequate job. I would call them and leave a polite message saying "Thanks, but I've decided to go in another direction." No need to explain, in a positive or negative way.

With a new doctor, you don't want to discuss previous experiences until you are sure you've settled on someone you can trust. You really just want to talk to the person answering the phones or leave a message briefly explaining that you are looking for a new doctor, and perhaps a bit about what issues you're dealing with, just in a very general blanket way. If that makes you uncomfortable, then just say "I'm looking for a new psychiatrist, and wanted to make sure you are in network for my insurance." (Or something to that effect - I only deal with doctors covered by my insurance, but that might not be an issue for you.) And go from there with whoever is scheduling appointments.

Once in your in the intake appointment, talk about the issues you are facing with, and if it seems appropriate, you can then mention some of the strategies other doctors tried that weren't successful. You don't have to gossip, accuse the previous doctor, anything that doesn't make you feel comfortable. But you can certainly say "you know, my previous doctor tried [X] and it was really difficult. I don't think I was on a high enough dose." That gives the new doc info that can help them titrate your dose. Any doctor would be grateful for ANY data you can give them that would help them treat you better or set optimal med levels. It doesn't have to get personal. If it helps, pretend you are seeing a new kidney specialist instead of a new psychiatrist. It's really just another part of the body, in some ways. If that helps.

As for the medical records, if you think there's something grossly unfair that would be going on in the medical records of the incompetent doctor, than you have to decide whether you want to deal with her office again to get her records sent. Again, it might be helpful for your new doctor to have all the data, but you're right, medical records from an incompetent doctor might not be valuable and could actually be damaging. If it was me, I would have the records from your most recent COMPETENT doctor sent to your new doctor, and then ask the new doctor if they WANT the records from the incompetent doctor, which is when you can discuss your concerns about how she treated you.


Oh, and you ARE doctor shopping. I would just own it, and be up front about it. "I'm looking for a new doctor, and your practice is in network." Go from there. And do some research first. Scour a prospective practice's website, look at Yelp and other online reviews (can be very revealing!), gauge the energy and happiness level of others in their waiting room when you are waiting for that first appointment, get the opinion of your previous GOOD and trustworthy doctors (if you can - you'd be surprised about how much doctors know about other doctors in the same field in the same city), etc. And also pay attention to how you are treated by their staff/front desk. Do they call you right back, or did you have to wait two weeks or call multiple times to get a call back? Are they courteous, sensitive, and respectful? Are they easy to deal with and knowledgeable when it comes to billing and insurance issues? Do they seem to have respect for the doctor(s) on staff?

Hope this has helped.

D.
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Last edited by DanielGM1970; 09-19-18 at 10:09 AM.. Reason: Clarification
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Old 09-20-18, 08:46 AM
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Re: Explaining to new Psych

You have the right to request all your own records I would do that and then you can review them and bring the ones with you that you think are relevant.
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Old 09-20-18, 05:32 PM
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Re: Explaining to new Psych

Where did you get the idea that there was something wrong about shifting doctors?

People leave and quit doctors they don't like all the time. I once went through about four incompetent therapists in a row ... before I found the guy I'm with now. Best thing I ever did.

So a couple of things ... first, you do need to speak up loudly and clearly with this new person ... write out a script or type out a note ahead of time to hand to her or to read from.

So what you do is present all the new difficulties you are having since you changed medications ... I have trouble doing X. I'm struggling with X ... Z is a problem. You have to spell out the specific problems you're having ... and it is YOUR DUTY to do this ... as no psychiatrist can read our minds.

I had to learn to do this ... because I tend to want to put a happy face on any meetings with people. So my former psychiatrist would ask me how I was doing, and my reflex was to say, "fine. I'm doing good." ... I realized this was dumb and defeated the entire purpose of going to a psychiatrist. (Actually I didn't realize this so much as my therapist realized this and got in my face about this ... and told me my job was not to impress any doctors, but to tell them exactly what's going on so they can help me.)

Anyway, I started a new move when I met with my psychiatrist. He'd ask me how I was ... and I'd say, "OK, let me think." And I'd look away ... and I would concentrate on all my problems ... and then share what was not going well ... He responded to me in a whole different way when I did this.

Now, this is a habit ... and I keep track of what's working well and what's not when I meet with my psychiatric nurse practitioner.

So speak up! ... Here's where I would get tripped up ... Start of session ... psychiatrist comes in and says, "So how have you been?" ... My reflex was to say "OK." No!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! That's the time to say, "Well I've been struggling with X ... having trouble with Y ... having trouble concentrating at work ... feeling tired. Whatever!"

Right at the start.

So try this ... if you're already doing this, then call for a new psychiatrist ... Really, the psychiatrist doesn't care really why you left the last one. They want to treat your symptoms you have now.

The question is ... this ... when you go to a new person ... should you mention your most recent ineffective prescription regimen ... or just mention the old regimen? ... the one that was effective.

I'm tempted to say it would be better to simply mention the effective regimen. I have noticed that new psychiatrists tend not to want to change meds immediately. That's possibly a cautionary move. Every time I've changed the new one has kept me on the previous prescription for a while ... and then later, they would recommend a change.

So your new person is strange in changing your rx dramatically from the get-go.
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Old 09-21-18, 06:43 PM
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Re: Explaining to new Psych

Thank you all for the responses. The advice makes me more confident about the process. I was concerned that in looking at the database they would see the change and think I’m just upset that I want more “drugs” and think the other doctor must have had a reason. In searching for doctors I actually found information on the one I am leaving. Turns out her previous position with with a substance abuse program. Knowing that I think she still has that mind set that patients are all abusing meds or something. This was just a regular practice.

With my records my previous doctor was in the same practice. He was wonderful. When he left she was his replacement. So I don’t know if I can ask for only his records to be sent.

Thanks again for the great advice!
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Old 09-21-18, 07:36 PM
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Re: Explaining to new Psych

OK ... so let's say you get your good doctor's records ... and the records of the latest one and present BOTH to the new person.

I think that works.

Organize the records so that the new person easily sees what you've been on ... say in the last two years ... or the last year ...

The new person will definitely ask, "Why the change?" or "What do you think about change?"

And then weigh in! ... Have your specific examples of your struggles ready to share. Describe your deterioration ... and new person will know that you want to return to previous medications.
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Old 09-21-18, 07:41 PM
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Re: Explaining to new Psych

Quote:
Originally Posted by Royce1013 View Post
She said I shouldn’t even be on adderall because adults don’t have ADD. I’ve never dealt with a doctor this incompetent.
Going to a doctor who doesn't believe that you have the medical condition they're supposed to be treating you for or who is ignorant about that medical condition is a big problem. I went to a psychiatrist for a while who I could tell right away didn't know very much about ADHD which undermined my confidence in his ability to treat my ADHD effectively. So, I stopped going to him after a few months.

I need to trust that my doctors know what they're doing in order to have a productive doctor-patient relationship with them. And trusting my doctors allows me to be more candid with them as well. I've been seeing the person who is treating my ADHD now for a little over a year, and have come to trust his knowledge and his judgement and have built a good rapport with him.
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Old 09-22-18, 10:30 PM
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Re: Explaining to new Psych

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Originally Posted by Royce1013 View Post
I was concerned that in looking at the database they would see the change and think I’m just upset that I want more “drugs” and think the other doctor must have had a reason.!
Sorry for offtopicing, what database does Royce talk about ?

Is this an insurer's system or pharmacy-related ? An what kind of info is there ?
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Old 09-23-18, 04:49 AM
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Re: Explaining to new Psych

Quote:
Originally Posted by Royce1013 View Post
With my records my previous doctor was in the same practice. He was wonderful. When he left she was his replacement. So I don’t know if I can ask for only his records to be sent.

Thanks again for the great advice!
It doesnt matter if you want the records for a new doctor or if you want them to frame and hang on your wall- they are yours and you are entitled to them. Ask how you can get a copy regardless.
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