I have been seeing Dr. R. for eight years. He helped me through my major meltdown and skillfully, gradually mixed the cocktail of medications that would get me and keep me functioning at an acceptable, livable level. He got me through my near-brush with ECT (although he also suggested it).
Dr. R. is moving to another state. He sent all his clients a letter listing half a dozen or so local psychiatrists he could recommend, though he didn’t know if they were accepting new patients or what insurance plans they took. This week was my last appointment with him.
I looked at the inch-thick file he was holding. “I was really messed up back then,” I said.
“Yep,” he replied.
I left with a hearty handshake, good luck wishes, a paper stating my diagnosis (bipolar disorder, anxiety disorder – I guess there was no insurance code for bipolar 2) and six months of refills on my prescriptions. That’s how long I have to find a new psychiatrist.
So where will my inch-thick file end up next? That’s a good question.
I’ve written before about finding a psychotherapist (http://wp.me/p4e9Hv-1m), but oh, I hate the process of finding and breaking in a new shrink.
At least this time I probably won’t have to go through the whole Reader’s Digest Condensed Version of my screwed-up life, since what I really need at this point is someone who will prescribe and monitor my meds, though it will also be nice to have someone standing by in case of another major meltdown, should I have one.
My first avenue of exploration is whether my primary care physician will prescribe my psychotropics, so I can continue with just a psychotherapist. Dr. R. says that most GPs would shy away from the somewhat lengthy list of meds, but every time I see Dr. S. I update him on what meds I am taking, and I always mention the psychotropics, which have mostly been the same for years.
I have an appointment to see Dr. S. next month and sent a query about the prescription issue (his office has a robust online presence), so with luck, I may have a solution before Halloween.
My next step would be to start with the list that Dr. R. provided. Only one of the offices is at all close to me and I’ll likely start there. Does the doctor accept new patients? Does the practice take my insurance? What’s the charge if they don’t?
I’ll also need to contact my insurance provider for a list of local psychiatrists who do take that insurance, but with that I’ll be flying blind. Dr. R.’s recommendations are people he knows, and knows are good.
I hope they’re as good as Dr. R.
Comments on: "The Quest for a Psychiatrist" (3)
Going in with a diagnosis and working cocktail should help a lot. The whole starting over thing is what’s kept me with Dr. Serious as a neurologist when I don’t really care for him that much. I figure I can put up with him for 30 minutes a year to get my script written. I’m even considering staying with him if/when we move up north to avoid having to go through the search and update and avoid arguing with a new person about whether I should change to their favorite brand of DMD.
I have had the same Doctor for fifteen years and have stayed out of the hospital (knock on wood) for that time. There were some close calls. I’m bipolar I with Tardive Dyskinesia and Metabolic syndrome. It’s tough. I’ve gotten some second opinions as a matter of research to see who else is out there. Not all doctors want to treat patients who are ‘damaged goods’ with ‘tardive dyskinesia.’ Part of that is that they don’t want to deal with the rigamarole of labwork and paperwork in prescribing Clozaril, the only antipsychotic that does not aggravate Tardive. (Tardive is a side effect of antipsychotics many don’t know that.) so…um, another doctor refused to treat me because I have ancient history of substance abuse, and then when I asked if I could see his partner they had a policy (and a lot of offices do)that if you see one doc in their office, you can’t see another.
Then I saw Dr Commandante, a Cuban dictator who is the chief of psychiatry at Aventura Hospital. I have ADHD, chronic pain and Tardive Dyskineisa, so he didn’t like my blend of meds, even tho I am doing well. You may wonder, if I was doing so well, why was I in his office? My new primary care doctor asked me to interview three other psychiatrists…just to see. So Doctor “Castro” (I don’t remember his name) threw me out of his office in three minutes but billed Medicare for an entire 45 minute ‘intake’ session. I have medicare via disability. I’ve had bipolar twenty five years. I worked for the first fifteen but my case progressed. I got disability the first time I tried. They take bipolar disorder very seriously.
Anyway, good luck. Letters work,and comparing notes with other people with mental illness can help too;.
I’ve never heard of a PCP asking for three opinions. I think I would quickly be looking for a new doctor instead of a new psychiatrist.