The Psychiatrist

My son and I both hate his psychiatrist. This man has the personality of a brick wall and to make matters worse he is condescending, arrogant and appears, to me, to clinically depressed and scarily angry.  His office is 40 minutes from my house and the only way to get there is on a road that is chronically congested. His waiting room always smells like smoke because 95% of his patients are depressed adults who are all so poorly treated that they self medicate with copious quantities of nicotine.   The office even sounds bad.  He has these old sound neutralizers placed all about his waiting area and office, so confidential information is not overheard.  These 1980s contraptions make this obnoxious kind of blowing whine that drives my son and I crazy.

His office staff does not appear to ever answer the phone and leaving a message on the voice message system is like screaming into the top of a well, the only response that you will ever get is an echo. His procedure for making an appointment, canceling an appointment, adjusting a medication or getting a refill is purposely difficult.  If you want to torture yourself and make a followup appointment, you best do so while you are there because it will, otherwise, be impossible to schedule.

He charges $25.00 if you lose your prescription and $50.00 if you miss your appointment. He spends no more than five minutes with you (which my son and I are actually grateful for), asks you condescending and rude questions (Have you taken the time to email his teachers to see how he is doing in school?), fills in the answers to his questions with whatever he wants the answer to be (The Psychiatrist: "How are you doing with the vyvanse?" My son: "The Vyvanse takes away my appetite for 13 hours", The Psychiatrist: "So everything is going great, no appetite means it's working.")

I have been having these psychiatrist revenge fantasies where I win the lottery but instead of blowing off the next scheduled appointment (after all what is a mere $50.00 to a lottery winner),  I go to the appointment armed with a case of Febreeze for his smelly office, brand spanking new sound neutralizers, and a prescription for him for some Paxil or Effexor. I tell him to get his damn depression treated and to only return to seeing patients when he is cured of his anger and sadness.  In my fantasy I forward the office phone line to a real psychiatrist that I have personally paid for and I save all the other miserable patients in this practice from the incompetence of this evil psychiatrist.

I am sure you are asking yourselves why on earth we are still going to this awful physician. We go there because this is where our insurance will pay for us to go. There is a child psychiatrist that is wonderful and that we have paid out of pocket to see but with two kids in private school and only one of us working full time, we cannot afford to see them regularly. So we are stuck with the horrible psychiatrist.

I recently tried to get a referral from him for a Cognitive Behavioral Therapist (CBT). He said that this type of treatment was not necessary for my son and that he would not write the referral. Our insurance might pay for the CBT if I had a referral but Dr. Do-Nothing will not write a referral so we will have to continue to pay out of pocket for that treatment.

Our situation is not as bad as it could be. I and my spouse both have prescriptive privileges and this makes the prescription situation a little easier for us as we can write a prescription if my son's Vyvanse runs out before we can get him in for an appointment or if, as happened this summer, we go on vacation and forget his medication. I do not think it is good form to right prescriptions for family members so we only do this if there is some sort of emergency.  Still we have that option which I recognize is a God sent.

I am sure that there are many people seeing psychiatrist or psychologist that they hate because they are the only pyschiatrist in town or the only psychiatrist that their insurance will authorize. I have no advice for you except to suggest that you read all you can on your condition and try to educate yourself on all your options. Persist, insist and make a pest out of yourself if you are not getting better and your psychiatrist is giving you the 'five minute write off'. If all this fails, scrounge up all your pennies and pay for a psychiatrist that is recommended by a University in your area, by CHADD, or by your primary care physician.

Any of the above referrals are bound to be better than an nsurance company referral. I also suggest that while you are saving your pennies you should indulge yourself and think up a good psychiatrist revenge fantasy. It will make you feel tons better and it is absolutely free.

10 comments:

  1. Suggest you write your insurance company a detailed letter and get mames of people there to call agin & again.....Also any letters from school consulors and any other doctors you take your son too....You really have to fight these insurance companies HARD! Again & again.

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  2. I totally agree with the comment above ! You can lose, you can only gain !

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  3. Our insurance is the same as the Military's insurance because my spouse works for the Uniformed Health Service. I have spoken to them many times but you are right, writing a letter would be much better. This insurance has no psychiatrist on their list that is geographically close to us that specializes in children.

    I have given our insurance company a list of psychiatrist that we would like to see. What they say is that I can go to these psychiatrist and file for reimbursement but that what they will reimburse will likely not be but a portion of the bill.

    The evil psychiatrist files the insurance claim and accepts whatever payment the insurance company gives him. I will go somewhere else and pay out of pocket if need be but for right now my son is doing fairly well and we will stay the course. Thanks for your comments!!

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  4. This psychiatrist may have had complaints filed against him...Contact local medical associations.He has to be certified to practice.. At least how to file a complaint. He has to do certain things to keep his license. Keep going higher and higher on the "food chain" of insurance authorities....WRITE an APPEALS LETTER with details of problem and Damage it is doing to your child...Almost malpractice.. and send a copy to EVERY Executive at the Insurance Company

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  5. I need to consult the best psychiatrist. I had a traumatic experience a week ago and it's bothering me so much..

    I've already read some articles how to find the best one at http://clevelandpsychiatrist.org/

    However, I still need more details before choosing the right one..Can you recommend me to someone who can really help me..

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  6. Your closest CHADD chapter can help. We have seen a fantastic child psychiatrist that was recommended by our CHADD chapter and we pay and go to him whenever there is an issue with either of our sons that requires a 'real' psychiatrist. I will not escalate my issues with this physician by suing him for malpractice but I will schedule an appointment with another psychiatrist on my insurance panel. After getting these comments I realize that I should be doing more than creating revenge fantasies and venting.

    Thanks you all for the wake up call!!

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  7. I have fantasies as well, but mine include violence towards my insurance company who makes changing prescritptions an act of God and refuses to pay for a blasted thing- referral or no referral.

    I feel your pain. My 3 kids are in parochial school and my insurance would not pay for speech therapy or occupational therapy ( although this exact same plan paid for OT for years, then suddenly stopped because all of a sudden it wasn't a medical necessity). We did pay for short term cbt to help with sleeping troubles. It worked and was worth it.

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  8. What I really meant to say. If you mail (certified) or Fedex a letter to Executives of said insurance company. THEY will read it and you may get a positive response.

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  9. WOW...what a loser! Thanks for sharing your story...my prescriber gets about an 80% approval rating from me, but recently he basically said to me that he thought I was just fine and didn't really need any treatment and would have been fine if I'd never come into his office.

    Um. Yeah. Okay. Is that code for...you can't figure out how to treat me effectively so I must be the problem? (I've tried an insane amount of med combos in the past year and a half, I'm just med sensitive and it's hard to treat ADHD and anxiety simultaneously anyway...duh...)

    D'oh...we really do have to advocate for ourselves...good for you for having a critical eye on your son's treatment.

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  10. You are right. The management of this insurance company, at the very least, needs to hear that not having a child psychiatrist on their panel of physicians is unacceptable.

    It is estimated that up to 5%-20% of children and adolescents are receiving some sort of mental health treatment. For a huge insurer,like this one, not to have a specialist for children's mental health issues is ridiculous.

    I will write the letter. Thanks for the kick in the but!!

    18 Channels, I cannot even imagine what it would be like to try to deal with our psychiatrist if my son did not respond well to the medications or had unmanageable side effects. More people with Inattentive ADHD have anxiety and one of the major problems with the stimulants, including coffee, is that they make some folks incredible anxious. In a small subgroup of these people, Intuniv or Strattera works. Coaching and Cognitive Behavioral Therapy is all that is left, at this point, for everyone else with anxiety and ADHD-Pi and I can see where that would, often, just not be enough. There are a few new medical therapies in the pipeline...

    Thanks so much for your comments!!

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