Firing your psychiatrist

[Missykins]

Howdy folks,

I've been struggling with my current psychiatrist for quite some time now, and I think it's time to move on.
Specifically, he RARELY returns phone calls--I would say that he returns ~ one of each twenty phone calls
I make to him. He prefers to communicate via text messaging which I find infuriating. I can't get my
questions answered via a text message. He does not have a receptionist handling his phone calls, so you
are forced to leave a message to which he rarely responds, making it very difficult to have a dialogue.

Sometimes, I think that he confuses me with another patient. For example, I contacted him yesterday for
a medication refill (you have to give him 5-7 days' notice, otherwise forget it) that is due to be refilled
on 10/15/11. His reply (via a text, of course) was "according to my records you have enough until the end
of this month." My reply was "last refill was 9/16/11, I have what's left in the original bottle, call my
pharmacy for verification if needed." No response.

I don't ask for much. I don't call him in a crisis (although there was a time when I was in crisis and he
asked me why I didn't call him before calling 911 and I said "because you don't answer your phone").
My questions are usually about refills and meds. I'm also a medical professional, and if I
treated a patient this way, I wouldn't have any.

So, how do I fire this $250/hour, doesn't-take-insurance charlatan? I'm not keen on making another
appointment with him at $250/hr just to fire him, and he doesn't return phone calls or emails. My biggest
concern is finding another doctor. Few "addiction psychiatrists" take insurance and are outside of big cities--I also drive 200 miles to see him because there is no one in the smallish town I live in.

Any suggestions?

 

[Bojangles69]

Yeh as good as it may make you feel psychologically you're not really "firing" your shrink. Because he will still have a job, and still have more patients than he knows what to do with. And thats usually why they act the way they do. Because they know a patient can not fire them and there will always be a new patient right around the corner.

You can do what I did and just stop going. I had seen my psychotherapist for 6 years. He was GREAT. The best dr I could have ever asked for. But the limits of psychotherapy itself were what led me to discontinuing the therapy. I had learned a TON, and became very educated about people and myself, but had not exactly changed in one bit. So I told him I was thinking about not seeing him anymore, that he was a great dr and it had nothing to do with him. He would always talk me into coming back the following week so we could "explore" my reasons more.

Pretty soon I realized what was happening and stopped going. Did not call him or anything.
And this was a dr that came to prison to visit me for christs sake when I was really fucked up and going through shit in life. He was ALWAYS there. And I don't know of any drs that went out of the way as much as he did. He was close to my family, close to me, it was a great relationship we had developed over the years.

I do miss him too a lot it was almost like a father/son relationship but he was more like a philsopher dad than anything. But the therapy was just a waste of time because he believed he was competent to handle addiction and he could not "handle" addiction with biweekly appointments for 40mins twice a month. HOW THE FUCK do you plan on managing a 24 hour a day, 7 day a week addiction, with 2 measily appointments a month? It didn't add up and never will.

But seriously. You don't need to tell him much of anything. Leave him bad feedback on vitals.com if you need too and that should be it. I always leave feedback for my drs on vital.com sometimes good sometimes bad depending on the dr obviously. And after that just get on with your life and find a better doctor. But make sure to actually read reviews on him first before you see him. Kinda like you would for professors at college. Makes a WORLD OF DIFFERENCE ime.

gluck

 

[Snarky91]

Basically find another psychiatrist who is more to your liking. Don't make any more appointments with the first psychiatrist.

I personally believe that almost all psychiatrists are fucked in the head, in one way or another, which is why they were drawn to psychiatry in the first place, probably. The most important criteria for choosing a prospective psychiatrist in my mind are cost, willingness to write prescriptions, and whether or not the receptionist is a bitch, because she is your gateway to setting up appointments and/or cancelling and rescheduling appointments.

 

[n3ophy7e]

I personally believe that almost all psychiatrists are fucked in the head, in one way or another, which is why they were drawn to psychiatry in the first place, probably.

I tend to agree with this statement
However of course there are some great psychs out there too. They're not ALL douchebags


Missykins, as Snarky also said, call some other psychs and see if they will take you as a new patient. Check with them if you'll need a new referral, and if so, go and see your GP. Alternatively you could just go to your GP straight up and ask them for a referral to a different psych and see who they recommend. I know it's annoying/frustrating to have to tell yet another doctor your history and develop a rapport etc etc. But your current psych is NOT doing his job and he is NOT helping you, so it's time to move on.

Then once you've found a new psych, just stop going to/calling your old psych. Easy as pie. If he doesn't answer your calls as his patient it's not likely that he's going to call you to check why you haven't made another appointment :D

Good luck hun, you deserve to find a good psych who will genuinely help you

 

[Bojangles69]

You definitely don't need to be fucked in the head to get into psychiatry although I understand the sentiment. All you really need is to be aware of how fucked up other people actually are. I did not start thinking about wanting to be a psychologist till I was in prison. And sometimes I think it started because I was begining to realize how fucked up I was as a person. But then another side of me said "its really the complete opposite". I felt like every other person around me was the one who was really fucked up and like THAT was making me fucked up. So if I could figure out how to fix them, I can fix myself. =]

In the end I really have too much to say about that topic and would kill this thread with tmi, so let me leave alone. But before I go I will say that some of the most level headed people I have met in this world have been either professors of psych or counselors. The "fucked up" part we see as patients I believe is the commercialized aspects of the industry, and related 100% to money.

I realized this once I started contracting large commerical jobs for the sales industry where there is absolutely no therapy involved. And this is just my opinion of course but your avg salesmen is usually WAYYYYY more fucked up than any shrink you will ever meet. You have no idea what these people do on a daily basis and what schemes they concoct just to make a few extra dollars. Money is always the root of evil imo.

 

[n3ophy7e]

You definitely don't need to be fucked in the head to get into psychiatry although I understand the sentiment.

Hey, it can be a good thing!! It means that they have personal experience with mental illness, so they will theoretically be more sympathetic/empathetic towards their clients

 

[Missykins]

Finding a new doctor is the hardest part. You can't even get a prospective doctor to return a phone call.

Plus I've been with my current doctor for five years.

 

[bagochina]

I was with my last psych doc [errr drug pusher] for 8 years! No more pills, no more blahblahbullshit, so much fucking happier. Just walk away and I hate to say it but deal with your issues in a healthier manner maybe things will change in a positive manner. If not you can always go get another addiction psych. Are you talking about having trouble finding another doctor to prescribe you buprenorphine? Anyways good luck!

he RARELY returns phone calls--I would say that he returns ~ one of each twenty phone calls
I make to him.

How often are you calling him?

 

[effie]

I agree that a lot of people go into psychiatry because they have some personal experience with psychiatric problems - as n3o said, this can work to their advantage as they have more empathy and understanding, but the key is they must not bring their personal issues into the professional relationship. They are your psychiatrist, they should be focussed on helping you.

I think you just need to let this guy go. Write him a letter maybe if you feel the need to understand, but certainly don't spend money on an appointment just to fire him!

I understand the difficulties of finding someone new, however. Do you have anyone who has seen a good psychiatrist who could give you a personal recommendation?

I disagree that a willingness to write prescriptions is a good thing - I'm from the UK, and psychiatry (and medicine in general) is very different over here, but to me a good psychiatrist is holistic and considers all aspects - the "bio-psycho-social" model - biological illness that needs treating eg with antidepressants or antipsychotics, psychological factors which can benefit from counselling, CBT or psychotherapy (or just talking them over with your psychiatryst) and social aspects - your support network, living cirucmstances, job, finances and all the other myriad aspects that have a bearing on our mental health. Just writing a prescription is only addressing one aspect of the problem.

It is very hard for me to hear that finances play such a big part. They really shouldn't at all, but I realise that they do in any country that has privatised healthcare.. and that is part of the "social" aspect I mentioned above. Getting into debt is not condictive to mental wellbeing..

Good luck!

 

[Missykins]

Good luck is right. It really doesn't matter if you are in the position to pay a doctor privately (as opposed to third-party billing by an insurance
company), access to care is still very limited. Every doctor I spoke with (with the exception of one doctor who charges $600 for the initial evaluation and
$325 per session thereafter) has either not been accepting new patients, or simply didn't return my phone call.

Going off my meds cold turkey isn't an option.

So I'm going to have to be an adult about it and let him know how I am feeling, and if I can't live with the outcome, then I'll schedule a consult
with another private-pay doctor.

 

[Mariposa]

Missykins,

I have a great one, and if I did not, I don't believe my sanity would be saved. I private-pay. I don't necessarily recommend that as an option. If insurance is an option, I'd go with that.

It takes a bit to click with a therapist. If I took my meds (benzos and Ritalin) as directed, I'd be a total mess. My MD spends an hour with me, has heard me cry my guts out (which even my NLP coach has not) and is a reputable professional who speaks to me on the level. It took a long time for me to find my MD. He hands me tissues when I cry. I think I'll bring him a 5-pack of tissues next I see him.

I pay $90/hour - most of his clients pay nothing, as most are completely indigent. We spend the hour talking about life, medication management, random shit, whatever. We respect each other.

If I were in your position, I would seek a doctor that meets your needs. We cannot place a currency value on our mental health. I hope the best for you and your budget. You may feel like a mess, but out of the mess, you'll find your personal truth. Intelligence and persistence are the way.

My best to you. Please follow up - your contributions are awesome. Most of all, keep your head up. A voice of confidence, from whatever source, is so valuable to those who seek the help of a professional.

 

[Snarky91]

I understand the difficulties of finding someone new, however. Do you have anyone who has seen a good psychiatrist who could give you a personal recommendation?

I disagree that a willingness to write prescriptions is a good thing - I'm from the UK, and psychiatry (and medicine in general) is very different over here, but to me a good psychiatrist is holistic and considers all aspects - the "bio-psycho-social" model - biological illness that needs treating eg with antidepressants or antipsychotics, psychological factors which can benefit from counselling, CBT or psychotherapy (or just talking them over with your psychiatryst) and social aspects - your support network, living cirucmstances, job, finances and all the other myriad aspects that have a bearing on our mental health. Just writing a prescription is only addressing one aspect of the problem.

It is very hard for me to hear that finances play such a big part. They really shouldn't at all, but I realise that they do in any country that has privatised healthcare.. and that is part of the "social" aspect I mentioned above. Getting into debt is not condictive to mental wellbeing..

Good luck!

You live in the UK right? I was reading an article about how the UK system of healthcare is in jeopardy by a push toward privatization.

http://english.aljazeera.net/indepth/features/2011/10/2011101218221595955.html

 

[Missykins]

I've decided to make an appointment with him to discuss my concerns. He's been my doctor for five + years, and has gotten me through some
difficult times.

 

[effie]

You live in the UK right? I was reading an article about how the UK system of healthcare is in jeopardy by a push toward privatization.

http://english.aljazeera.net/indepth/features/2011/10/2011101218221595955.html

Yeah.. worrying times the trouble is, we can't sustain the spiralling costs of an ageing population and expensive new drugs. I don't know what the solution is, but I would hate to see free healthcare disappear

I've decided to make an appointment with him to discuss my concerns. He's been my doctor for five + years, and has gotten me through some
difficult times.

Fair enough - good luck! Stick to your guns - if he's not helping you right now, then you should definitely find someone who can