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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by AnneL on October 17, 2001, at 9:18:19
Hi,
I am currently without a formal pdoc at the moment, although I can access care through my wonderful gp at any time. When I started having a major bout of depression in February I went to my trusted gp who agreed that I needed an AD and started me on Effexor XR and gave me literally "tons" of samples. My follow-ups were at one month, 3 months, 6 months, etc. At the one month mark I decided that maybe I should get a
"formal" diagnosis and saw my child's pdoc (not knowing where to go). He gave me a standardized test (I suppose it was a HAMM test) and after he scored it and spoke with me for a "few" minutes diagnosed Major Depression, single episode. He said I was on a "good" AD and that was that. Since my gp is located in the building where I work, my gp upped my dose at my suggestion and then I saw the pdoc one more time. I stopped seeing him because I felt he was very conservative with his use of Effexor and I wasn't getting results.In July I became very depressed (later found out it was exacerbated by the Pill) and was desperate for a new Pdoc (IMHO, not an easy thing to do) so I went to a colleague of the physician I work with (on the DL).
I found out quickly why the doc I work with dosen't refer many patients to this Pdoc. He is a nice man, but is ready for retirement and does not seem up to speed with new research,etc. In order to help him save face since I work with someone he truly admires and has a friendship with and to find someone that my insurance will cover, I asked him to help me select a Pdoc on a list of in-network providers. He did so and now I have an appointment next week with the Pdoc he helped select.My question is this. . . I really want to get a consistent treatment plan going, but haven't had much success with the 2 Pdocs I have gone to. How can I start out on the "right" foot with this new one and how do I deal with what I see might be construed as a
"flakey patient" image? I feel like I look like a "doctor shopper" and do not want to give this new Pdoc the wrong image, thus getting on the wrong foot.
Any ideas on how to address my "jumping" around and inconsistant treatment? Thanks so much, Anne :)
Posted by Hattree on October 17, 2001, at 9:41:36
In reply to Flakey patient image? How to overcome this?, posted by AnneL on October 17, 2001, at 9:18:19
I don't think you sound so flaky, the pdoc might not think so either. I'd go with the truth. On the other hand, seems like you could leave out that 1st pdoc without omitting much useful information.
> Hi,
>
> I am currently without a formal pdoc at the moment, although I can access care through my wonderful gp at any time. When I started having a major bout of depression in February I went to my trusted gp who agreed that I needed an AD and started me on Effexor XR and gave me literally "tons" of samples. My follow-ups were at one month, 3 months, 6 months, etc. At the one month mark I decided that maybe I should get a
> "formal" diagnosis and saw my child's pdoc (not knowing where to go). He gave me a standardized test (I suppose it was a HAMM test) and after he scored it and spoke with me for a "few" minutes diagnosed Major Depression, single episode. He said I was on a "good" AD and that was that. Since my gp is located in the building where I work, my gp upped my dose at my suggestion and then I saw the pdoc one more time. I stopped seeing him because I felt he was very conservative with his use of Effexor and I wasn't getting results.
>
> In July I became very depressed (later found out it was exacerbated by the Pill) and was desperate for a new Pdoc (IMHO, not an easy thing to do) so I went to a colleague of the physician I work with (on the DL).
> I found out quickly why the doc I work with dosen't refer many patients to this Pdoc. He is a nice man, but is ready for retirement and does not seem up to speed with new research,etc. In order to help him save face since I work with someone he truly admires and has a friendship with and to find someone that my insurance will cover, I asked him to help me select a Pdoc on a list of in-network providers. He did so and now I have an appointment next week with the Pdoc he helped select.
>
> My question is this. . . I really want to get a consistent treatment plan going, but haven't had much success with the 2 Pdocs I have gone to. How can I start out on the "right" foot with this new one and how do I deal with what I see might be construed as a
> "flakey patient" image? I feel like I look like a "doctor shopper" and do not want to give this new Pdoc the wrong image, thus getting on the wrong foot.
> Any ideas on how to address my "jumping" around and inconsistant treatment? Thanks so much, Anne :)
Posted by AnneL on October 17, 2001, at 22:17:54
In reply to Re: Flakey patient image? How to overcome this?, posted by Hattree on October 17, 2001, at 9:41:36
> I don't think you sound so flaky, the pdoc might not think so either. I'd go with the truth. On the other hand, seems like you could leave out that 1st pdoc without omitting much useful information.
>
Hi Hattree,Thanks for your post. You made it so simple. I have a way of making a lot out of little things when I'am anxious. I never thought it would be so difficult to find a Pdoc, but I am having a devil of a time. The Pdoc who said he was going to call me today to schedule our appt. next week did not call today. I think I will just have to be patient (no pun intended-ha-ha) and if he himself turns out to be flakey, I'll move on to the next one on my list. Thanks again, Anne :)
Posted by Gracie2 on October 18, 2001, at 0:33:05
In reply to Re: Flakey patient image? How to overcome this? » Hattree, posted by AnneL on October 17, 2001, at 22:17:54
I think it was Churchill who said Never give up, never never never.
I'm a "doctor shopper" for both GPs and Pdocs. It was particularly important for me to find a decent GP since, under HMO guidelines, he was my primary physician and I could not be referred to a specialist without his say-so. One of the few sensible allowances under an HMO is that you can change your primary physician as many times as you like without penalty.
It is essential to have a doctor that you trust
and who you feel provides you with good medical care. Sometimes it helps to get a reference from a friend but not always. Ten years ago, a friend of mine recommended an OB/GYN who I will always be completely devoted to. Although I am as horrified by pap smears as anyone else, he always makes it as easy and comfortable as possible. He even has those awful metal stirrups on the exam table covered with little flowered padded pillows for your feet. He's a great guy.On the other hand, in an orthopedic office where I worked, the oldest physican was uninterested in any new medical developments. Some of his patients had been with him for 20 years and just loved him. However, it pained me to see him put a cast on a child, because plaster had always worked for him and he saw no need to change that.
Two children with the same type of fracture would come into the office; one child saw the old doctor and the other child saw a younger doctor. The younger doctor would cast with fiberglass, a lightweight material that now comes in all colors and patterns, and can be dried with a hairdryer should it get wet. The child who saw the old doctor would emerge with a heavy, cumbersome, ugly white plaster cast that could cause skin damage should the plaster get wet and often caused intense itching underneath the plaster.So there are good reasons for "doctor shopping".
I believe it has a bad name only because of the patients who see multiple doctors to attain more drugs. This rarely works anymore as pharmaceutical
computers appear to be hooked up so that information on a patient is available from all other pharmacies, inside or outside a particular pharmaceutical chain. In other words, they have our number.I changed primary physicians three times in a year before I found a doctor I liked. I also changed psychiatrists because my first one would take extended trips to Pakistan without informing the patient or providing coverage in her absence.
I found this to be totally irresponsible.So you just keep looking. Sooner or later you will find a doctor that "clicks" with your particular personality, and you'll be glad that you went to the trouble.
-Gracie
Posted by ChrisK on October 18, 2001, at 4:31:58
In reply to Flakey patient image? How to overcome this?, posted by AnneL on October 17, 2001, at 9:18:19
I found that when seeing a new doctor it is easiest to write out your history regardless of which doctor may have treated you at the time. Just keep track of symptoms, possible diagnosis and of course the meds you have tried (whether successful or not). When I have seen new doctors they will usually give my list a cursury look and then start in with their own evaluation anyway. At least it's there and up front and you really don't have to say that you've seen 3 doctors through this time.
It doesn't have to be a full narative - just a list of the highlights.
BEst of luck to you,
Chris
Posted by AnneL on October 19, 2001, at 0:12:45
In reply to Re: Flakey patient image? How to overcome this?, posted by Gracie2 on October 18, 2001, at 0:33:05
>
Dear Gracie,I can't tell you how nice it was to come home after a stressful day at work and read your message! You are so right, there is someone out there for me, I just have to keep at it. The new Pdoc did call me this evening and scheduled an appt. for next week. I am a little anxious about going to another doc, but also feel curious and excited about the prospect of finding someone I can stick with and have some kind of continuum of care and make a plan. Thank you so much for taking your time to respond. It really makes me feel validated. :) Anne
Posted by AnneL on October 19, 2001, at 0:16:32
In reply to Re: Flakey patient image? How to overcome this?, posted by ChrisK on October 18, 2001, at 4:31:58
Dear Chris,
Great, wonderful, fantastic idea. Just the highlights. Possible diagnosis, meds tried and failed, etc. etc. That really helps, because I know that I can go on and on and on, especially if the doc is not very assertive and helps to keep me focused. It's just part of the anxiety process for me to get very fragmented. Working off of a piece of paper will really help. Thanks,
Chris, I will do just that! :) Anne
Posted by Gracie2 on October 19, 2001, at 16:05:04
In reply to Re: Flakey patient image? How to overcome this? » ChrisK, posted by AnneL on October 19, 2001, at 0:16:32
> Dear Chris,
>
> Great, wonderful, fantastic idea. Just the highlights. Possible diagnosis, meds tried and failed, etc. etc. That really helps, because I know that I can go on and on and on, especially if the doc is not very assertive and helps to keep me focused. It's just part of the anxiety process for me to get very fragmented. Working off of a piece of paper will really help. Thanks,
> Chris, I will do just that! :) Anne
Posted by susan C on October 19, 2001, at 21:08:05
In reply to Re: Flakey patient image? How to overcome this? » ChrisK, posted by AnneL on October 19, 2001, at 0:16:32
Thanks all for the posting on this subject, I have been postponing seeing a new GP, and vacilatting about who and what and that...
that 'flakey patient image' is what is underneath it all...I love that term...'flakey patient image' kind of like dandruff in the mirror...mouse getting ready to try on 'new clothes'
susan C
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