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Re: Bad doctors (Dr. Bob, someone, help!)

Posted by Elizabeth on May 29, 2001, at 12:47:30

In reply to Re: Bad doctors (Dr. Bob, someone, help!), posted by Marissa on May 28, 2001, at 12:58:09

> I am really struggling to find a good doctor. The doctor-patient relationship can have a big power imbalance, which I don't like -- I want a doctor and I to work TOGETHER on helping me, I don't want to just do whatever he says. Yesterday I went to a doctor for the first time, and withing 15 minutes he thought he had everything all figured out, and wanted to change me over to Effexor. He said "Depression is treated with serotonin, not norepinepherine", even though I told him that the norepinepherine drugs tend to work better for me than the more serotonergic ones.

Argh! I know I don't have much information, but it really sounds like you just found a bad doctor. A statement like the one you quoted is simply absurd. I *don't* like to make absolute judgments about people (especially with so little information), but after hearing that, I can't imagine anything that would convince me that the doctor you saw is a competent one. I don't think this guy deserves a second chance; I think you should find someone else. That you need for your doctor to treat you with respect (I'm the same way) only makes it worse. This is not a doctor you should be seeing. (If I were in that position, I'd be reluctant even to pay him for the initial "consultation.")

> He said "If you want me to help you, I can help you, but I won't fight with you. I'm not going to do what you want me to do. I've been a pharmacologist since before you were born."

I agree that it's no use for a doctor and patient to be fighting with each other, but it sounds like he's twisted the situation around. He's not willing to accept it if you even *question* him -- not at all the same thing as fighting.

As an aside, I think that it's deceiving for an MD physician to call himself a "pharmacologist," especially one who demonstrates so little understanding of pharmacology! MDs take two semesters of pharmacology in medical school. That's it. A pharmacologist is someone who has a degree (almost always a PhD) in pharmacology. I have more right to call myself a mathematician than he has to call himself a pharmacologist, and I only have a bachelor's degree!

> When we were walking out of the office, he told his receptionist to make an appointment for me with the therapist he works with, even though I never said I wanted a therapist, much less that one.

I hope you cancelled it?

> I've had depression for 11 years, and a doctor should not make decisions about my treatment within 15 minutes of meeting me.

No, he shouldn't. He needs to review his professional ethics -- it sounds like he doesn't understand the concept of "informed consent." A doctor can't force a patient into any type of treatment.

In my experience, the best way to find a good doctor is by word of mouth -- talk to other people who might know a psychiatrist in your area, and see if you can get a few referrals. A good way to do this if you don't know people in the area is to go to a support group for people with mood disorders. (I don't know any pdocs in Atlanta, but I'm sure that NDMDA -- the National Depressive and Manic-Depressive Association, a network of support groups across the country -- has one or more meetings in Atlanta.)

Another strategy: talk to a doctor on the phone before you make an appointment. Make a list of questions to ask him in advance so you can get an idea of what he's like. (One I always ask is, "What are some of the strategies you employ when a depressed patient has not responded to the standard treatments?")

You said that you've tried a lot of ADs with "insufficient" effectiveness. That sounds like you mean they worked some, but not enough. My thought would be that combining two or more partially effective ADs is what you'd need to do in order to get a more complete effect.

I hope that I've been of some help. Don't get discouraged (I know, easier said than done).





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