Posted by Else on July 21, 2001, at 8:05:44
In reply to Re: How effective are MAOIs?, posted by JohnL on July 21, 2001, at 4:29:20
Hello again John,
> Incrementalism has been my technique for years. In Canada, the health care system is different. There is a shortage of specialists so even if my doctor wanted to schedule me in more often to make more money he couldn't. And he gets paid by the state. Changing doctors is DIFFICULT here and having seen others I think I should consider myself lucky. GPs would never prescribe something like Parnate and the waiting list for psychiatrists (in non-emergency situations of course) can go from months to years. I am behaving right now. I work, I haven't done anything self-destructive in a year, I'm no longer truly depressed. Maybe he'll give me a chance. Of course, it's unlikely that he could see me every week but arrangements could be made with a GP or something. But I wont push my luck just yet. He's just agreed to prescribe Klonopin which he would never have considered months ago. I do trust him and I'm willing to wait a while for the good stuff. Anyway, thanks again. BTW, I don't hear much about you.
> If I were you I would simply see another doctor who will prescribe Parnate for you. You could even ask up front if they will. If they won't, call another doctor. Someone will be willing to help you out, but you might have to do a little hunting to find them.
>
> If you want to stay with your current doctor, here is a strategy that can work. It's called incrementalism. Do whatever you have to do, beg, plead, get on your knees, whatever, to get a two week supply of Parnate for trial. You'll have to go overboard to sell the doc on the fact that you will not do cocaine. Only ask for two weeks and agree to see the doc in two weeks. In a worst case scenario, bargain for just a one week supply instead. At that point, if all is well, ask for another two week supply. And set another appointment. The whole idea here is to slowly build trust with the doc and ease into the situation without any longterm commitments. Keep in mind the doc is protecting himself/herself from a lawsuit, and that is likely the main reason he/she is reluctant. If he/she prescribes Parnate, and then you do cocaine, and something bad happens, the doc could be in trouble.
>
> Some doctors are in the business because they have a passion for it. But for most, it is their profession, it is the money that brings them into the office each day. By asking for only a small supply and rescheduling frequent visits, the doc will silently know he/she will be making easy money.
>
> Anyway, assuming all goes well, over time you will earn the doc's trust. And, once the doc sees how well you are doing (assuming Parnate does work well), then both of you will have carefully eased into a more committed situation. Then longterm Parnate use won't be such a reluctant issue. The whole idea is to ease into it very gradually and incrementally. This often helps overcome any reluctance on the doc's part.
>
> Hope something here helps.
> John
poster:Else
thread:71122
URL: http://www.dr-bob.org/babble/20010720/msgs/71190.html