Posted by Questionmark on November 25, 2004, at 18:54:44
In reply to Re: Finding a pdoc who prescribes MAOIs » Questionmark, posted by King Vultan on November 24, 2004, at 13:04:23
> > i agree with this, ideally, but it's not that easy-- especially in the UK probably. i'm in the freaking States and about a month ago i called every psychiatrist i could find in two phonebooks for the surrounding area. i did this because i currently have to travel 2 hours to see my psychiatrist (who prescribes me my Nardil), and i wanted to see if i could find someone closer.
> > Each time i called and spoke to the doctor or, usually, the secretary, i said something like "i'm interested in seeing Dr. So-and-So, but i would like to know if he/she is willing to prescribe an MAOI before i make an appointment", they would reply "Well I don't know, that would be his/her decision and s/he would have to talk to you first ." Then i would say "No i know, i'm just wondering if s/he would be WILling to prescribe it. i know i would have to talk to him/her first. It's just that some psychiatrists don't prescribe these medications anymore and i don't want to spend all the money (and the time) on an appointment if s/he is not even willing to presribe them." And then they would just say the same stupid thing to me like they weren't even listening. i swear there's something about secretaries who work in psychiatric offices-- so many are ignorant [can't-use-the-word]s (*AND NO NOT ALL, i said "MANY"). Of course, the same is true with many psychiatrists. There's something wrong with the whole psychiatric industry. i don't get it.
> > Anyway, sorry for that long shpiel. My point is that it might not be that simple for TheOutsider to find a psychiatrist who is willing to prescribe MAOIs-- particularly to determine whether one does or not.
> I only have experience dealing with a couple of branches of a clinic where both my GP and pdoc work, but my experience when calling in on technical issues is that I am inevitably referred to a nurse, who then communicates with the doctor on my specific question and gets back to me. I don't know if it's necessarily reasonable to expect the receptionists and such who answer the phones to have that much familiarity with all the different drugs that are available, particularly when it's something as obscure as an MAOI. In fact, I now typically ask in the beginning of the conversation to speak to my doctor's nurse regarding a dosage question, refill, problem, etc.
> I called in a couple weeks ago and asked to speak to my pdoc's nurse about increasing my dosage of Parnate, and the lady who answered the phone asked me to repeat the name of the drug because she had never heard of it. Now here, I was actually a bit surprised, as I would think this drug is at least notorious enough that she would have heard of it, even though it isn't prescribed much. OTOH, my pdoc said it had been about 10 years since he had used it, and I don't know if the other psychiatrists in the office even use it at all. Anyway, the nurse seemed to be on the ball when I spoke with her later, and she then conferred with my pdoc and called me back to say that it was okay to go up in dosage. This system seems to work pretty well unless a person's situation is unusually complicated. In those cases, it may be better to just go in and see the doctor.
Good advice Todd. Unfortunately not every pdoc has a nurse under him/her. But for those who do, that's a good idea.
Also, bytheway, you said: "I don't know if it's necessarily reasonable to expect the receptionists and such who answer the phones to have that much familiarity with all the different drugs that are available, particularly when it's something as obscure as an MAOI."
i totally agree. i would not just ask the receptionist if Dr. So-and-So is willing to prescribe MAO inhibitors and leave it at that. i would either ask to speak to Dr. So-and-So, or i would say something like "Do you know if Dr So-and-So is willing to prescribe an MAO inhibitor at all?" and if they did not know, i would then ask if it would be possible to speak to that Dr. at some point.