![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
Posted by Rockets on June 6, 2000, at 9:54:20
In reply to Re: Anybody been fired by their pdoc?, posted by Cindy W on June 6, 2000, at 9:25:05
I think we should set our expectations a little more realistically. pdocs are trained medication dispensers who make quite a bit of money to do that. Sometimes you get lucky and find one that is more than that. They usually charge more too. I personally use a really good pre-qualified psychologist/counselor for emotional support and therapy. I only expect my pdoc to dispense the right medications properly. Most pdocs are not psychologists. Their training is different.
Posted by kazoo on June 6, 2000, at 10:50:50
In reply to Re: Anybody been fired by their pdoc?, posted by Snowie on June 6, 2000, at 2:37:24
> Kazoo,
>
> My mother is livid. Neither she nor I intend to tell my sister (who is bipolar and sometimes suicidal), since we're afraid she might go off the deep end. After all, he did this to me ... he could easily do it to her. However, if he has any sense he won't mention my name again.^^^^^^^^^^^^^^
How are you sure that he's not doing this to your sister, but she's too distressed to recognize, much less understand, the import of his actions?
How effective a physician can this person be if he willy-nilly discharges you simply because he cannot "control" you?
Remember: he can do more damage than good. I'd get her away from this guy ASAP.
Also, I thought it wasn't an accepted practice for psychiatrists to treat members of the same family? I don't know of any who do this.kazoo
Posted by Snowie on June 6, 2000, at 11:59:17
In reply to Re: Anybody been fired by their pdoc? (2), posted by kazoo on June 6, 2000, at 10:50:50
> How are you sure that he's not doing this to your sister, but she's too distressed to recognize, much less understand, the import of his actions?
Kazoo, I don't know that since he has never discussed her with me, except to say that her problems are worse than mine.
> How effective a physician can this person be if he willy-nilly discharges you simply because he cannot "control" you?
He's a "mature" man, probably in his early 60s. (According to his internet bio, he graduated in 1958.) He couldn't "control" me like he has my sister (who is afraid of him), but I always listened when he gave me good advice, which unfortunately wasn't that often.
> Remember: he can do more damage than good. I'd get her away from this guy ASAP.
It's not my decision. If my mother can find another pdoc for my sis, I expect she will. I'll respect whatever decision they make; however, if they decide to keep him, I won't want to hear anything more about him.
> Also, I thought it wasn't an accepted practice for psychiatrists to treat members of the same family? I don't know of any who do this.
You're probably right, but my sister lives in a different city with my mother. I live alone in Tampa (we're both single). Also, our problems are totally different, hers being much more severe than mine. Doesn't mean my problems aren't important to me, but then again, I've never been Baker Acted nor tried to kill myself. And I certainly wouldn't go over the edge because of this ... I wouldn't give my ex-pdoc the satisfaction.
Snowie
Posted by Greg on June 6, 2000, at 12:16:49
In reply to Re: Anybody been fired by their pdoc? (2), posted by Snowie on June 6, 2000, at 11:59:17
Snowie,
Sorry to intrude here, but I was curious. What does Baker Acted mean? It's a term I've never heard before.
Greg
Posted by kazoo on June 6, 2000, at 16:13:00
In reply to Re: Anybody been fired by their pdoc? (2), posted by Snowie on June 6, 2000, at 11:59:17
> > How are you sure that he's not doing this to your sister, but she's too distressed to recognize, much less understand, the import of his actions?
>
> Kazoo, I don't know that since he has never discussed her with me, except to say that her problems are worse than mine.
>
> > How effective a physician can this person be if he willy-nilly discharges you simply because he cannot "control" you?
>
> He's a "mature" man, probably in his early 60s. (According to his internet bio, he graduated in 1958.) He couldn't "control" me like he has my sister (who is afraid of him), but I always listened when he gave me good advice, which unfortunately wasn't that often.
>
> > Remember: he can do more damage than good. I'd get her away from this guy ASAP.
>
> It's not my decision. If my mother can find another pdoc for my sis, I expect she will. I'll respect whatever decision they make; however, if they decide to keep him, I won't want to hear anything more about him.
>
> > Also, I thought it wasn't an accepted practice for psychiatrists to treat members of the same family? I don't know of any who do this.
>
> You're probably right, but my sister lives in a different city with my mother. I live alone in Tampa (we're both single). Also, our problems are totally different, hers being much more severe than mine. Doesn't mean my problems aren't important to me, but then again, I've never been Baker Acted nor tried to kill myself. And I certainly wouldn't go over the edge because of this ... I wouldn't give my ex-pdoc the satisfaction.
>
> Snowie
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Snowie, my dear,>>"He's a "mature" man, ..."
(For the lack of a better word, I suppose.)
A "mature" man doesn't intimidate people simply because they know more than he does.
A "mature" man make people fear him.
A "mature" man isn't a control freak.
A "mature" man doesn't dole out good advice selectively.And this guy is a "doctor"?
I'm sorry, Snowie, but I disagree with you whole-heartedly about having Sis still
see him.>>" ... if they decide to keep him, I won't want to hear anything more about him."
And, by all means, stay on top of the situation and monitor what's going on.
I wouldn't throw caution to the wind in this situation!kazoo
Posted by Archangel on June 6, 2000, at 16:33:10
In reply to Re: Anybody been fired by their pdoc? (2) » Snowie, posted by Greg on June 6, 2000, at 12:16:49
> Snowie,
>
> Sorry to intrude here, but I was curious. What does Baker Acted mean? It's a term I've never heard before.
>
> Greg_________________________________________________
Greg,
I don't know all of the legalities but I do have a friend in Florida who was "Baker Acted" a few years ago. Apparently, someone can claim you are a threat to yourself and have you locked up for a few days of psychiatric observation.
Here's my buddy's story: His ex-girlfriend and a coconspirator "Baker Acted" him out of some very vicious spite. It happened on a Friday night and it took him all weekend to find a judge who would spring him :)
I think the Baker Act is a Florida phenomenon. Perhaps someone out there will fill us in on the specifics of who, what, where, when and how.
Best regards,
Archangel (Michael)
Posted by Archangel on June 6, 2000, at 16:40:28
In reply to Re: Anybody been fired by their pdoc? (2) » Snowie, posted by Greg on June 6, 2000, at 12:16:49
> Snowie,
>
> Sorry to intrude here, but I was curious. What does Baker Acted mean? It's a term I've never heard before.
>
> Greg_________________________________________________
Greg, regarding my previous post in this thread:
I should have said I don't know *ANY* of the legalities of the Baker Act. Saying that I don't know "all" of them implies that I know something, which clearly I do not :) All I have is hearsay information. ~ Archangel (Michael)
Posted by Greg on June 6, 2000, at 17:26:42
In reply to Re: Anybody been fired by their pdoc? (2) » Greg, posted by Archangel on June 6, 2000, at 16:40:28
> > Snowie,
> >
> > Sorry to intrude here, but I was curious. What does Baker Acted mean? It's a term I've never heard before.
> >
> > Greg
>
> _________________________________________________
>
> Greg, regarding my previous post in this thread:
> I should have said I don't know *ANY* of the legalities of the Baker Act. Saying that I don't know "all" of them implies that I know something, which clearly I do not :) All I have is hearsay information. ~ Archangel (Michael)Arch,
What I like most about Babble is that I learn something new everyday. Thanks for responding. I'm now a day older....and smarter.
Greg
Posted by Snowie on June 6, 2000, at 19:10:10
In reply to Re: Anybody been fired by their pdoc? (2) » Snowie, posted by Greg on June 6, 2000, at 12:16:49
Greg,
Sorry ... I'm in Florida. I forgot the Baker Act is a Florida legislative creation, not Federal. My sister was Baker Acted by a law enforcement officer when she took a truckload of pain killers and sleeping pills last year. If you're interested, you can copy and paste the URL below which explains more about Florida's Baker Act.
Snowie
http://www.leg.state.fl.us/citizen/documents/statutes/1997/ch0394/E463__.HTM#0394.463
>Snowie,
>Sorry to intrude here, but I was curious. What does Baker Acted mean? It's a term I've never heard before.
>
> Greg
Posted by Dave A on June 6, 2000, at 20:23:44
In reply to Anybody been fired by their pdoc?, posted by Snowie on June 5, 2000, at 21:03:43
> After 5 years, the receptionist in my pdoc's office told me today that my pdoc would be discontinuing his services to me. In a word, I was shocked, and after I hung up the telephone I began to cry, probably from the fear of abandonment more than anything else. Actually, I should have fired him years ago, but I didn't because of our long association. It's strange, but I never felt like he really understood me nor cared ... obviously, I know now that he didn't. I've heard of people firing their pdocs, but I've never heard of a pdoc firing a patient. I know this too shall pass and he probably was doing me a favor, but I'm feeling extremely vulnerable right now. Was the fact that I research the internet really so imtimidating? He was so nasty toward the end, and every question of mine was followed by some sarcastic "ask your internet friends" type response. Paul, I certainly understand what you went through now. I guess surviving and doing well is the best revenge, but first I have to find a replacement. It's also a little awkward since my sister still uses him, and I don't want to jeopardize her relationship with him. At the same time, I don't want him to know anything further about me, and I don't want to know anything further about him. Anybody experience anything like this before?
>
> Snowie
Hi:I have had this dismissal experience several times in the past, although in a more subtle, nicer manner.
Mainly, the doctor is too dumb to understand how
to treat my situation which I believe is fairly
straight forward. One thing I've learned is that the two main things most important things to a doctor are getting paid and not getting sued.
They really don't care if you get better or not.There are exceptions, of course, and these are the
doctors you should try to find. Also, I think
psychiatrists are a better bet than psychologists.
It is much easier to become a psychologis,
and thus psychiatrists are more likely to be
intelligent, and understand how to treat your
problem. I mention this because, once I went to
a psychologist, and he greatly exacerbated my
problem because he didn't know what he was doing.Luck,
Dave
Posted by Janice on June 6, 2000, at 23:20:54
In reply to Re: Anybody been fired by their pdoc?, posted by Snowie on June 6, 2000, at 1:42:48
Hi Snowie,
Well I don't know you well, but you sound much better today. I can easily see how strong your personality is.
I was reading your postings to everyone, and this guy sounds so much like the psychiatrist I saw--even their ages are the same. Maybe at one time, the criticizing and making fun of patients, was some kind of official therapy. And these two never got over it.
I agree it's not appropriate for a pdoc to hug their patients or to inappropriately talk about sex.
Now you sound good and you say you don't want to sue or report him. I got quite a bit of satisfaction screaming at him (he was so shook-up, it took him 3 tries to write my lithium prescription). I also got satisfaction from both my family doctor and new pdoc telling me that I was right, and what he did was wrong (he actually lied). I also got satisfaction from reporting him to the College of Surgeons and Physicians.
But if you are fine, you are fine. You will probably be very pleasantly surprised with your next pdoc. THe other pdoc I've had never had anything but my best interest at hand.
I hope you find someone like this Snowie.
Janice
Posted by Kim on June 7, 2000, at 0:40:40
In reply to It's all about the Benjamins, posted by Rockets on June 6, 2000, at 9:54:20
> I think we should set our expectations a little more realistically. pdocs are trained medication dispensers who make quite a bit of money to do that. Sometimes you get lucky and find one that is more than that. They usually charge more too. I personally use a really good pre-qualified psychologist/counselor for emotional support and therapy. I only expect my pdoc to dispense the right medications properly. Most pdocs are not psychologists. Their training is different.
Rockets--That's why I fired my Pdoc. I was only seeing him for "medication management," but he was still a jerk. He once told me I should work with my therapist on my "psychotic delusions"--which was his interpretation of my comment that I didn't feel like I should do something fun unless my house was clean. (Obsessive, maybe, but not psychotic or delusional.)
But the final straw was that he did NOT prescribe my medication correctly. He told me to take temazepam up to three times a day. He thought it was an anti-anxiety, and it's a sleeping pill. Fortunately my pharmacist caught the error.
I think you're right, it must be about money. The information sheet he gave me on my first visit said that his office "chooses not to handle emergencies," and was limited to patients who were not "seriously disturbed." In other words, the easy bucks.
Posted by Snowie on June 7, 2000, at 6:54:44
In reply to Re: It's all about the Benjamins, posted by Kim on June 7, 2000, at 0:40:40
Rockets and Kim,
What's wrong with wanting it all? I understand that most pdocs are nothing more than med dispensers because that's what the insurance companies require them to be. However, not all pdocs are willing or content to be puppets of the insurance industry. And pdocs ARE trained in therapy, but many forego that aspect of their training because they can make more money by dispensing meds for patients who constantly march in and out, much like an assembly line. My ex-pdoc saw me for 10 minutes every other month or so. How can any pdoc know what meds a patient needs in that amount of time? IMHO, he can't ... only a pdoc who has spent TIME listening and conversing with a patient can correctly identify the problems of the patient in order to prescribe the proper meds for that individual. For the rest of the pdocs, it's just a hit or miss proposition, which seems to be forcing many of us to research our own meds. Also, although it is about money in general, my pdoc's bills were always paid in full at every visit. He got his ... I'm still wondering what I got.
Snowie
> > I think we should set our expectations a little more realistically. pdocs are trained medication dispensers who make quite a bit of money to do that. Sometimes you get lucky and find one that is more than that. They usually charge more too. I personally use a really good pre-qualified psychologist/counselor for emotional support and therapy. I only expect my pdoc to dispense the right medications properly. Most pdocs are not psychologists. Their training is different.
>
> Rockets--That's why I fired my Pdoc. I was only seeing him for "medication management," but he was still a jerk. He once told me I should work with my therapist on my "psychotic delusions"--which was his interpretation of my comment that I didn't feel like I should do something fun unless my house was clean. (Obsessive, maybe, but not psychotic or delusional.)
>
> But the final straw was that he did NOT prescribe my medication correctly. He told me to take temazepam up to three times a day. He thought it was an anti-anxiety, and it's a sleeping pill. Fortunately my pharmacist caught the error.
>
> I think you're right, it must be about money. The information sheet he gave me on my first visit said that his office "chooses not to handle emergencies," and was limited to patients who were not "seriously disturbed." In other words, the easy bucks.
Posted by Greg on June 7, 2000, at 8:07:46
In reply to Florida's Baker Act, posted by Snowie on June 6, 2000, at 19:10:10
2. A law enforcement officer shall take a person who appears to meet the criteria for involuntary examination into custody and deliver the person or have him or her delivered to the nearest receiving facility for examination.
Wow! I don't think I'd want a California policeman being able to make the decision on whether or not I "met the criteria". Cal cops already have far too much latitude when it comes to making arrests. I believe here, at the minimum, a Psychotherapist must be called to the scene to make that call (I could be wrong). This made for some VERY interesting reading!
Do you feel this law is a justifiable one? I would think that a cop would have to be trained in Psychology before being allowed to make a decision to institutionalize (sp?) someone. Otherwise any cop having a bad day could put someone away. I wonder if there are other states that have laws similar to this?
JMHO
Greg
Posted by Kim on June 7, 2000, at 15:34:46
In reply to Re: It's all about the Benjamins, posted by Snowie on June 7, 2000, at 6:54:44
My ex-pdoc saw me for 10 minutes every other month or so. How can any pdoc know what meds a patient needs in that amount of time? IMHO, he can't ... only a pdoc who has spent TIME listening and conversing with a patient can correctly identify the problems of the patient in order to prescribe the proper meds for that individual.
Snowie,
I agree 100%. But my insurance company won't pay for me to see a Pdoc for therapy, only medication management. Then they pay my psychologist for therapy. The insurance company thinks they're saving money. And I sure couldn't pay it on my own.I don't know why the insurance company can't understand that having one person do both would probably help me get better more quickly. Instead I keep slogging through therapy and getting no where, and slogging through different medications which don't work.
Kim
Posted by Rockets on June 7, 2000, at 18:20:57
In reply to Re: It's all about the Benjamins--both ways, posted by Kim on June 7, 2000, at 15:34:46
As Chief Lone Watie said to the evil carpetbagger in that Clint Eastwood movie [The Outlaw Josey Wales] (http://www.clinteastwood.net/welcome.html) when the carpetbagger tried to sell him some "special formula" that was "good for most anything": What's in it? The evil carpetbagger was speechless and stuttered out "I really don't know.. I'm just the salesman." To which Chief Lone Watie replied "then you drink it" as he walked away.
Posted by Adam on June 7, 2000, at 22:00:04
In reply to Anybody been fired by their pdoc?, posted by Snowie on June 5, 2000, at 21:03:43
Snowie,
If you haven't left out any details, this does sound rather abrubt and confusing.
Did the doctor offer any explanation at all beyond his testyness at your asserting
yourself?Anyway, this is a tough question for me, as I don't know for certain if I have been
"fired" or not. But if I have, it has happened at least once, and possibly twice.
The first time, I had to leave my old physician because I changed jobs and insurance.
I was on Welbutrin, but decided on my own to stop it, as it didn't seem to be doing
much of anything for me. After a few months of more depression as usual and no
progress in therapy, I sought out a new doc. I laid out from the beginning my history,
the lack of results I had gotten from drugs, X, Y, Z, etc., the side effects I hoped
to avoid, and so on. We tried Welbutrin again, but no dice.We decided on Serzone as a
possible solution. I started taking Serzone in small doses, saw no improvement, and
then began aggressively upping the dose. I started to get, if anything, worse, with a
great deal of anxiety accompanying my depression. My doctor had me stay on the drug,
and continued to up the dose. After about a month and a half, I came to the
conclusion that Serzone just wasn't doing it for me. I was feeling not just depressed,
but rather frenzied. It was going from oppressive to mind-numbing. He told me to
stay on the Serzone, and augmented with clozapine. No improvement, and really things
got even worse. I, after coming very close to killing myself on the highway
(deliberately), checked myself into the hospital.About a week into the visit, my doctor called. He said that while he did not object to
me as a person in any way, he was dissatisfied with our arrangement, meaning that he
preferred to administer both psychopharmacological and psychotherapeutic care to his
patients, not just the former. When I reminded him that my insurance company made the
arrangement, he just continued, saying that he was glad to hear that I was getting ECT,
that he wished me the best of luck in my treatment, and that was it.I suppose I could take him at his word, but he knew from the outset what his role as
my physician was, and made no mention of changing until after I landed in Mass.
General (a move I made on my own, by the way, at the hypothetical recommendation of
my psychotherapist, who had originally referred me to the doctor). Perhaps he was
really not happy all along, and just saw this as an opportune time to bail, I don't
know. Something just smacked if disingenuousness. I told the head resident as soon
as I saw him next. He was silent for a bit, and then said "we can refer you to
someone from here so you can be followed when you leave." Another therapist later on
also met the story with a disconcertingly long silence. He ended the pause with "Hmm.
Pretty slick."The next time was with the very physician I had been referred to. After seeing him
for a few months, and getting, again, nowhere on a drug combo. (initially Remeron, then
Remeron plus a very small dose of Zoloft), we began to talk about Parnate, which had
been recommended to me while I was in the hospital, though I was freaked out by what I
heard about the drug and opted then not to try it. At this point we were meeting once
per month. Between that visit and the next, I decided to enrol in a clinical trial of
the Selegiline transdermal system for depression. It was a study I had heard about
earlier, but could not try because I had receive ECT too recently. Now I could qualify,
so I went for it. My doctor was not at all happy. My therapist was even less happy.
I was a bit shocked, to be honest, at their response. The seemed a bit irritated with
me, and very irritated with the investigators in the trial, and I guess some heated
words were exchanged. If I had known my actions were going to create such a stir, I
might never have entered the study, which would have been a shame, to but it mildly.
Anyway, what followed was a period of six weeks where I was (at their insistance) seeing
my old p-doc, the therapist, and the docs in the trial on a weekly basis, which was
a big disruption of my life, since all the meetings were on different days, etc. It
wrought havoc with my work schedule. After the double-blind portion of the trial I went
into the open-label phase, and had a robust, almost hypomanic response within about three
days of initiation. I haven't been the same since, thank goodness.Well, I stayed with my old pdoc, who I genuinely liked, for a couple more months, but
we both decided that while the other docs were following me, and while I was doing so
well, we could take a breather and reassess when the trial was over. He actually called
me towards the end to see how I was doing. I left him a message saying I still wanted
to work with him because, even though selegiline was doing for me what I didn't thing was
possible from a drug, I still had some nagging anxiety concerns, and since he was an OCD
specialist (my other Dx), I wanted to know what he thought of some augmentation strategies
I was thinking of. I told him in the message my favorite candidate was inositol, and I
wondered what he thought of the safety of MAOI plus inositol. I said my reasoning was
that since it was involved with the 5-HT2C-receptor signalling pathway, which, as I was
sure he knew, was implicated in OCD, it might be worth trying, according to an Isreali
study, which I was also sure he already knew about.He didn't reply to my message, and I never heard from him again.
The trial ended. I was hoping I could continue with the docs. who ran the trial, but my
insurance company wouldn't let me. The doc. who was seeing me in the trial called my old
pdoc and asked him about seeing me again. My old doc replied that since he had no
expertise with selegiline, he didn't feel comfortable prescribing it. And that was that.
The head of the trial was quite skeptical about this explanation, but did not elaborate. He
just brushed it aside, saying they would be very happy to refer me to some very good
doctors in the outpatient clinic at McLean. It was deja-vu all over again.This new arrangement is working quite well, I must admit, so I have little cause to
complain, I suppose. But, well, the experience of doctors deciding for somewhat mysterious
reasons not to see me anymore, has been disconcerting. It has made me wonder on more than
one occasion if there is something unlikable about me as a patient. I have never been
rebellious, though I do have many of my own ideas, and share them often enough. I never
was non-compliant, though I voiced objections or concers if I wasn't comfortable at first.
I don't know what to think, really. I have to say, the way the relationships were severed
leaves me little nostalgia for them.
> After 5 years, the receptionist in my pdoc's office told me today that my pdoc would be discontinuing his services to me. In a word, I was shocked, and after I hung up the telephone I began to cry, probably from the fear of abandonment more than anything else. Actually, I should have fired him years ago, but I didn't because of our long association. It's strange, but I never felt like he really understood me nor cared ... obviously, I know now that he didn't. I've heard of people firing their pdocs, but I've never heard of a pdoc firing a patient. I know this too shall pass and he probably was doing me a favor, but I'm feeling extremely vulnerable right now. Was the fact that I research the internet really so imtimidating? He was so nasty toward the end, and every question of mine was followed by some sarcastic "ask your internet friends" type response. Paul, I certainly understand what you went through now. I guess surviving and doing well is the best revenge, but first I have to find a replacement. It's also a little awkward since my sister still uses him, and I don't want to jeopardize her relationship with him. At the same time, I don't want him to know anything further about me, and I don't want to know anything further about him. Anybody experience anything like this before?
>
> Snowie
Posted by Snowie on June 8, 2000, at 0:28:57
In reply to Re: Anybody been fired by their pdoc?, posted by Adam on June 7, 2000, at 22:00:04
> Snowie,
> If you haven't left out any details, this does sound rather abrubt and confusing.Adam, there's not enough space for every detail, but nothing was left out that would explain it any better. I think my ex-pdoc actually liked me, but he couldn't handle the fact that I can think for myself. I would have loved the benefit of his wisdom, but he rarely shared it with me.
> Did the doctor offer any explanation at all beyond his testyness at your asserting yourself?
At the end? No ... it was just don't come back, but he had been rolling his eyes and making fun of me for quite some time. My feeling is that he thought I should have put all of my faith in him. Also, he didn't seem to want to hear any bad news ... only that everything was going swell and that he was wonderful. That's nice, but it's not the real world. He also wasn't open to technology and new ideas. Maybe he was afraid that I might learn more than he. Was I ever nasty to him? No, that's not my style. I was knowledgeable, persuasive, and persistent, and I believe he resented that.
> Anyway, this is a tough question for me, as I don't know for certain if I have been "fired" or not. But if I have, it has happened at least once, and possibly twice.
> The first time, I had to leave my old physician because I changed jobs and insurance. I was on Welbutrin, but decided on my own to stop it, as it didn't seem to be doing much of anything for me.I've stopped meds more times than I can count. Every time I stopped a med on my own initiative (for legitimate reasons) my ex-pdoc was very displeased.
>After a few months of more depression as usual and no progress in therapy, I sought out a new doc. I laid out from the beginning my history,
the lack of results I had gotten from drugs, X, Y, Z, etc., the side effects I hoped to avoid, and so on. We tried Welbutrin again, but no dice.We decided on Serzone as a possible solution. I started taking Serzone in small doses, saw no improvement, and then began aggressively upping the dose. I started to get, if anything, worse, with a great deal of anxiety accompanying my depression. My doctor had me stay on the drug, and continued to up the dose. After about a month and a half, I came to the conclusion that Serzone just wasn't doing it for me. I was feeling not just depressed, but rather frenzied. It was going from oppressive to mind-numbing. He told me to stay on the Serzone, and augmented with clozapine.Sounds like you were honest with this guy up front. I also have my ground rules ... I won't take anything long-term that will make me fat or decrease my libido. I also tried Serzone ... it just made me terribly dizzy. The combination of clonazopam and Serzone would have made me a zombie.
> No improvement, and really things got even worse. I, after coming very close to killing myself on the highway (deliberately), checked myself into the hospital.
Good for you! At least you wanted to live. Your pdoc should have supported you 100%.
> About a week into the visit, my doctor called. He said that while he did not object to
me as a person in any way, he was dissatisfied with our arrangement, meaning that he preferred to administer both psychopharmacological and psychotherapeutic care to his patients, not just the former. When I reminded him that my insurance company made the arrangement, he just continued, saying that he was glad to hear that I was getting ECT, that he wished me the best of luck in my treatment, and that was it.What? Didn't he even send flowers? The insurance companies yield far too much power over the mental health industry, in my opinion. However, your pdoc certainly should have understood the status quo from the beginning. I guess he got annoyed that you took matters into your own hands, even though you know a drug's effect in your body, and he should have listened to your concerns. However, I personally think that if you had wanted to continue treatment with this pdoc, he should have been advised and consented prior to you receiving the ECT.
> I suppose I could take him at his word, but he knew from the outset what his role as my physician was, and made no mention of changing until after I landed in Mass. General (a move I made on my own, by the way, at the hypothetical recommendation of my psychotherapist, who had originally referred me to the doctor).
Funny you mention your psychotherapist. Right before my ex-pdoc "let me go" I had started seeing a psychologist for therapy. During my last pdoc visit, I casually mentioned my psychologist. I thought my ex-pdoc would be happy that I was getting therapy, but it seem to bother him. This is one reason I want to find a pdoc who also does therapy ... no competing egos to deal with.
> Perhaps he was really not happy all along, and just saw this as an opportune time to bail, I don't know. Something just smacked if disingenuousness. I told the head resident as soon as I saw him next. He was silent for a bit, and then said "we can refer you to someone from here so you can be followed when you leave." Another therapist later on also met the story with a disconcertingly long silence. He ended the pause with "Hmm. Pretty slick."
I guess you'll never really know for sure, but I know exactly what you mean. The last time I saw my ex-pdoc he gave me a hug and enough medicine to last several months. I had been looking for a pdoc on my insurance plan who does med management and therapy, but could find no such person. When I told people what happened with my ex-pdoc, I got some long silences also.
> The next time was with the very physician I had been referred to. After seeing him for a few months, and getting, again, nowhere on a drug combo. (initially Remeron, then Remeron plus a very small dose of Zoloft), we began to talk about Parnate, which had been recommended to me while I was in the hospital, though I was freaked out by what I heard about the drug and opted then not to try it. At this point we were meeting once
per month. Between that visit and the next, I decided to enrol in a clinical trial of the Selegiline transdermal system for depression. It was a study I had heard about earlier, but could not try because I had receive ECT too recently. Now I could qualify, so I went for it. My doctor was not at all happy. My therapist was even less happy. I was a bit shocked, to be honest, at their response. The seemed a bit irritated with
me, and very irritated with the investigators in the trial, and I guess some heated words were exchanged. If I had known my actions were going to create such a stir, I might never have entered the study, which would have been a shame, to but it mildly.I guess I can understand their reactions to that. I never went elsewhere for treatment while I was seeing my ex-pdoc. If I had wanted to join a study I would have attempted to obtain my ex-pdoc's permission in advance.
> Anyway, what followed was a period of six weeks where I was (at their insistance) seeing my old p-doc, the therapist, and the docs in the trial on a weekly basis, which was a big disruption of my life, since all the meetings were on different days, etc. It wrought havoc with my work schedule. After the double-blind portion of the trial I went into the open-label phase, and had a robust, almost hypomanic response within about three days of initiation. I haven't been the same since, thank goodness.
Was that a good or bad experience, and in hindsight, was it worth it?
> Well, I stayed with my old pdoc, who I genuinely liked, for a couple more months, but
we both decided that while the other docs were following me, and while I was doing so well, we could take a breather and reassess when the trial was over. He actually called me towards the end to see how I was doing. I left him a message saying I still wanted to work with him because, even though selegiline was doing for me what I didn't thing was possible from a drug, I still had some nagging anxiety concerns, and since he was an OCD specialist (my other Dx), I wanted to know what he thought of some augmentation strategies I was thinking of. I told him in the message my favorite candidate was inositol, and I
wondered what he thought of the safety of MAOI plus inositol. I said my reasoning was that since it was involved with the 5-HT2C-receptor signalling pathway, which, as I was sure he knew, was implicated in OCD, it might be worth trying, according to an Isreali study, which I was also sure he already knew about.What you just related is very similar to what I might has told my ex-pdoc during a visit. I would tell him that Xanax was definitely helping, but I was occasionally having terrible bounts of anxiety. I would then mention something I had heard that might work for me. However, I suspect the call from your old pdoc was simply a courtesy gesture of goodwill and nothing else.
> He didn't reply to my message, and I never heard from him again.Oh, well ... consider the source. My sister is still seeing my ex-pdoc, so I won't talk with her further about pdocs, meds, and therapy. He'll one day want to know what happened to me, but he doesn't deserve to know.
> The trial ended. I was hoping I could continue with the docs. who ran the trial, but my insurance company wouldn't let me. The doc. who was seeing me in the trial called my old pdoc and asked him about seeing me again. My old doc replied that since he had no expertise with selegiline, he didn't feel comfortable prescribing it. And that was that.Well, at least you got some closure and an explanation, such as it was.
> The head of the trial was quite skeptical about this explanation, but did not elaborate. He
just brushed it aside, saying they would be very happy to refer me to some very good doctors in the outpatient clinic at McLean. It was deja-vu all over again.I'm surprised that you would have gone back to your old pdoc. Mine could get on all fours and I wouldn't be interested. It's almost impossible to go back ... it's much easier to push forward. That's the reason I'm trying to stay optimisic about the future. There's new territory to conquor and new pdocs to annoy!
> This new arrangement is working quite well, I must admit, so I have little cause to complain, I suppose. But, well, the experience of doctors deciding for somewhat mysterious reasons not to see me anymore, has been disconcerting. It has made me wonder on more than one occasion if there is something unlikable about me as a patient. I have never been rebellious, though I do have many of my own ideas, and share them often enough. I never was non-compliant, though I voiced objections or concers if I wasn't comfortable at first.
You sound like me, except I would never have put myself through a trial without my pdoc's consent. That's the only part of your story I see that might have caused some problems between you and your doctors.
> I don't know what to think, really. I have to say, the way the relationships were severed
leaves me little nostalgia for them.I'm trying to get past this. I want to find a pdoc that I can respect, and one who respects me in return. Hopefully, that's not too much to ask for. I hope the same for you as well.
Snowie
Posted by Snowie on June 8, 2000, at 6:50:15
In reply to Snowie…, posted by Janice on June 6, 2000, at 23:20:54
> Hi Snowie,
>
> Well I don't know you well, but you sound much better today. I can easily see how strong your personality is.Thanks, Janice. I've been in the dumps somewhat, but I am a survivor. I guess doing well is the best revenge. Since my problems don't include ongoing depression, I guess my pdoc felt I could "take it." However, my blood bleeds just like everybody else's. In a few months this hopefully will be just a strange memory.
> I was reading your postings to everyone, and this guy sounds so much like the psychiatrist I saw--even their ages are the same. Maybe at one time, the criticizing and making fun of patients, was some kind of official therapy. And these two never got over it.What kind of a medical professional would make fun of his patient? Why did I continue to see him, and what does that say about my self-esteem? That makes me very sad.
> I agree it's not appropriate for a pdoc to hug their patients or to inappropriately talk about sex.
He asked me once or twice whether I was masturbating, and a few times whether I was having sex. Those questions (and several others that I have forgotten) took me by surprise for a pdoc who supposedly only does med management. Maybe those questions were appropriate; I don't know. Also I was surprised when he asked me for a hug twice. Maybe it also surprised him the first time.
> Now you sound good and you say you don't want to sue or report him. I got quite a bit of satisfaction screaming at him (he was so shook-up, it took him 3 tries to write my lithium prescription). I also got satisfaction from both my family doctor and new pdoc telling me that I was right, and what he did was wrong (he actually lied). I also got satisfaction from reporting him to the College of Surgeons and Physicians.
I prefer to forget it. That would just bring it all up again, especially since my sis is still seeing him. Nobody in my family has told her what happened so she won't feel uneasy during her appointments.
> But if you are fine, you are fine. You will probably be very pleasantly surprised with your next pdoc. THe other pdoc I've had never had anything but my best interest at hand.Sheesh, I sure hope so. I'm past due for some good luck.
> I hope you find someone like this Snowie.Me too, Janice. Thanks.
Snowie
Posted by judy1 on June 8, 2000, at 20:36:42
In reply to Re: Anybody been fired by their pdoc?, posted by Snowie on June 8, 2000, at 0:28:57
Dear Snowie,
Sorry I wasn't able to read through this entire thread (too many drugs) but I too was fired by my pdoc. After a suicide attempt and months of mediation, it turned out he felt he was "over-involved" in my care. There were many verbal and physical boundary crossings, transferance and countertransferance, and lots of other new words for me. I am slowly coming to terms with this, but it has been an extremely difficult journey. To terminate abruptly is unethical, and if you feel you need some closure he is obligated to provide that to you. If he refuses, then report him to your state board of psychiatrists. Your reaction sounds considerably healthier than mine, perhaps because I was in love and was told it was reciprocated, I was particularly devestated. You have every right to be angry, to grieve, and to receive as much help as you need to get through this. Take care.
Posted by judy1 on June 8, 2000, at 20:49:26
In reply to Re: Florida's Baker Act » Snowie, posted by Greg on June 7, 2000, at 8:07:46
I'm also a resident of California, and several months ago overdosed on a medication to stop some agitation- probably manic. My pdoc called 911, and after having my stomach pumped, I was visited by two police officers who spoke to me all of 2 minutes and decided I was suicidal (which I denied). They had me involuntarily committed for 72 hours (they did, not my pdoc or ER physician) and so it was done. And I mean 72 hours, not even the psych hosp shrink could let me out earlier. Just though I would let you know what our state's police can do. Take care.
Posted by Greg on June 9, 2000, at 9:12:54
In reply to Re: Florida's Baker Act-Greg, posted by judy1 on June 8, 2000, at 20:49:26
Sounds like your experience was a real nightmare! I'm wondering if the call from your pdoc technically gave the officers "probable cause" (another California born term that absolutely turns me inside out!). I believe I have read that for most Cal institutions a 72 hour stay is mandatory regardless of whether it's voluntary or involutary. But I guess I wouldn't be surprised if the cops were able to make the call all on their own, they certainly seem to able to violate people's rights anytime it suits their purpose!
I'm glad that at least the experience is behind you, and I hope that everything is going better for you now.
Hugs,
Greg> I'm also a resident of California, and several months ago overdosed on a medication to stop some agitation- probably manic. My pdoc called 911, and after having my stomach pumped, I was visited by two police officers who spoke to me all of 2 minutes and decided I was suicidal (which I denied). They had me involuntarily committed for 72 hours (they did, not my pdoc or ER physician) and so it was done. And I mean 72 hours, not even the psych hosp shrink could let me out earlier. Just though I would let you know what our state's police can do. Take care.
Posted by Rockets on June 9, 2000, at 13:04:05
In reply to Re: Florida's Baker Act-Greg » judy1, posted by Greg on June 9, 2000, at 9:12:54
The California Police State B#@&*rds. Sorry, I am a law abiding citizen but it goes way too far. A drunk evil gossip can, without any consequences, just pick up the phone and say you mistreat your kids.. kiss em goodbye cause it will be awhile before you see them again. Another example: Did you know traffic control wrote 25,000 tickets collecting over $2,000,000 of taxpayer money because people had the gall to put a For Sale sign in their own vehicle while it was parked on the street. Apparently that is a crime in California and one that is taken rather seriously. The ACLU is taking it to the California State Supreme court to try and get some relief for us on the grounds that it is unconsititutional. Looks like they are going to win too. But think about it. We have to pay our tax dollars to the government who uses them to defend a law we don't want in the first place! :/. We screwed no matter what. Did you know that just the state of California has more people in prison than any country in the world save China. That means that one state in the U.S. has more people in prison than any other entire country in the world save China (who is well known for persecuting their population). Don't get me wrong. I don't want those prisoners let out or anything if they need to be there! However, I hate big government octupuses with tentacles reaching into every area of my life.
Posted by Janice on June 9, 2000, at 22:35:04
In reply to Re: Snowie…, posted by Snowie on June 8, 2000, at 6:50:15
Why did I continue to see him, and what does that say about my self-esteem?
for medications.
maybe nothing.I think it was Freud who said 'sometimes, a cigar is just a cigar'.
goodluck, Janice
>
Posted by Snowie on June 10, 2000, at 7:22:43
In reply to Re: Snowie…, posted by Janice on June 9, 2000, at 22:35:04
> Why did I continue to see him, and what does that say about my self-esteem?
>
> for medications.
> maybe nothing.
>
> I think it was Freud who said 'sometimes, a cigar is just a cigar'.
>
> goodluck, JaniceThanks, Janice. I really needed that.
Snowie
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