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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 olysi79 on September 8, 2004, at 11:02:17
Hello,
I need help. I have been seeing a very nice PDOC for about 4 months now. She is nice... but I've noticed problems that have bubbled to the surface today at our last visit... basically, she forgets everything about me each time she sees me... also, she tends to have very black and white issues about medications (i.e- all serotogenic drugs are the same and she also seems to have trouble differentiating between BP I and other types of BP... the impression I got is that she kinda goes by the rule that there's just BP I and everything else seems to be attributable to other disorders). She is VERY busy and works at a total of 3 facilities, hence she is on the go (LOL told me she needs the $$). Today the bubble burst because I called her over the weekend because I was having a lithium problem. She told me today that she is a stressed single parent and not to call her. I can understand if I was calling her every weekend, but in the 4 months I have been seeing her, I have only called her 3 times on a weekend, all of which were during a crisis... NOT for med refills, etc... I have called other times (NO, not daily or even weekly for that matter), but only during office hours to leave a quick message with the triage nurse (i.e- please fix the coding on my refill, or side effect rash- should I get it checked??- Stuff like that). Question... should I fire this PDOC and work with another one? I don't want to be hasty and inconsiderate... she has a right to a life and relaxation... but as someone I'm paying for this critical care, I have the expectation that she will at least review my chart before seeing me, and also be a person I can call if I am in dire straights. How do you advise I proceed witht his? When working with a PDOC, what should I look for... I would like a PDOC that is flexible, yet remembers my issues at least and isn't resentful of me calling them!
Posted by gardenergirl on September 8, 2004, at 11:35:46
In reply to PDOC problems, I need help and advice, posted by olysi79 on September 8, 2004, at 11:02:17
It sounds to me that if you take out personal feelings about the pdoc...like she is very nice and deserves a life, etc...that you have answered your own question. She may very well be nice, and of course she deserves a life, but it does not sound like she is able to meet your needs right now.
Change is often hard, but I think you deserve a pdoc who does not have so much on her plate that she is unable to give you basic care. She also sounds like perhaps she has less time to keep up with research, i.e. the BP I vs. II and III thing.
Good luck whatever you decide.
gg
Posted by King Vultan on September 8, 2004, at 11:37:07
In reply to PDOC problems, I need help and advice, posted by olysi79 on September 8, 2004, at 11:02:17
Fundamentally, even though she may be nice, it doesn't sound like she really has her act together in the pdoc department. You have the right to expect that she will be prepared for your visits, be familiar with your case, and meet some kind of minimum standard of competency. I would certainly advise looking for a replacement.
As for contacting a doctor or their office outside of a regular visit, the only times I have ever done so was when experiencing med intolerability problems or needing a refill. I have only communicated through the doctor's nurse, never directly, and obviously only during their regular hours. However, I don't really know what the generally accepted standards are for doctor/patient communications outside of a regular office visit.
Todd
Posted by olysi79 on September 8, 2004, at 12:07:03
In reply to Re: PDOC problems, I need help and advice, posted by King Vultan on September 8, 2004, at 11:37:07
Thansk for the response. The office I go to allows for paging a doctor after hours during tiems of emergency. I paged my doctor once in may when I was considering hospitalization, once in July when I was having a severe reaction to a med (she said I was "admisssable" in that case when talking to me later.. so I have to asume it was obviously an emergency) and once in September- another reaction, though upon recollection, this one could have waited... I feel I am reasonable. I've decided to most likely terminate treatment with her. I called and left a VM for my therapist today as he may have soem good PDOC leads. Any other feedback from others would be appreciated.
Thanks> Fundamentally, even though she may be nice, it doesn't sound like she really has her act together in the pdoc department. You have the right to expect that she will be prepared for your visits, be familiar with your case, and meet some kind of minimum standard of competency. I would certainly advise looking for a replacement.
>
> As for contacting a doctor or their office outside of a regular visit, the only times I have ever done so was when experiencing med intolerability problems or needing a refill. I have only communicated through the doctor's nurse, never directly, and obviously only during their regular hours. However, I don't really know what the generally accepted standards are for doctor/patient communications outside of a regular office visit.
>
> Todd
Posted by HappyGirl on September 8, 2004, at 13:19:05
In reply to Re: PDOC problems, I need help and advice, posted by olysi79 on September 8, 2004, at 12:07:03
Hi:
It's a terrible, difficult question, ... but have you ever thought about yourself? When you visit your pdoc., what sort of conversation do you exchange with your pdoc.? Are you fairly 'cooperative' patient who is willing to work with your pdoc.? You never demanded anything about which your pdoc. seemed NOT to want? I never called my pdoc. over weekends. If I need an E.R.basis-med. change, I usually wait on Monday morning and ask his secretary first before attempting to talk with my pdoc.
In my case, ... I went through four different pdocs. for the past six years after dxed with Bp II. Surprisingly, none of those 'good' pdocs. explanied about what Bp is,... "How does this affect my life?"(then, I was in early 20') and etc., ... not mention about Bp II and such. I found my 'REAL' dx by studying here, in Internet. In addition to this, I did 'research' a *lot* about Bp illness, day and night when I got this illness.Most of pdocs. seem just giving rx slips to get by, although my insurance paying quite a bit of money for a 15 minutes' visit. None of them seems to want to spend the time to talk about my mental illness and mostly importantly, ... no 'kind' words when I often expected and needed due to my condition, mostly major depression, rather manic phrase.
Last time when I asked a brand new med., 'Cybalta(sp?)' about which there are a lot of discussions here, but my pdoc. just shruged off and said, ... 'always new ones coming,' ... that's it! I kinda used to this kind of treatment I've getting from the pdoc., hence NO compalin about it. What I mostly expect on my visit is to get my rx slip accurately without any hassles, for which my pdoc. is VERY competent. However, I can say this is probably, in the past, ... yes my pdoc. helped me a lot about med. change and even 'free' med. from drug companies(plural).
Then, overall I have no compalian about my pdoc.
In my opinion, if you started to suspect her attitude(non-caring), then you may need to find someone who has more compassionate to your health, not mentally also emotionally. But, this is just my personal view, ... you need to listen to others.
H.G.
Posted by olysi79 on September 8, 2004, at 13:54:40
In reply to Re: PDOC problems, I need help and advice, posted by HappyGirl on September 8, 2004, at 13:19:05
Hi:
These are all good questions. as fas as interactions with my PDOC is concerned, I attempt to have thoughtful respectful interactions with her... I'm an "easy one" so to speak. I don't like confrontation and this PDOC is pretty cool in terms of working with me and having discussion. If I make a suggestion and she says no, that's it, there's nothing more to discuss unless I can provide more information as to why this or that treatment may benefit me. I think one sore point for her is my reluctance to take a benzo on a regular basis as there is serious addiction issues in my immediate family and given some of my impulsive patterns, it would just be innappropriate. Also, if I see something that interests me, I'll bring in some sort of research, which she likes.
I have a rousing suspicion that she was having a bad day... the patient before me had waited over 45 mintutes to see her, and stormed out, yellign at the secretary about it. She asked me if he had left when I met with her, I told her indeed he had, and she did not look happy. She was somewhat aggressive today... I think she's got more on her plate and if my problems were a bit more simple, I think she'd be a keeper, but I need soemone who has a bit more time for me. I get very upset with her lack of memory as to who I am, med reactions I've had, and other types of issues... She's mistaken me numerous times for some of her other clientele. She is simply having a hard time keeping up. I have to add in a comment that my friend said to me today after I talked about the PDOC issue... we pay them to help us with serious issues that affect us 24 hours a day, 7 days a week. It's not a relatiosnhip where we're at their mercy... if they cannot adequately assist, then we move on and fire them. Next comes in the question of adequate assistance... if a person expects their doctor to talk to them everyday, including weekends, and are having that much trouble, they need to go to the hospital in my opinion... but during med changes, if the occasional crisis emerges, and that extra visit is necessary, then the PDOC probably needs to absorb that stress and be more compassionate.
Posted by quarterwit on September 8, 2004, at 14:06:56
In reply to PDOC problems, I need help and advice, posted by olysi79 on September 8, 2004, at 11:02:17
Switch! But seriously, this sounds like this pdoc is not watching out for your best interest. I think that sort of response to an emergency call (even a NON emergency call) is unprofessional and inconsiderate.
As long as we're relegated to the often hit-and-miss approach of psychiatry (too bad neuroimaging hasn't gotten more precise yet!!), having a considerate and experienced pdoc is important. And a patient one, too. Cynically, sounds like your pdoc has been "HMO'ed", where even prescribing psychiatric meds has become formulaic, and preferences on meds are chosen less on clinical experience and more on which meds are more strongly marketed! I know, too cynical, but sometimes I see that in wading through Doctors.
I still have't found the right solution, so I can relate. The only one taking new patients under my health plan shuns MAOIs, so I pay personally to see a more experienced one.
> Hello,
> I need help. I have been seeing a very nice PDOC for about 4 months now. She is nice... but I've noticed problems that have bubbled to the surface today at our last visit... basically, she forgets everything about me each time she sees me... also, she tends to have very black and white issues about medications (i.e- all serotogenic drugs are the same and she also seems to have trouble differentiating between BP I and other types of BP... the impression I got is that she kinda goes by the rule that there's just BP I and everything else seems to be attributable to other disorders). She is VERY busy and works at a total of 3 facilities, hence she is on the go (LOL told me she needs the $$). Today the bubble burst because I called her over the weekend because I was having a lithium problem. She told me today that she is a stressed single parent and not to call her. I can understand if I was calling her every weekend, but in the 4 months I have been seeing her, I have only called her 3 times on a weekend, all of which were during a crisis... NOT for med refills, etc... I have called other times (NO, not daily or even weekly for that matter), but only during office hours to leave a quick message with the triage nurse (i.e- please fix the coding on my refill, or side effect rash- should I get it checked??- Stuff like that). Question... should I fire this PDOC and work with another one? I don't want to be hasty and inconsiderate... she has a right to a life and relaxation... but as someone I'm paying for this critical care, I have the expectation that she will at least review my chart before seeing me, and also be a person I can call if I am in dire straights. How do you advise I proceed witht his? When working with a PDOC, what should I look for... I would like a PDOC that is flexible, yet remembers my issues at least and isn't resentful of me calling them!
Posted by 4WD on September 8, 2004, at 19:14:46
In reply to Re: PDOC problems (we pay them) » HappyGirl, posted by olysi79 on September 8, 2004, at 13:54:40
> Hi:
>
> These are all good questions. as fas as interactions with my PDOC is concerned, I attempt to have thoughtful respectful interactions with her... I'm an "easy one" so to speak. I don't like confrontation and this PDOC is pretty cool in terms of working with me and having discussion. If I make a suggestion and she says no, that's it, there's nothing more to discuss unless I can provide more information as to why this or that treatment may benefit me. I think one sore point for her is my reluctance to take a benzo on a regular basis as there is serious addiction issues in my immediate family and given some of my impulsive patterns, it would just be innappropriate. Also, if I see something that interests me, I'll bring in some sort of research, which she likes.
> I have a rousing suspicion that she was having a bad day... the patient before me had waited over 45 mintutes to see her, and stormed out, yellign at the secretary about it. She asked me if he had left when I met with her, I told her indeed he had, and she did not look happy. She was somewhat aggressive today... I think she's got more on her plate and if my problems were a bit more simple, I think she'd be a keeper, but I need soemone who has a bit more time for me. I get very upset with her lack of memory as to who I am, med reactions I've had, and other types of issues... She's mistaken me numerous times for some of her other clientele. She is simply having a hard time keeping up. I have to add in a comment that my friend said to me today after I talked about the PDOC issue... we pay them to help us with serious issues that affect us 24 hours a day, 7 days a week. It's not a relatiosnhip where we're at their mercy... if they cannot adequately assist, then we move on and fire them. Next comes in the question of adequate assistance... if a person expects their doctor to talk to them everyday, including weekends, and are having that much trouble, they need to go to the hospital in my opinion... but during med changes, if the occasional crisis emerges, and that extra visit is necessary, then the PDOC probably needs to absorb that stress and be more compassionate.
I think you should tell your pdoc exactly what you've told us. If necessary, print out your post and let her read it. She needs to know that she comes across as too busy and too uncaring.
Maybe if she becomes aware that this is a significant problem, she will make some changes and be a better doctor to her other patients even if you decide to go elsewhere.Of course she may truly be primarily interested in the money. In which case, she isn't worth your time.
Posted by olysi79 on September 8, 2004, at 23:00:42
In reply to Re: PDOC problems (we pay them) » olysi79, posted by 4WD on September 8, 2004, at 19:14:46
Hi there, thanks for the response. My Pdoc has told me how much she needs money... she told me this when she explained that she works at 3 different facilities. I think that might be why she likes all new meds. At any rate, She's a colorful bright woman, but I think she's a bit too busy for me and need to find someone a bit more settled. I'm going to "shop around" so to speak, my insurance allows me to visit any mental health facility at any time I desire (no restrictions). Hence, I will play more of an active role as a consumer.
This is the end of the thread.
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