![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Jakeman on January 20, 2005, at 23:54:03
I am firing my psychiatrist. Here's why.
My psychiatrist (a D.O.), basicly does medication management. We talk for about 10 or 15 minutes about what is or is not working, he writes a prescription and I leave. When I first go in I have to brief him on what I've been taking because he usually doesn't remember. Sometimes I write down a summary on paper in order to save time in the session. In the beginning I tried talking to him about underlying physical symptoms and how they may play into my depression. Or I would bring in studies trying to educate him about alternative treatments. But those discussions never went anywhere, and he always seemed in a hurry, so I gave up. Today I asked about the new insomnia medication (Lunesta) that is being introduced in the US. He had not heard of it but spent some time reading materials about it which I provided.We rarely, if ever, talked about my personal life. I had a psychotherapist for that anyway.
I got there today about 10 minutes early, and then spent the next 40 minutes in the waiting area with a bunch of other down-trodden souls. I went in to talk to the receptionist about some claims my insurance company has refused to pay. There I learned about the world of "CPT Codes". My Dr. had submitted claims under code 90805: individual psychotherapy and medical management services- 20-30 minutes, and Code 90807, same services, 45-50 minutes.
When I finally got to see him I confronted him about it, in that I had never received psychotherapy, and I never had an appointment over 30 minutes. His immediate response was that those were the codes that he used but he could refer me to another physician who just does "medication management" (Code 90862).
He said this in a nice way but I was taken aback at his readiness to immediately send me to someone else, rather than try to work things out. Then he got defensive when I said, "you make me pay for your time, but what about me when I sitting outside waiting for you?" (my employer can dock my pay for that). Then he said it was my fault I had to wait, because I had interrupted the receptionist with her duties of calling in patients. After I left and got to the pharmacy I realized he didn't write me a refill scrip for the antidepressant that I'm taking. The other stuff He was supposed to write them for 1 refill. He didn't.
There's more to this story but this is already too long. Does anybody know if I have any recourse for his inaccurate coding and submission of claims (because of this I owe about $600 out of pocket).
This topic raises the larger issue of why are there so many complaints about psychiatrists. I see it all over the internet and in books like
"Darkness Revealed" in which William Styron rebukes his pdoc "Dr. Gold." Is the psychiatric community aware of the growing perception of them being greedy and incompetent? Just some thoughts, comments appreciated.Jake
Posted by Willyee on January 21, 2005, at 0:36:57
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
> I am firing my psychiatrist. Here's why.
>
> My psychiatrist (a D.O.), basicly does medication management. We talk for about 10 or 15 minutes about what is or is not working, he writes a prescription and I leave. When I first go in I have to brief him on what I've been taking because he usually doesn't remember. Sometimes I write down a summary on paper in order to save time in the session. In the beginning I tried talking to him about underlying physical symptoms and how they may play into my depression. Or I would bring in studies trying to educate him about alternative treatments. But those discussions never went anywhere, and he always seemed in a hurry, so I gave up. Today I asked about the new insomnia medication (Lunesta) that is being introduced in the US. He had not heard of it but spent some time reading materials about it which I provided.We rarely, if ever, talked about my personal life. I had a psychotherapist for that anyway.
>
> I got there today about 10 minutes early, and then spent the next 40 minutes in the waiting area with a bunch of other down-trodden souls. I went in to talk to the receptionist about some claims my insurance company has refused to pay. There I learned about the world of "CPT Codes". My Dr. had submitted claims under code 90805: individual psychotherapy and medical management services- 20-30 minutes, and Code 90807, same services, 45-50 minutes.
>
> When I finally got to see him I confronted him about it, in that I had never received psychotherapy, and I never had an appointment over 30 minutes. His immediate response was that those were the codes that he used but he could refer me to another physician who just does "medication management" (Code 90862).
>
> He said this in a nice way but I was taken aback at his readiness to immediately send me to someone else, rather than try to work things out. Then he got defensive when I said, "you make me pay for your time, but what about me when I sitting outside waiting for you?" (my employer can dock my pay for that). Then he said it was my fault I had to wait, because I had interrupted the receptionist with her duties of calling in patients. After I left and got to the pharmacy I realized he didn't write me a refill scrip for the antidepressant that I'm taking. The other stuff He was supposed to write them for 1 refill. He didn't.
>
> There's more to this story but this is already too long. Does anybody know if I have any recourse for his inaccurate coding and submission of claims (because of this I owe about $600 out of pocket).
>
> This topic raises the larger issue of why are there so many complaints about psychiatrists. I see it all over the internet and in books like
> "Darkness Revealed" in which William Styron rebukes his pdoc "Dr. Gold." Is the psychiatric community aware of the growing perception of them being greedy and incompetent? Just some thoughts, comments appreciated.
>
> JakeMy doc barly rembers my name,or medication.Her office never calls me back,she never makes eye contact and blows off any questions i have.
But i have been to almost everyone local,and shes the best,so imaginae,plus i can get cancelations for quick drop ins.
My theory on mine is i ignore her,i consider her useful for nothing but her singature,and thats it.I do my own research,and obtain meds if i feel shell give me a hard time.
I am lucky i amon a med that helps,when i wasnt,and suffering badly,it was a nightmare relying on these people to save me,very scary thought.
Why do i not fire here,because she could not care less if i did,then i would be looking at weeks for a new doc appt with a good chance itll be the same scenerio,ill be looking at the initial high first visit fee,as well as any office policys such as seeing one of their therpaists first only to spend more money and wait more time.
Then i have to hope they r willing to prescribe me the same med.
So my doc who i deemed judge judy since she looks just like her,has me by the choppers,my advice swallow it,its sucks but its much harder to get a new one.I wish i had a stamp with her signature on it,her visits are a complete waste of time,shes prob older than the pdr she uses.
Posted by Emily Elizabeth on January 21, 2005, at 8:13:43
In reply to Re: Psychiatrists (and others) please read, posted by Willyee on January 21, 2005, at 0:36:57
I'm so sorry to hear about your awful experience. You absolutely should find someone else.
I also just have to say that I have worked with 2 amazing pdocs. For example, when i am having med probs she always will work to squeeze me in. She returns my calls promptly. She talks to my therapist. She always goes the full 1/2 hr and will run over if we need to.
Keep looking for a good pdoc. There are still some good apples out there!
EE
Posted by partlycloudy on January 21, 2005, at 9:06:41
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
If your doctor has been coding insurance claims incorrectly, you can request that the denied claims be appealed. This request must come from you, as the patient. You can try calling the 800 number you would have on the insurance ID card to initiate the appeal, but will probably have to request it in writing, too.
Good luck. I try to remind myself that half of the doctors out there graduated in the bottom half of their class...
Posted by Ritch on January 21, 2005, at 9:47:21
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
>...My Dr. had submitted claims under code 90805: individual psychotherapy and medical management services- 20-30 minutes, and Code 90807, same services, 45-50 minutes.
When I finally got to see him I confronted him about it, in that I had never received psychotherapy, and I never had an appointment over 30 minutes. His immediate response was that those were the codes that he used but he could refer me to another physician who just does "medication management" (Code 90862).
...There's more to this story but this is already too long. Does anybody know if I have any recourse for his inaccurate coding and submission of claims (because of this I owe about $600 out of pocket).
Ummm, isn't that defrauding (unintentional?) the insurance company? Instead of bringing it up to him directly, try his receptionist... maybe if you talk to one of his staff that is responsible for filing the claims you can get it straightened out. Just a thought, but if you don't spend any quality time with this guy anyhow, maybe you would be *no worse* off with someone who does just "medication management"? Get your money back from his staff though.. if you let them (the staff) know that the insurance company has been overbilled and you don't know how to solve the problem and you think you might have to contact the insurance company about it.. you might get things straightened out.. and then find someone else quick.
Posted by Wildman on January 21, 2005, at 9:52:57
In reply to Re: Psychiatrists (and others) please read » Jakeman, posted by Ritch on January 21, 2005, at 9:47:21
He sounds like a clown. Fire him immediately. It should not be too difficult to find someone better than this clown.
I am very fortunate to have a pdoc that I like as a person, as well have a great deal of professional respect. My sessions with him are 50 minutes long, the first 40 minutes are spent talking about how I feel, what is going on in life, etc. Only after that will we talk about any change in meds. I have upped both my Lex and my Seroquel when I thought it was worth trying and he supported my thought-out decisions both times. He's a good guym and I don't have to wait long to see him, sessions always start on time.
Has cheezy music in the waiting room, but also some very cool obscure magazines.
Hang in there, you can do better than this sorry excuse for a pdoc.
Wildman
Posted by Bill LL on January 21, 2005, at 11:42:02
In reply to Re: Psychiatrists (and others) please read » Jakeman, posted by Ritch on January 21, 2005, at 9:47:21
This sort of thing happened to me before. Just send him note in the mail marked "personal and confidential". Tell him that because of the inaccurate coding (which is absolutely illegal- it's insurance fraud), you are out $600. Tell him that you would like for him to take the $600 off of your bill.
Then, a few days later, call his secretary and see if it is still on your bill. If it is, explain the situation to her.
If that does no good, send another letter saying that if it is not taken off your bill, you will need to do 2 things:
1) Call your insurer and see if they can get the doctor to take it off your bill
2) File a claim for $600 in small claims court
Wait 3 more days. If no response, start with #1 above, then go to #2 if necessary.
"...There's more to this story but this is already too long. Does anybody know if I have any recourse for his inaccurate coding and submission of claims (because of this I owe about $600 out of pocket). "
Posted by alexandra_k on January 21, 2005, at 16:00:06
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
I agree with Bill. Fact is, that is unacceptable and he should not be able to get away with this.
I personally would be a fan of giving him your post. Then he knows how you feel about him (for very justified reasons) and he knows how he has undermined your faith in the profession in general.
Shame on him :-(
That being said I do have sympathy that some psychiatrists in some settings are very overworked. But it is still no excuse.
If you possibly can see someone else I really would go and do that. You deserve much better than that.
I really wouldn't let him get away with the miscoding as a matter of general principle. Really.
Posted by banga on January 21, 2005, at 17:25:35
In reply to Re: Psychiatrists (and others) please read » Jakeman, posted by alexandra_k on January 21, 2005, at 16:00:06
I agree. There are so many great docs out there that do their best and do all coding and billing accurately. This person is a bad apple and is giving the profession a bad name. This is blatant insurance fraud. Your insurance may be quite interested in your story.
Posted by Cairo on January 21, 2005, at 19:32:36
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
Intentional overcoding/billing is fraud. Unintentional overcoding/billing should still be brought to the attention of your insurance company. If a records review reveals that he overcoded and his records cannot back up the level of code that he used, then he may be required to pay back the insurance company. Ask your insurer what they would advise you do about getting your money back from the Pdoc. At the very least, they may seriously talk to him about his status as a provider for their company.
Either way, notify your insurance company IN WRITING. Keep copies of the receipts you received at each session, cancelled checks, billing notices, etc. You will need a paper trail to confirm your claims.
You can also ask your insurance company to provide you with a list of billing codes and what services they entail. Usually there is a checklist of what must be done and documented. If documentation does not take place (eg. he did it but didn't note it), then it didn't take place as far as the insurance company is concerned.
Too many doctors are not familiar with what is entailed for higher level coding, but they sure are familiar with reimbursement rates for higher codes. Buyer beware.
Cairo
Posted by Jakeman on January 21, 2005, at 20:50:39
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
Hey thanks SO much for all the support and advice. You guys are great. I completely sympathize with all of you who try to get real help and run into problems like I have.
I want to fill in the facts a bit. My insurer limits visits to psychotherapists to 20 per year. I am seeing both a therapist and the psychiatrist. I thought the psychiatrist was billing me for medication management only. But in fact he was billing me also for indivdual psychotherapy. So the insurance company was counting both the psychiatrics visits and therapist visits against the 20 per year limit. (I had been carefully monitored my the psychotherpists sessions so I would stay under 20).
Because I went over the 20 visit limit for psychotherapy (due to the improper coding by the pdoc) I now owe my psychotherapist $480 and the pdoc $150. I have no problem refusing to pay the psychiatrist and clueing in the insurance company if necessary. But my therapist was not at fault in this mess and I owe him $480.
Now just to vent a bit. I feel the pdoc is more concerned about money than his patients. He is always is a hurry and patients are backed up waiting to see him. My impression is that is case load is too big and he is running a patient mill so to speak.
I didn't realize at all the time issue until yesterday. (I was never offered a receipt until I asked for it yesterday). Now I know, that when I walk into his office the clock starts running, much like a taxi meter. If you stay under 20 minutes the charge is $90. If you go over that, say 30 minutes, the charge jumps to $150. Maybe somehow its necessary, but I find this detailed attention to minutes and fees a bit in conflict to the doctor's responsibity for dealiing with our suffering.
I am probably going to just stop going to a psychiatrist for help with medications. One reason is that I have no way I finding a good one. I can ask around, but that is iffy too...I don't want everyone to know I've got mental problems. My primary care doctor will write these kind of presciptions and insurance will pay it with so hassle as an office visit so that is an option.
Another option is to just forget about doctors. For a while I had no insurance and little money. I ordered all my meds from pharmacies in the US and overseas. I never had a problem getting them and I didn't have to pay outrageous fees from psychiatrists.
By the way, I wonder if any psychiatrics read this forum?
Jake
Posted by Impermanence on January 21, 2005, at 21:44:54
In reply to Re: Psychiatrists (and others) please read, posted by Jakeman on January 21, 2005, at 20:50:39
I'm sick of psychiatrists. They think they understand your mind after a ten minute session through textbooks, like we're all just sheep. Put this one in this category, stick him on this med and that should warp his mind to suit society. The last psychiatrist I seen took me off Zispin and bromazepam cold turkey and put me on Zyprexa for depression, what was she thinking. After she relized I could no longer get out of bed on the stuff she switched the Zyprexa for Lexapro and then put me back on benzos. Now I'm no doctor but that was just crazy and she put me through hell for a few months. When ever I questioned her actions and told her I'd been studing my problems and medication she would tell me to stop using the internet, throw away my books on psychology and leave it to the professionals. It's a power thing with them, they love control. I eventually left her and I don't intend to ever see a pdoc again. I talk to a therapist, see my G.P. for antidepressants and use internet pharmacies or street dealers to self medacate with whatever else I feel I need. It's so much easier to study and look after your own mind and not have to leave it in the hands of someone who gets hand outs from pharmaceutical companies. I feel so well these days through exercise, meditation and my own choice of drugs I think I'm ready to start tapering off the antidepressents. Power to the people I say, who needs pdocs to tell us how to perceive the world.
Posted by alexandra_k on January 21, 2005, at 21:46:33
In reply to Re: Psychiatrists (and others) please read, posted by Jakeman on January 21, 2005, at 20:50:39
Well Dr Bob does :-)
I would say that your p-doc owes your psychotherapist a sum of money...
I would talk to your p-doc about the billing and say that if the problem is not sorted out to your satisfaction then you fully intend to report him to your insurer for insurance fraud.
Ball is in his court then.
Hopefully it can be sorted by either your p-doc or the insurer so your psychotherapist can get paid. Have you told your psychotherapist what has been going on? I mean it is unethical of your p-doc to be giving you psychotherapy if you have a psychotherapist already. I would imagine your real psychotherapist should have a bone to pick with him...
Posted by johnsmith12345 on January 22, 2005, at 0:59:49
In reply to Re: Psychiatrists (and others) please read, posted by Impermanence on January 21, 2005, at 21:44:54
>she would tell me to stop using the internet, throw away my books on psychology and leave it to the professionals.
That is appalling. And I agree with you about taking your treatment into your own hands. If you are diligent enough to do research and take all necessary precautions, then why not. If I ever met an understanding, intelligent psychiatrist I might change my mind, but so far that has not been the case.
Posted by mcp on January 22, 2005, at 11:31:06
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
*
> I am firing my psychiatrist. Here's why.
>
> My psychiatrist (a D.O.), basicly does medication management. We talk for about 10 or 15 minutes about what is or is not working, he writes a prescription and I leave. When I first go in I have to brief him on what I've been taking because he usually doesn't remember. Sometimes I write down a summary on paper in order to save time in the session. In the beginning I tried talking to him about underlying physical symptoms and how they may play into my depression. Or I would bring in studies trying to educate him about alternative treatments. But those discussions never went anywhere, and he always seemed in a hurry, so I gave up. Today I asked about the new insomnia medication (Lunesta) that is being introduced in the US. He had not heard of it but spent some time reading materials about it which I provided.We rarely, if ever, talked about my personal life. I had a psychotherapist for that anyway.
>
> I got there today about 10 minutes early, and then spent the next 40 minutes in the waiting area with a bunch of other down-trodden souls. I went in to talk to the receptionist about some claims my insurance company has refused to pay. There I learned about the world of "CPT Codes". My Dr. had submitted claims under code 90805: individual psychotherapy and medical management services- 20-30 minutes, and Code 90807, same services, 45-50 minutes.
>
> When I finally got to see him I confronted him about it, in that I had never received psychotherapy, and I never had an appointment over 30 minutes. His immediate response was that those were the codes that he used but he could refer me to another physician who just does "medication management" (Code 90862).
>
> He said this in a nice way but I was taken aback at his readiness to immediately send me to someone else, rather than try to work things out. Then he got defensive when I said, "you make me pay for your time, but what about me when I sitting outside waiting for you?" (my employer can dock my pay for that). Then he said it was my fault I had to wait, because I had interrupted the receptionist with her duties of calling in patients. After I left and got to the pharmacy I realized he didn't write me a refill scrip for the antidepressant that I'm taking. The other stuff He was supposed to write them for 1 refill. He didn't.
>
> There's more to this story but this is already too long. Does anybody know if I have any recourse for his inaccurate coding and submission of claims (because of this I owe about $600 out of pocket).
>
> This topic raises the larger issue of why are there so many complaints about psychiatrists. I see it all over the internet and in books like
> "Darkness Revealed" in which William Styron rebukes his pdoc "Dr. Gold." Is the psychiatric community aware of the growing perception of them being greedy and incompetent? Just some thoughts, comments appreciated.
>
> Jake
Posted by Jakeman on January 22, 2005, at 17:02:54
In reply to Re: Psychiatrists (and others) please read » Jakeman, posted by alexandra_k on January 21, 2005, at 21:46:33
You and everybody else have given me some great ideals on how to resolve this issue with dignity.
No, I have now discussed this yet with my therapist. I haven't seen him since November, which is when I was notified by the insurance co. that I had exceeded my yearly benefit. I agree there are some violation of ethics to say the least.
I plan on putting my stating my greivances in a letter to the pdoc with a request for a refund of fees. The prospect of an insurance investigation should motivate him to cooperate. Then as others suggested, there's the avenue of small claims court if I have to. In fact, I'd love to tell my story to a judge.
I know there are some great p-docs out there, I just have not encountered them, and frankly (as Impermance noted) I am sick of them. I have to be the one in control of my mental health care and refuse to be someone's pawn.
> Well Dr Bob does :-)
>
> I would say that your p-doc owes your psychotherapist a sum of money...
>
> I would talk to your p-doc about the billing and say that if the problem is not sorted out to your satisfaction then you fully intend to report him to your insurer for insurance fraud.
>
> Ball is in his court then.
>
> Hopefully it can be sorted by either your p-doc or the insurer so your psychotherapist can get paid. Have you told your psychotherapist what has been going on? I mean it is unethical of your p-doc to be giving you psychotherapy if you have a psychotherapist already. I would imagine your real psychotherapist should have a bone to pick with him...
Posted by alohashirt on January 22, 2005, at 17:21:50
In reply to Re: Psychiatrists (and others) please read » alexandra_k, posted by Jakeman on January 22, 2005, at 17:02:54
My knee jerk reaction to your post was "What do you expect?"
In a 2 mile radius of where I live there are 40 bagel shops. Three of them are excellent, one of them is copnsitently appalling (staff & stale bagels) and the rest are in the middle.
I don't think psychiatrists are any different, although the stakes are higher and its not so easy to switch from one to another.
My experience suggests that pretty much everything has these tiers:
10% excellent
40% largely good
40% mediocre
10% apallingI imagine that most pdocs would straddle three of these groups for different patients. My pdoc is very well informed, creative, analytical, forgets my history, accidently bills me for the wrong codes, is always in a hurry. Today I'd give him an "A" for excellent. The bill problems all get resolved eventually, I'm in a hurry too so I don'ty need the bedside manner and I don't take the forgetfulness personally. I'm sure he has patients who would rate him a C and in a different context I'd give him that too.
Now maybe your psychiatrist is a bad apple, maybe he's mediocre or just a bad fit for you.
It's a stressful, difficult job that exacts a heavy toll on people and not something I would be willing to do.
My advice is don't take any of it personally, recognize that you will always need to manage your doctor, and find a way to get superb care from someone who is "good enough."
Good Luck!
Posted by Jakeman on January 22, 2005, at 17:30:53
In reply to Re: Psychiatrists (and others) please read » alexandra_k, posted by Jakeman on January 22, 2005, at 17:02:54
I am posting this again because I made a bunch of typos on the one above. I'm a terrible typist.
You and everybody else have given me some great ideals on how to resolve this issue with dignity.
No Alexandra, I have not discussed this yet with my therapist. I haven't seen him since November, which is when I was notified by the insurance co. that I had exceeded my yearly benefit. I agree there are some violation of ethics to say the least.
I plan on my stating my greivances in a registered letter to the pdoc with a request for a refund of fees. The prospect of an insurance investigation should motivate him to cooperate. Then as others have suggested, there's the avenue of small claims court if I have to. In fact, I'd love to tell my story to a judge.
I know there are some great p-docs out there, I just have not encountered them, and frankly (as Impermance noted) I am sick of them. I have to be the one in control of my mental health care and I refuse to be a pawn in a power game.
> > Well Dr Bob does :-)
> >
> > I would say that your p-doc owes your psychotherapist a sum of money...
> >
> > I would talk to your p-doc about the billing and say that if the problem is not sorted out to your satisfaction then you fully intend to report him to your insurer for insurance fraud.
> >
> > Ball is in his court then.
> >
> > Hopefully it can be sorted by either your p-doc or the insurer so your psychotherapist can get paid. Have you told your psychotherapist what has been going on? I mean it is unethical of your p-doc to be giving you psychotherapy if you have a psychotherapist already. I would imagine your real psychotherapist should have a bone to pick with him...
>
>
Posted by Jakeman on January 22, 2005, at 18:19:02
In reply to Expectations (Re: Psychiatrists (and others), posted by alohashirt on January 22, 2005, at 17:21:50
> I don't think psychiatrists are any different, although the stakes are higher and its not so easy to switch from one to another.Your point is well taken, but yes the stakes are very much higher. The competence of a psychiatrist can literally impact every aspect of a person's life, including at times if the client lives or dies. I do expect more from my $200 an hour pdoc than I do from my bagel maker. It's very hard avoiding the bad apples because the medical profession is virtually closed to outside scrutiny. There's no consumer reports guides for pdocs.
For a first hand account about this issue and depression in general I highly recommend to anyone William Stryon's little book "Darkness Visible, A Memoir of Madness".
Posted by Dr. Bob on January 22, 2005, at 22:59:32
In reply to Re: Expectations (Re: Psychiatrists (and others) » alohashirt, posted by Jakeman on January 22, 2005, at 18:19:02
> For a first hand account about this issue and depression in general I highly recommend to anyone William Stryon's little book "Darkness Visible, A Memoir of Madness".
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book, movie, or music without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by jerrympls on January 22, 2005, at 23:26:41
In reply to Expectations (Re: Psychiatrists (and others), posted by alohashirt on January 22, 2005, at 17:21:50
> My knee jerk reaction to your post was "What do you expect?"
>
> In a 2 mile radius of where I live there are 40 bagel shops. Three of them are excellent, one of them is copnsitently appalling (staff & stale bagels) and the rest are in the middle.
>
> I don't think psychiatrists are any different, although the stakes are higher and its not so easy to switch from one to another.
>
> My experience suggests that pretty much everything has these tiers:
> 10% excellent
> 40% largely good
> 40% mediocre
> 10% apalling
>
> I imagine that most pdocs would straddle three of these groups for different patients. My pdoc is very well informed, creative, analytical, forgets my history, accidently bills me for the wrong codes, is always in a hurry. Today I'd give him an "A" for excellent. The bill problems all get resolved eventually, I'm in a hurry too so I don'ty need the bedside manner and I don't take the forgetfulness personally. I'm sure he has patients who would rate him a C and in a different context I'd give him that too.
>
> Now maybe your psychiatrist is a bad apple, maybe he's mediocre or just a bad fit for you.
>
> It's a stressful, difficult job that exacts a heavy toll on people and not something I would be willing to do.
>
> My advice is don't take any of it personally, recognize that you will always need to manage your doctor, and find a way to get superb care from someone who is "good enough."
>
> Good Luck!
I have absolutley NO sympathy for the excuse that psychiatrists are in a difficult profession and are tired and overworked. BOO! They chose this profession and if they are overworked it's their fault for booking paitients every 10 mins. Is they can't remember a certain code for insurance or tell you it's YOUR fault for having to wait so long in the waiting room then they're far from professional. I know RESIDENTS who have their acts together better than estabished "professional" pdocs.I had a doc who spent most of MY time with her during appointments talking about how I was behind with my payments. She was part of a private practice including 4 other psychiatrists. I finally was so fed up I wrote a letter explaining how I'd been treated to her and CC'd the pther docs in the practice and in a couple weeks I got a letter saying she was no longer with the practice.
Oh they have so many patients to remember...they work such long hours...they have to deal with insurance companies...CRY CRY CRY. I have NO sympathy for them.
Posted by alohashirt on January 23, 2005, at 14:09:05
In reply to Re: Expectations (Re: Psychiatrists (and others), posted by jerrympls on January 22, 2005, at 23:26:41
Jerryimpls,
I wasn't suggesting that you should have sympathy for anyone. Simply making the point that if 90% of everything is crap, the same metric will (and does) apply to psychiatrists. The fact that they work with human psyches and get paid relatively well to do so doesn't exempt them from this.
There is a model for how children feel about their parents that can equally apply to teachers therapists and pdocs:
1.) first we love them and think they're godlike.
2.) then we see the cracks and think they are incompetent, uncaring boobs.
3.) Eventually we see them realistically, as flawed human beings (just like us.)It's upto us to get the quality care we need. This forum is a big help to me - if I left it upto my pdoc the great care I'm getting would possibly have been mediocre. My two cents ...
This is the end of the thread.
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