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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by harry b. on June 30, 2000, at 14:18:38
My psychologist and my psychiatrist share an office
suite. They are the only practitioners in this office.They have seperate practices. Billings are separate.
I see the psychologist once a week, the psychiatrist
once a month.What irritates me is that they never seem to consult
with one another about me, their common patient. I don't
think it is a question of legalities or a patient's rights
to privacy. Even if that was the case, I have responded
to questions from each of them with "that's in my file."
I would also gladly sign a consent of release of information
limited to them.I think my time, effort, and money could be better utilized
if they would sit down together maybe once a week and
review their common patients' status. Are they too
greedy to sacrifice a billable hour or two a week?Am I asking too much?
hb
Posted by noa on June 30, 2000, at 14:56:44
In reply to Do your docs communicate?, posted by harry b. on June 30, 2000, at 14:18:38
harry,
I think some patients want that and some don't. But since you do, you can request that they consult each other. I don't know that they would do it every week, but hopefully, they would respond to your request.
Mostly, my docs don't talk to each other (my psychopharm is impossible to reach anyway). But when my depression was getting really bad, my psychologist asked if I thought it would be a good idea for them to talk. I did, and they did. I think it was somewhat helpful, but didn't have a big impact.
Even if your docs consult, I think it might be hard for them to hold onto all information received through such a consultation, and it would probably seem more reliable to hear it directly from you anyway. Their communication would be useful in terms of coordination of treatment, to be sure that they are on the same wavelength, especially since you are still struggling to find a treatment protocol that works for you. Perhaps that is why it IS so frustrating for you that they don't talk to each other about you on a regular basis--that is, you have a right to be frustrated because you have not been able to settle on an effective treatment plan yet.
So, Yeah, I think asking them to consult is a good idea.
Posted by Rockets on June 30, 2000, at 16:58:10
In reply to Re: Do your docs communicate?, posted by noa on June 30, 2000, at 14:56:44
I concur with Harry
Posted by Snowie on June 30, 2000, at 21:58:22
In reply to Do your docs communicate?, posted by harry b. on June 30, 2000, at 14:18:38
No offense intended, but I'm certainly glad I got out of that rat-mouse race! And what a mess it was ... my old pdoc (the rat) was strangely intimidated by my seeing a psychologist (the mouse), although when prompted the rat agreed that I needed therapy. My new pdoc does it all ... therapy and med management. I wish you all the same good fortune. Thanks again, Angela!
Snowie
Posted by kazoo on July 1, 2000, at 1:15:30
In reply to Do your docs communicate?, posted by harry b. on June 30, 2000, at 14:18:38
> Am I asking too much?
^^^^^^^^^^^^^^^^^^^^^^^Absolutely NOT!
It has been my understanding that these two fields/professions work
with one another. Based on what you tell the psychologist, medication
can be dispensed from the psychiatrist, who is a doctor. But in order for that to happen, the psychologist and
psychiatrist must COMMUNICATE with each other, and for some reason they're
not in your situtaion (rivalry? animosity? envy? who knows?)What I would do would be to get BOTH these birds together in one room, and tell them
how you feel and what you think. If they both feel they're beyond this form of
reality testing, and your straight-forward honesty, then how effective can they
be in helping you?kazoo
Posted by paul on July 1, 2000, at 2:35:37
In reply to Do your docs communicate?, posted by harry b. on June 30, 2000, at 14:18:38
my two know of each other-my msw soggested my present-and bgy far the best-pdoc. i've never thought of asking them to consult but i'll bring it up next time i see them. i trust both of them solidly. what a joy!
harry-no you're NOT asking too much. these people work FOR YOU after all. if they balk, find out why and maybe even remind them who the boss is-YOU!!
pcl
Posted by JohnL on July 1, 2000, at 3:30:29
In reply to Do your docs communicate?, posted by harry b. on June 30, 2000, at 14:18:38
My various doctors and/or counselors have consulted over the year. The reasons were either: my request; to get another opinion on my history and diagnosis; to confirm what has already been tried and what the results were. I don't think any teamwork collaboration ever took place though. It was mainly a comparing notes kind of thing.
The only doctor who really impressed me with his professional consultation was Dr Jensen. After the one hour-long phone consultation with me, he faxed my local doctor his diagnosis, reasons for the diagnosis, a review of drugs already tried and what their responses meant about my chemistry, drugs to try, exactly why those drugs should be tried, what chronolocial order the drugs should be tried, and what to do in case of adverse reactions. Prior to the consultation, he called my local doc personally to get his side of the picture before talking with me. The whole thing was pretty darn impressive. But in my experience it was also pretty darn rare.
Posted by ksvt on July 1, 2000, at 23:14:56
In reply to Re: Do your docs communicate?, posted by JohnL on July 1, 2000, at 3:30:29
> My various doctors and/or counselors have consulted over the year. The reasons were either: my request; to get another opinion on my history and diagnosis; to confirm what has already been tried and what the results were. I don't think any teamwork collaboration ever took place though. It was mainly a comparing notes kind of thing.
>
> The only doctor who really impressed me with his professional consultation was Dr Jensen. After the one hour-long phone consultation with me, he faxed my local doctor his diagnosis, reasons for the diagnosis, a review of drugs already tried and what their responses meant about my chemistry, drugs to try, exactly why those drugs should be tried, what chronolocial order the drugs should be tried, and what to do in case of adverse reactions. Prior to the consultation, he called my local doc personally to get his side of the picture before talking with me. The whole thing was pretty darn impressive. But in my experience it was also pretty darn rare.Harry you're not asking too much. My pdoc used to also be my therapist but at some point I didn't seem to be getting anywhere and he helped me find my present therapist. I've discovered that they communicate reasonably frequently, alot of it precipitated by my psychiatrist who likes to monitor what's going on. When my therapist leaves town for more than a week or so she tries to get me to go see the psychiatrist or she gets him to call me. I'm not sure how much of a difference all this makes. i went through a real slide this winter and no one made any suggestions about changing meds until I raised the issue. Nonetheless, it's sort of reassuring to know that the communication is there and that my psychiatrist feels he should stay involved even though I really don't see him very often.
Posted by allisonm on July 2, 2000, at 12:06:02
In reply to Re: Do your docs communicate?, posted by ksvt on July 1, 2000, at 23:14:56
ksvt,
It sounds as though you have a good set-up of caring people. Just curious, and I don't mean to pry: how did your pdoc and you arrive at the decision to find another therapist? Did he bring it up? Did you? How did he help you find your current therapist?I'm just wondering because my pdoc asks me periodically whether I think I'm benefitting from our visits. I've always said yes, but now am beginning to wonder whether he keeps asking because thinks differently (or maybe I'm just paranoid).
Thanks.
Allison
Posted by ksvt on July 2, 2000, at 21:39:36
In reply to Re: Do your docs communicate?¿ksvt, posted by allisonm on July 2, 2000, at 12:06:02
> ksvt,
> It sounds as though you have a good set-up of caring people. Just curious, and I don't mean to pry: how did your pdoc and you arrive at the decision to find another therapist? Did he bring it up? Did you? How did he help you find your current therapist?
>
> I'm just wondering because my pdoc asks me periodically whether I think I'm benefitting from our visits. I've always said yes, but now am beginning to wonder whether he keeps asking because thinks differently (or maybe I'm just paranoid).
>
> Thanks.
>
> Allison
Allison. I don't mind the question. I saw my pdoc in therapy for almost 2 years and I stopped because I was sort of burned out on therapy (for most of that time I was going twice a week) and because I had exceeded my insurance company's lifetime cap on mental health benefits, so regular therapy was feeling very unaffordable. However I stayed in touch with him after that (more typically he with me) and saw him periodically as I'd feel real stressed about something. With one 4 month exception, I never saw him after that time for more than 2 weeks in a row, so it wasn't like I was really engaged in therapy that was headed anywhere. After about 2 years, I found myself way overextended at work and very stressed about it. I was convinced that the problem was an issue of time management and organization. I think it was also that I just had more to do than I could handle. Anyway, I it occurred to me that I had a work life that was a breeding ground for depression and I needed to find ways to work less/more efficiently. My pdoc had a pretty traditional approach and was not really into the behavorial stuff at all. I also was feeling that I would really rather see a woman. I had a name of someone who I had heard about a few years before, and I considered just contacting her on my own without ever discussing it with my pdoc, because I really did feel sort of awkward about this. As tempting as this approach was, I knew it was a pretty shitty way to treat someone who had always tried to be helpful to me. I think I couched it to him in terms of wanting to see a therapist who could deal with some very specific behavorial issues. He picked up on the idea pretty quickly, probably because he'd rather have me in therapy than out. He recommended the same therapist I had thought of calling and he sort of set things up with her. He's made himself very available since then both to me and to her, and I'm sort of tied to him anyway because of my ongoing need for prescription medications. The therapy I'm in now is considerably more extensive had has gone on a lot longer than I really bargained for, but my pdoc has really encouraged me to stick with it. The money issue isn't as big now because my state passed a law prohibiting health care caps that just targeted mental health services. Sometimes I wonder if I stuck with my therapy with my pdoc too long, because I really think I relate better to a woman therapist. On the other hand, my pdoc has always been very professional and has demonstrated to me on numerous occasions that his ego would not get in the way of what I thought was best for me. I'm very grateful for his willingness to stay involved.
I would encourage you to be up front with your own doctor about this. I know its hard, but if the guy is any good at all, he should be able to help you work through this. I can think of countless times that I wish, in retrospect, that I had been more proactive and considerably more candid about issues related to therapy. Of course when you're depressed, it's hard not to just want to put yourself in someone else's hands anyway, so its hard to be disposed to take control yourself. If you can raise these issues I think you'll probably be better off for it. Good Luck!
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