Psycho-Babble Medication Thread 474694

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Finding a pdoc

Posted by fires on March 23, 2005, at 16:46:35

I can't believe it. I live near a major US metro area with several teaching U. hospitals. I can't find a pdoc who takes my PPO insurance.

I can see a resident, but that didn't work well last time. I was recently referred to a pdoc, but he doesn't take insurance. Another isn't taking new patients. Another doesn't have any appointment openings until May. (Those are all about 30 miles from my home).

Closer to home, I can't find out much about any pdocs.

Anyone have any unique ideas for finding a good pdoc?

 

Re: Finding a pdoc fires

Posted by jerrympls on March 23, 2005, at 19:55:46

In reply to Finding a pdoc, posted by fires on March 23, 2005, at 16:46:35

> I can't believe it. I live near a major US metro area with several teaching U. hospitals. I can't find a pdoc who takes my PPO insurance.
>
> I can see a resident, but that didn't work well last time. I was recently referred to a pdoc, but he doesn't take insurance. Another isn't taking new patients. Another doesn't have any appointment openings until May. (Those are all about 30 miles from my home).
>
> Closer to home, I can't find out much about any pdocs.
>
> Anyone have any unique ideas for finding a good pdoc?
>

I've been where you are and I feel you pain-really. I had to eventually go to the ER when I moved to MN because I couldn't get in to see a pdoc. So I wnet to the ER and said - "I need refills and I can't get in to see a doc." Luckily there was a pdoc on the floor and overheard about my difficulties and offered to take me in as a patient. I wish I had better advice...

Good luck
Jerry

 

Re: Finding a pdoc

Posted by fires on March 23, 2005, at 21:47:00

In reply to Re: Finding a pdoc fires, posted by jerrympls on March 23, 2005, at 19:55:46


> I've been where you are and I feel you pain-really. I had to eventually go to the ER when I moved to MN because I couldn't get in to see a pdoc. So I wnet to the ER and said - "I need refills and I can't get in to see a doc." Luckily there was a pdoc on the floor and overheard about my difficulties and offered to take me in as a patient. I wish I had better advice...
>
> Good luck
> Jerry

I need to find a new pdoc, or at least find one for a second opinion. I wish there were groups that could track pdocs as to which will prescribe meds like Parnate (most in my area won't), Klonopin, etc.., which specialize in bipolar, etc...

I don't think I'll have to resort to the ER, but thanks for the sugestion. BTW, ERs in my area typically get a lot non-emergency patients who simply don't have MDs.

 

Re: Finding a pdoc fires

Posted by Phillipa on March 23, 2005, at 22:03:17

In reply to Re: Finding a pdoc, posted by fires on March 23, 2005, at 21:47:00

Any major Hospital should have a list of pdocs. I guess you then have to call around until you find one who takes your insurance. Fondly, Phillipa

 

Re: Finding a pdoc

Posted by Bill LL on March 24, 2005, at 8:48:05

In reply to Finding a pdoc, posted by fires on March 23, 2005, at 16:46:35

My experience is that pdocs are the only physician specialty in the US that does not take insurance (with few exceptions). But it makes sense. Other specialties bill for a wide variety of services where they can play around with the billings to make more money. They can also bill a full amount for visits even if they only see you for 3 or 4 minutes.

Pdocs, on the other hand, have to bill psychotherapy codes that go by actual time. So they can't just see you for 3 or 4 minutes and bill for a code that specifies 45 minutes.

Most prescriptions for antidepressants are written by non-pdocs such as internists, GP's, and OB-GYN's. They are very experienced with these drugs. Unless you need psychotherapy, or you want a second opinion with your meds, you don't have to see a pdoc.

> I can't believe it. I live near a major US metro area with several teaching U. hospitals. I can't find a pdoc who takes my PPO insurance.
>
> I can see a resident, but that didn't work well last time. I was recently referred to a pdoc, but he doesn't take insurance. Another isn't taking new patients. Another doesn't have any appointment openings until May. (Those are all about 30 miles from my home).
>
> Closer to home, I can't find out much about any pdocs.
>
> Anyone have any unique ideas for finding a good pdoc?
>

 

Re: Finding a pdoc Bill LL

Posted by fires on March 24, 2005, at 10:38:50

In reply to Re: Finding a pdoc, posted by Bill LL on March 24, 2005, at 8:48:05

> My experience is that pdocs are the only physician specialty in the US that does not take insurance (with few exceptions). But it makes sense. Other specialties bill for a wide variety of services where they can play around with the billings to make more money. They can also bill a full amount for visits even if they only see you for 3 or 4 minutes.
>
> Pdocs, on the other hand, have to bill psychotherapy codes that go by actual time. So they can't just see you for 3 or 4 minutes and bill for a code that specifies 45 minutes.
>
> Most prescriptions for antidepressants are written by non-pdocs such as internists, GP's, and OB-GYN's. They are very experienced with these drugs. Unless you need psychotherapy, or you want a second opinion with your meds, you don't have to see a pdoc.
>
> > I can't believe it. I live near a major US metro area with several teaching U. hospitals. I can't find a pdoc who takes my PPO insurance.
> >
> > I can see a resident, but that didn't work well last time. I was recently referred to a pdoc, but he doesn't take insurance. Another isn't taking new patients. Another doesn't have any appointment openings until May. (Those are all about 30 miles from my home).
> >
> > Closer to home, I can't find out much about any pdocs.
> >
> > Anyone have any unique ideas for finding a good pdoc?
> >

My other docs sent me to pdoc, because they know they are in over their heads. Now my current pdoc has told me some very questionable "facts":

My med reactions are psychosomatic; 300 mg of Wellbutrin can't trigger mania; (the others escape me at the moment).

Thanks

 

Re: Finding a pdoc fires

Posted by CareBear04 on March 24, 2005, at 13:12:21

In reply to Finding a pdoc, posted by fires on March 23, 2005, at 16:46:35

hey fires--
sorry you're having trouble.
most univeresity teaching hospitals have outpatient clinics where the 3rd and 4th year residents train. i know you didn't have a good experience with the one person you saw, but maybe you could try again. i've only seen residents in the hospital setting, but i've had a few that are really smart and caring. sometimes you can catch them before they get cynical and disillusioned. when you say it didn't work out, what was the problem? was the resident incompetent? or was it that your personalities didn't click? the residents all have supervisors, so you could probably ask the resident to pass your opinions along or ask to have the supervisor sit in on a session. if one resident isn't a fit, maybe you can try another. when i've been in the hospital with all the layers of authority, i've usually made the best connections with those low on the ladder-- the nursing students, the medical students, and the residents. most of them still seem to care and know that they're there to learn. that's just my experience.

a lot of insurnace companies have a website where you can do a search to see which specialists in your area are preferred and covered. if not, you can usually call a number on your insurnace card and talk to a rep who can give you some names and numbers.

do you need a pdoc for drugs or therapy or both? if you just need the meds, what someone else wrote about not needing a pdoc may be true. when my doctors were in over their head, i went for a one-time consultation with the big-name psychopharmacologist in the area. he reserves a good part of his time to consult on difficult to treat cases. i saw him for an hour, and he was so quick that he was able to devise treatment strategies and options, which he later wrote up and sent to my doctor. i don't need to see him again, but he's willing to consult with my doctor if needed. maybe you could go in for a one-time consultation/assessment for treatment suggestions. with those instructions, a primary care doctor should be able to carry them out, and that would be covered by your insurance, right? i don't know if the consultation would be. mine was covered at least in part.

if you live in a major urban area near at least one academic medical center, i wouldn't lose hope at all. of all the faculty and affiliated pdocs, someone is bound to take your insurance. otherwise, a lot of primairy care doctors are fully able to treat psych ailments with guidance from a specialist.

good luck! please post on how things turn out.

 

Re: Finding a pdoc

Posted by Bill LL on March 24, 2005, at 13:31:14

In reply to Re: Finding a pdoc Bill LL, posted by fires on March 24, 2005, at 10:38:50

I really don't know enough about meds to say if 300 mg of Wellbutrin can trigger mania. I just know that when I was on Wellbutrin, it made me jittery.

Maybe you could check with people you know to see if they have heard of, or have experience with, a good p-doc.

Some p-docs will see people, even new patients, for relatively short, and therefore inexpensive visits. But some will only see patients for longer, psychotherapy type visits.

The one I consulted with a few years a go did not accept my insurance, but all of my visits were between 20 and 30 minutes. He charged by actual time. After I got my insurance payment it wasn't too bad.

> > My experience is that pdocs are the only physician specialty in the US that does not take insurance (with few exceptions). But it makes sense. Other specialties bill for a wide variety of services where they can play around with the billings to make more money. They can also bill a full amount for visits even if they only see you for 3 or 4 minutes.
> >
> > Pdocs, on the other hand, have to bill psychotherapy codes that go by actual time. So they can't just see you for 3 or 4 minutes and bill for a code that specifies 45 minutes.
> >
> > Most prescriptions for antidepressants are written by non-pdocs such as internists, GP's, and OB-GYN's. They are very experienced with these drugs. Unless you need psychotherapy, or you want a second opinion with your meds, you don't have to see a pdoc.
> >
> > > I can't believe it. I live near a major US metro area with several teaching U. hospitals. I can't find a pdoc who takes my PPO insurance.
> > >
> > > I can see a resident, but that didn't work well last time. I was recently referred to a pdoc, but he doesn't take insurance. Another isn't taking new patients. Another doesn't have any appointment openings until May. (Those are all about 30 miles from my home).
> > >
> > > Closer to home, I can't find out much about any pdocs.
> > >
> > > Anyone have any unique ideas for finding a good pdoc?
> > >
>
> My other docs sent me to pdoc, because they know they are in over their heads. Now my current pdoc has told me some very questionable "facts":
>
> My med reactions are psychosomatic; 300 mg of Wellbutrin can't trigger mania; (the others escape me at the moment).
>
> Thanks
>

 

Re: Finding a pdoc Bill LL

Posted by fires on March 24, 2005, at 17:48:40

In reply to Re: Finding a pdoc, posted by Bill LL on March 24, 2005, at 13:31:14

The pdoc I'm seeing is the one which most recommend in my area.

I think I may have to start a search all over again. I'm tempted to send out letters to many with a returnable questionnaire containing several key questions. No kidding.

Thanks

 

Re: Finding a pdoc

Posted by jerrympls on March 24, 2005, at 17:53:04

In reply to Re: Finding a pdoc fires, posted by CareBear04 on March 24, 2005, at 13:12:21

> hey fires--
> sorry you're having trouble.
> most univeresity teaching hospitals have outpatient clinics where the 3rd and 4th year residents train. i know you didn't have a good experience with the one person you saw, but maybe you could try again. i've only seen residents in the hospital setting, but i've had a few that are really smart and caring. sometimes you can catch them before they get cynical and disillusioned. when you say it didn't work out, what was the problem? was the resident incompetent? or was it that your personalities didn't click? the residents all have supervisors, so you could probably ask the resident to pass your opinions along or ask to have the supervisor sit in on a session. if one resident isn't a fit, maybe you can try another. when i've been in the hospital with all the layers of authority, i've usually made the best connections with those low on the ladder-- the nursing students, the medical students, and the residents. most of them still seem to care and know that they're there to learn. that's just my experience.
>
> a lot of insurnace companies have a website where you can do a search to see which specialists in your area are preferred and covered. if not, you can usually call a number on your insurnace card and talk to a rep who can give you some names and numbers.
>
> do you need a pdoc for drugs or therapy or both? if you just need the meds, what someone else wrote about not needing a pdoc may be true. when my doctors were in over their head, i went for a one-time consultation with the big-name psychopharmacologist in the area. he reserves a good part of his time to consult on difficult to treat cases. i saw him for an hour, and he was so quick that he was able to devise treatment strategies and options, which he later wrote up and sent to my doctor. i don't need to see him again, but he's willing to consult with my doctor if needed. maybe you could go in for a one-time consultation/assessment for treatment suggestions. with those instructions, a primary care doctor should be able to carry them out, and that would be covered by your insurance, right? i don't know if the consultation would be. mine was covered at least in part.
>
> if you live in a major urban area near at least one academic medical center, i wouldn't lose hope at all. of all the faculty and affiliated pdocs, someone is bound to take your insurance. otherwise, a lot of primairy care doctors are fully able to treat psych ailments with guidance from a specialist.
>
> good luck! please post on how things turn out.

I agree with Carebear-residents can be a good thing. I have been seeing 4th year residents for 3 years now. Last year when I had to switch to a different resident (the one I was seeing had a baby) I hated him and thought I was stuck with him - this was not so. I requested to switch to another resident and all I had to do was fill out a form stating why I wanted to switch and that was it. I got in to see a new resident within the month and am happy with him. He is the doctor who - along with his attending doc - is allowing me to augment my current treatment with an opiate. Also, like Carebear said - you can usually catch these "new" pdocs before they become cynical. The residents I have seen have been more than eager for me to bring in any research I find regarding new treatments, etc. They also aren't worried about billing and -in my situation- spend a full 30mins per visit with me. They aren't so anxious to get me out the door so they can squeeze in 100 patients in a day - you know.

Anyway--hang in there and good luck.
Jerry


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