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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by MidnightBlue on July 15, 2005, at 15:04:07
I have new insurance. That of course comes with a list of "approved" pdocs to choose from. I know almost nothing about them except most of them have offices 10-20 miles away and I hate to drive in heavy traffic. I also hate parking garages, elevators, etc. I live in a big city, but public transportation is not a very good option. I'm also concerned about the language problem. I really need someone I can understand and who will understand me, quite a few do not have English as a first language.
My old pdoc (who did me no good for two years) is not accepting new patients. I might be able to get back in with him, he is on the list, but I really don't want to.
My internist will prescribe psych meds, but he isn't very good at following up. For instance, he will start me on something new and say maybe come back in two months. I need more support than that.
I REALLY need to be on something other than fish oil and Ambien. How can I find out (for free) where a doctor trained, what his area of experience is, and how good he is?
MidnightBlue
Posted by Racer on July 15, 2005, at 16:32:29
In reply to Need some help here, posted by MidnightBlue on July 15, 2005, at 15:04:07
Hey! Something I can help with! Whoohoo!
The AMA has a website that tells where a doctor graduated from, and (I think) where he/she did residency. That's a good option for you, and you can search it by name and county. It won't tell you how good a doctor is, but at least you can weed out those who graduated from Joe's House of Mufflers and Medical School last month. The main address for the AMA is http://www.ama-assn.org Follow the links for consumers, for doctor-finder.
Your state licensing board probably has a similar site, though, that will tell you if the doctor's license is current, whether there are any public records on file about the doctor (a Bad Thing), and a few other bits of information that can help you. California's Medical Board also publishes a cute little listing of everyone who's being investigated or has been punished in some way in the current period, along with little notes about what the punishment is for. That's always an amusing read -- as long as your doctor ain't on it -- if you like that sort of thing. (Sadly, but also happily, there were more reprimands and suspensions for things like sloppy billing practices and physician's alcoholism than for incompetence. I'm sad that so many doctors have such trouble with alcohol, but relieved at how few were cited for gross incompetence.)
Beyond that, sometimes you can do a mini-telephone interview with pdocs, or find a litmus test question -- "when was the last time you prescribed an MAOI? Have you prescribed Florinef with it recently?" or something -- that might help you. You could do what I did finding my last PCP: went through the list of doctors on the plan and picked out those in the medical group I liked, who had admitting priveledges at the hospital I trusted; then picked out all the doctors who had offices in the same building as my opthalmologist -- because I knew where to park nearby; then narrowed it down to the two women amongst 'em; and chose the one whose name I liked better. Slightly better than closing my eyes and throwing a dart...
Hm... If you trust your PCP, I would suggest seeing if you can narrow the list a bit, then take the remaining names to him/her and ask for advice. Might help. Might not. Best I can come up with...
Hope that helps a little...
Posted by Phillipa on July 15, 2005, at 19:03:10
In reply to Re: Need some help here » MidnightBlue, posted by Racer on July 15, 2005, at 16:32:29
Racer you've done it again. We looked all my docs up on this site. It doesn't tell you about malpractice though. Do you know of one that does? Fondly, Phillipa
Posted by Racer on July 15, 2005, at 20:28:55
In reply to Re: Need some help here » Racer, posted by Phillipa on July 15, 2005, at 19:03:10
> Racer you've done it again. We looked all my docs up on this site. It doesn't tell you about malpractice though. Do you know of one that does? Fondly, Phillipa
Check your state medical licensing board. They will tell you about any public records, which I believe includes malpractice judgements for more than 30K. Your state may, of course, be different, but they will list any problems with a doctor's license.
Posted by MidnightBlue on July 15, 2005, at 22:12:50
In reply to Re: Need some help here » MidnightBlue, posted by Racer on July 15, 2005, at 16:32:29
Racer,
Thank you so much! I go see my internist next week and I'll try to narrow down the names some and get him to look at them. He is really a decent guy and has often spent 45 min or more with me. He is just hard to get in to see and has limited psych knowledge though he did call a psych friend once to ask about me.
Right now I'm just on fish oil and Ambien. Well, plus blood pressure meds, GERD meds, arthritis meds, etc. LOL And that's just not cutting it. He had mentioned Cymbalta. I used to take Wellbutrin but it quit working quite some time ago.
Thanks again!
MidnightBlue
Posted by MidnightBlue on July 22, 2005, at 21:15:49
In reply to Re: Need some help here » Phillipa, posted by Racer on July 15, 2005, at 20:28:55
Racer,
Thanks for all this info. I asked my internist for suggestions and out of over 50 he picked two. I checked them out with the AMA and state board. Only one is board certified and he was the second choice. I also checked out a few other people. One I think trained in another state with my all time favorite pdoc who I miss terribly! The other is older but a full professor at two medical centers and received some kind of award from a mental health alliance for being an outstanding pdoc.
What on earth should I do now? My internist offered Cymbalta, but I just started crying because I know I won't get the emotional support I will need to be able to try a new drug. He really wants me to see a pdoc. It will be a 10-20 mile drive in heavy traffic. Sigh.....
MidnightBlue
>>
> Check your state medical licensing board. They will tell you about any public records, which I believe includes malpractice judgements for more than 30K. Your state may, of course, be different, but they will list any problems with a doctor's license.
Posted by Racer on July 23, 2005, at 18:31:15
In reply to Re: Need some help here » Racer, posted by MidnightBlue on July 22, 2005, at 21:15:49
Sorry for the delay, I just saw this today.
Let's see what else I can offer...
>
> I asked my internist for suggestions and out of over 50 he picked two.That's about right -- usually, doctors recommend those doctors they have some experience with. Sometimes that means that they play tennis together twice a week, but more often it means that they share enough patients to trust each other as a referral. Recommending two is about as many as I usually hear.
> I checked them out with the AMA and state board. Only one is board certified and he was the second choice.
Board certification is great, but not necessary. It is one way to check credentials, but I've seen a lot of good doctors who were not board certified. In fact, my very well liked, very well respected by his peers, trusted, and excellent Dr CattleProd is not board certified. He has been head of several departments, including head of a psych department at a teaching hospital, has extensive experience and training in all phases of psychiatry, including ECT, and is a very excellent psychopharmacologist. The fact that the board certified doctor was second choice might tell you something -- that he's the second choice, despite the certification...
>I also checked out a few other people. One I think trained in another state with my all time favorite pdoc who I miss terribly!
Be careful that you're not trying to maintain a connection to your old pdoc, by seeing this one. I know that it's tempting, but be sure that you're still impressed and comfortable when you see this guy -- even if he does have good stories about your old pdoc, you know?
>The other is older but a full professor at two medical centers and received some kind of award from a mental health alliance for being an outstanding pdoc.
>That does tend to mean something. Check the award, though, to make sure it's based on what his clients think of him, rather than on what his peers think of him. While the peers may know something, it's the client experience that you care about.
> What on earth should I do now? My internist offered Cymbalta, but I just started crying because I know I won't get the emotional support I will need to be able to try a new drug. He really wants me to see a pdoc. It will be a 10-20 mile drive in heavy traffic. Sigh.....
>
> MidnightBlue
>Yeah, I gotta agree there. I think you're too new to know about what I was going through last year, but let's just say that I know how important it is to have that support when you start a new drug.
Take a deep breath now, and know that what I'm about to say comes only from concern: when you write about the drive, and the traffic, it kinda sounds as though you're at that point in depression where it's gonna take you a major effort just to get to someone who can help. Forget the traffic, try to make an appointment during the down time of the day, and remember that 20 miles is nothing if it results in you getting better. I drive 60 miles to see my dentist. And there are plenty of dentists much closer.
I won't offer any advice about what I think you "should" do, but I will tell you what I think I would do in your situation: I would first call the number one choice from my GP, and maybe make an initial appointment with him/her. If it didn't feel right to me, I would thank him/her for the time, and say it's not working for me -- and leave. Right then and there, even if I were in the middle of the appointment when I realized it wouldn't work. And in that case, I would move on to the second choice, and so on.
Remember, you get to make a choice. You don't have to continue to see a doctor who just doesn't work for you. You can fire a doctor! (And trust me: it feels really, really good to do so!)
Posted by MidnightBlue on July 23, 2005, at 20:57:31
In reply to Re: Need some help here » MidnightBlue, posted by Racer on July 23, 2005, at 18:31:15
Racer,
Thanks for answering. I babbled you too, but guess you didn't get it. I guess I will call that first guy. I need to look up his info again. I just don't feel like he knows much. I think he is only 10 miles away. I'm not sure how good he is with depression and I feel sure I'm in the resistant catagory! Some docs keep trying to make me bipolar 2 because I don't respond well to meds. I've seldom had an UP day in my whole life!
I don't drive much at all. I have severe back problems and have problems trying to merge in traffic because I can't look back. I'm also terrified of parking garages, etc. I don't drive the freeways at all. We have LOTS of freeways!
Okay this older guy received a National Alliance for the Mentally Ill Exemplary psychiartist award about 10 years ago. He is also a clinical professor of psychiatry at a Medical School and Clinical Professor of Psychiatry and behavorial Sciences at another one of its branches. He is in a high rise on a freeway. At least it looks like that from his address.
Yes, I can "pick" a doctor. BUT I have to call and beg and get permission first. And be pre-certified to see one. I am in a PPO. I'm sure most of the good docs aren't on it! I can't afford one that isn't unless it is a once or twice thing. I have seen two psychiatrists in this town and didn't like either one of them. One I saw once and QUICKLY fired, the other I went to for more than two years out of desperation. He didn't help me at all.
I have had SERIOUS problems switching drugs before. I know it is nothing to mess with. I am very sensitive to some meds and easily have side effects.
You have to understand there are daysI don't even go out of my apartment. At MOST I walk up to the apartment mail box, but have to make myself do that.
OOPS there is one other psychiatrist I saw. It was a research project I washed out of because of my EKG, and I don't think he even sees patients outside it. He is NOT on my insurance. He took my history, looked at me thoughtfully and said you haven't tried a couple of things yet. You aren't at the end yet. I really liked him, but he is 20 miles, up a parking garage, AND not affordable even if he sees patients!
MidnightBlue
Posted by Phillipa on July 23, 2005, at 21:12:24
In reply to Re: Need some help here » Racer, posted by MidnightBlue on July 23, 2005, at 20:57:31
Sounds like some agoraphobia too. I definitely have that. Fondly,Phillipa
Posted by MidnightBlue on July 23, 2005, at 21:53:52
In reply to Re: Need some help here » Racer, posted by MidnightBlue on July 23, 2005, at 20:57:31
Racer,
The number one guy is a CHILD psychiatrist. I give up!
MB
Posted by Racer on July 24, 2005, at 0:22:23
In reply to Re: Need some help here, posted by MidnightBlue on July 23, 2005, at 21:53:52
> Racer,
>
> The number one guy is a CHILD psychiatrist. I give up!
>
> MBLOL! That's pretty rich...
I'll make you laugh, back: I broke a rib this morning, getting up out of my chair... Cross my heart, can you imagine anyone being that klutzy?
Anyway, it sounds like maybe that one was a personal contact, rather than a shared patient thing. Or your GP thinks you look awfully young? ;-)
Good luck!
Posted by ed_uk on July 24, 2005, at 4:29:39
In reply to Re: Need some help here, posted by MidnightBlue on July 23, 2005, at 21:53:52
Hi!
How are you finding Celebrex?
~Ed
Posted by MidnightBlue on July 24, 2005, at 12:16:17
In reply to Re: Need some help here » MidnightBlue, posted by ed_uk on July 24, 2005, at 4:29:39
Ed,
I didn't take it after all. I started Mobic 15 mg yesterday. Is it possible it is making me sleepy? I'm so out of it. The nurse said to take it in the morning since it would only last 6-7 hours. That seems odd to me since it is a 1 time a day drug. Also I had to increase my Prilosec for my GERD to be able to handle it. Prilosec 40 mg wipes me out. I was taking 30mg or 1 1/2.
Also having to cut a 150 mg Avapro in half now for my blood pressure med. My insurance won't cover the 75 mg!
Just had a bunch of tests run last week. Hope to know something next week. Really need to find something for this depression. And a decent pdoc.
Posted by ed_uk on July 24, 2005, at 17:17:24
In reply to Re: Need some help here » ed_uk, posted by MidnightBlue on July 24, 2005, at 12:16:17
Hi!
Some NSAIDs can cause fatigue, I'm not sure about Mobic specifically though.
>Also I had to increase my Prilosec for my GERD to be able to handle it.
Celebrex is more selective for COX-2 than Mobic so the GI side effects of Celebrex should be milder.
>I started Mobic 15 mg yesterday.
Perhaps you could try 7.5mg.
~Ed x
Posted by MidnightBlue on July 24, 2005, at 23:18:44
In reply to Re: Need some help here » MidnightBlue, posted by ed_uk on July 24, 2005, at 17:17:24
Ed,
Can I cut the 15mg Mobic in half or is it specially coated? I think the doctor gave me that instead of Celebrex because it is stronger. At least that is the impression I got.
MB
Posted by ed_uk on July 25, 2005, at 14:15:40
In reply to Re: Need some help here » ed_uk, posted by MidnightBlue on July 24, 2005, at 23:18:44
Hi,
>Can I cut the 15mg Mobic in half or is it specially coated?
You can cut the UK version, it's scored.
>I think the doctor gave me that instead of Celebrex because it is stronger.
It's not stronger! They both have a similar effect.
Kind regards
Ed x
Posted by MidnightBlue on July 26, 2005, at 11:12:23
In reply to Re: Need some help here » MidnightBlue, posted by Racer on July 24, 2005, at 0:22:23
Racer,
I've been doing some more research on this child psychiatrist. Seems he is head of the mental health response team at the hospital my doc uses. Also he is running a a research clinic out of his office. At least it sounds like that. Not sure still searching. Love that Google! Also the number two guy shares an office with a so called "top doc". Still searching......
MB
Posted by MidnightBlue on July 26, 2005, at 11:20:05
In reply to Re: Need some help here » MidnightBlue, posted by ed_uk on July 25, 2005, at 14:15:40
Ed,
The US version isn't scored, but it is a simple tablet though it might be coated. I'll call the pharmacy later, but I'm thinking I'll try to take half a Mobic with dinner and see how that works. Yesterday I skipped it altogther. It was really helping the pain--so much my mood even improved!I think one reason the doc was a bit hesitant on the celebrex is I "may" have a sulfa (sp?) allergy. I was able to take the Bextra and know it is a metabolite of the Celebrex, but not sure if Celebrex would have something in it Bextra didn't that my poor old body might not like. :-)
MB
> Hi,
>
> >Can I cut the 15mg Mobic in half or is it specially coated?
>
> You can cut the UK version, it's scored.
>
> >I think the doctor gave me that instead of Celebrex because it is stronger.
>
> It's not stronger! They both have a similar effect.
>
> Kind regards
>
> Ed x
Posted by ed_uk on July 26, 2005, at 13:23:07
In reply to Re: Need some help here, posted by MidnightBlue on July 26, 2005, at 11:20:05
Hi!
>I'm thinking I'll try to take half a Mobic with dinner and see how that works.
I think that's a good idea.
Btw, we've got 10 boxes of Bextra in the pharmacy. We're not gonna be using them since it's not longer prescribed!
>I was able to take the Bextra and know it is a metabolite of the Celebrex, but not sure if Celebrex would have something in it Bextra didn't that my poor old body might not like.
Celebrex and Bextra both have a sulphonamide group. Bextra seems to be associated with more allergic reactions than Celebrex.
~Ed x
Posted by MidnightBlue on July 27, 2005, at 21:57:34
In reply to Re: Need some help here » MidnightBlue, posted by ed_uk on July 26, 2005, at 13:23:07
Hey Ed,
I seem to be doing okay on 1/2 a Mobic. My mood is even a bit better! I guess less pain helps! :-)
MB
Posted by ed_uk on July 28, 2005, at 17:08:23
In reply to Re: Need some help here » ed_uk, posted by MidnightBlue on July 27, 2005, at 21:57:34
>I seem to be doing okay on 1/2 a Mobic. My mood is even a bit better! I guess less pain helps! :-)
:-)
~Ed
Posted by ed_uk on August 7, 2005, at 16:25:58
In reply to Re: Need some help here » ed_uk, posted by MidnightBlue on July 27, 2005, at 21:57:34
Hi!
How are you doing on Mobic 7.5mg?
~Ed
Posted by MidnightBlue on August 7, 2005, at 21:38:44
In reply to Re: Need some help here » MidnightBlue, posted by ed_uk on August 7, 2005, at 16:25:58
Ed,
Really hurting. :-( Tonight I tried 3/4 of a 15mg tablet. Not sure if my stomach can take it. Should know in a few days. Thanks so much for asking.
Hugs,
MidnightBlue
Posted by ed_uk on August 8, 2005, at 14:05:41
In reply to Re: Need some help here » ed_uk, posted by MidnightBlue on August 7, 2005, at 21:38:44
Hi,
Perhaps you should try Celebrex instead.
~Ed
Posted by MidnightBlue on August 8, 2005, at 23:13:09
In reply to Re: Need some help here » MidnightBlue, posted by ed_uk on August 8, 2005, at 14:05:41
Ed,
I don't have a prescription for Celebrex, just samples. Why on earth would I be sleepy 3 hours after I wake up? Could Avapro do that? My doctor makes me take it at breakfast. Or could it be something from the night before?
I still can't decide whether or not to go to a pdoc.
>
> Perhaps you should try Celebrex instead.
>
> ~Ed
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