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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by NKP on November 12, 2022, at 5:37:17
It feels like they charge a small fortune for doing what a general practitioner can probably do equally well, at least in less severe instances of mental illness.
The only difference between my psychiatrist prescribing venlafaxine and lamotrigine, and my general practitioner prescribing venlafaxine and lamotrigine, is that the psychiatrist charges three times as much as the general practitioner.
Posted by undopaminergic on November 12, 2022, at 7:15:25
In reply to Do psychiatrists offer value for money?, posted by NKP on November 12, 2022, at 5:37:17
I never paid for seeing a psychiatrist.
-undopaminergic
Posted by linkadge on November 12, 2022, at 14:03:22
In reply to Re: Do psychiatrists offer value for money?, posted by undopaminergic on November 12, 2022, at 7:15:25
It's really down to whether they can see something that your regular doctor can't. With the internet, there is certainly no shortage of knowledge on the various permutations and combinations of medications that people try these days.
However, if the doctor can identify some factor that would make a particular combination useful to you, then it may be worth the money. Also, a regular doc may not be comfortable trying something that a psychiatrist would.
I just started seeing a psychiatrist. Here in Canada, it is 'free' although the wait list is very long. My regular doctor is new, and hence uncomfortable with pretty much everything.
I'm just hoping to try something out of the box. Perhaps an MAOI, dopamine agonist .. who knows.
I'd like another trial of parnate. I took it briefly about 20 years ago. It was working, but the dose was ramped up pretty quickly and I had some kind of hypertensive episode. We got scared and pulled the plug, but it was very effective in the time I had used it. Totally different feel from an SSRI .. deeper and more comprehensive. Not like a giant SSRI bubblebath.
Linkadge
Posted by SLS on November 12, 2022, at 14:29:09
In reply to Re: Do psychiatrists offer value for money?, posted by linkadge on November 12, 2022, at 14:03:22
I know the GPs that tried to treat me, and the limit of their clinical experience and psychiatric expertise.
I know the experts I've seen, and picked their brains with an insatiable desire to know what they knew (an impossibility, of course). I learned a lot that way. I had to. My ability to assimilate the written word was all but vacant. I could not read more than two sentences word-for-word. (I learned to skim).
I know the researchers and their input regarding the latest discoveries in biological psychiatry. My brain was one of the first to imaged on a PET scan in 1992 while I was a research subject at the National Institutes of Health.
Psychiatrists are probably the most underpaid of specialists. How much do you have to pay to enter a hospital and have an emergency appendectomy? What about near-fatal sepsis?
A surgeon is not a bargain if they accidentally lacerate your liver during the appendectomy.
A psychiatrist is not a bargain unless you achieve remission with one the first three treatments he uses on you.
I am sure that GPs exist who possess sufficient knowledge and experience to treat de novo cases of depression and anxiety disorders, but I doubt that they would be as valuable to treat TRD as are psychiatrists. Depression ruins lives and causes genuine psychic pain. Is it worth spending moderately more for someone who can treat you better and faster?
I would say that the probability of responding to treatment quickly is greater if you use an specialist. That's generally the way it is with medicine.
- Scott
Posted by Christ_empowered on November 28, 2022, at 6:27:20
In reply to Re: Do psychiatrists offer value for money?, posted by SLS on November 12, 2022, at 14:29:09
I lean towards...no. Not to sound wishy washy, but it also varies on a case by case basis.
In my case...no controlled substances, treatment is fairly standard, and the major need to make periodic adjustments has more to do with my (apparently never ending, lol) recovery than it does new and/or difficult to treat problems or...blah blah blah.
where I live...and I think a number of USA states in addition to my own...various highly educated nurses and physician's assistants have pretty much free range to prescribe. some choose to specialize in psychiatric nursing. and so..
here semi-locally, there are businesses that have people see nurses with the extra training and credentials for psych treatment, not a psychiatrist. not cheap, but even self-pay is far less than a shrink, and my impression is that insurance companies really, truly love the set up for cost savings.
I really don't think psychiatry can continue to justify it's existence if treatment continues this way, at least in the USA. Its...crazy insane ridiculous. Shrinks point to the "severely mentally ill" to justify their ongoing existence...
and many of them stop dealing with such people once they get into a suburban group practice that takes good insurance or a small urban practice than doesn't even deal with insurance, at all.
Personally, I wanted a family doc to write my prescriptions. Ugh. If only...new rule: you have to go to a specialist. I find it especially irritating because family doctors tend to be better about noting TD, weight changes, doing labs, that kind of thing.
I've been seeing psych nurse practitioners and I find them to be...more down to earth, more drug-centered than disease/illness-centered, and that's...immensely helpful. Not because I want and/or need to deviate from standard treatment (my own mix is basically text book), but because...
these are serious drugs that have serious effects on the whole body, the whole person. I've actually found psych nurse practitioners to be more honest about psych drugs than any psychiatrist I've ever dealt with, at all, ever.
ok. :-)
This is the end of the thread.
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