pdoc appointments for med check or therapy?

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Jade11
Regular Member


Date Joined Feb 2006
Total Posts : 105
   Posted 10/17/2006 8:48 PM (GMT -7)   
 
With my psychiatrist I have the option of scheduling my appointments for med checks or therapy.  I currently don't see him on a weekly or biweekly basis just for therapy(although I used to).  However, I do check in with him every 3 or 4 months.  I find that the med checks appointments are just too short.  It's a 20 minute appointment and half the time you are out in 10 minutes.  So, I like to just schedule an hour therapy appointment.  This way if anything comes up I have a chance to actually talk.
 
Does anyone else have a pdoc that does therapy as well?  I have found that most pdoc's don't do therapy.  I like the option of having a longer session.  It also seems better that the person treating you gets to see what is going on first hand.

CounterClockwise
Veteran Member


Date Joined Jul 2006
Total Posts : 1529
   Posted 10/18/2006 12:20 AM (GMT -7)   
Hi Jade --

I, like you, wish that more pdocs did both prescribing and therapy -- as you say, then they get to see what's going on rather than hear it all through a psychologist (which can lead to the odd chinese whispers type situation at least!).

In the UK it seems to be more the case that, if you need a therapist and medication, you see a psychiatrist and he/she does both. Well, that's my impression anyway (I've not seen any stats on this!).

I think you deal with the appointment time allocation business very well -- always better to have more time to discuss issues and medications -- and I do think that, the more you know about what you're taking, the more you will understand why it's needed and the better chance there is of med compliance. So a big thumbs up to your approach!! :)

Rosie x
********************

People are not like fish: they do not work well battered.

When I'm not in my right mind, my left mind gets pretty crowded...

********************

 
Moderator, Bipolar Forum


wmnak
Veteran Member


Date Joined Jul 2006
Total Posts : 1123
   Posted 10/18/2006 2:26 AM (GMT -7)   
hey jade
 
nice to see your post.
 
 
i have had mental health problems all of my life.  the first time i got professional help was when i was a teenager, in the 1960s.  that pdoc did both prescribing and therapy.  since then, except when i was an in-patient for a month in 1972, the pdocs have done the prescribing and a therapist did the talk therapy.  i agee that this situation is not ideal.  my new pdoc in al does both a med check and therapy during an apt.  shocked me when he told me.
 
my cynacism says that at least part of the reason for this separation  is money.  by the time a student is able to hang out their shingle as a pdoc, he/she is, on average, in debt over $50,000.  insurance companies (including medicare) only pay the doctor pennies on the $ for their work.  however, a pdoc can fit in a lot more patients doing med checks (as you say, 10 mins for a 20 min session) than in doing therapy (perhaps 1 patient an hour).  in either case, they are reimbursed only 50 % of their normal fee by the insurance companies for either med check or therapy.
 
i don't know if what i'm saying is the sufficient cause or contributing cause or no cause at all.  its simply an observation.  old men are allowed to observe (but not touch - lol).  devil
 
warren

Jade11
Regular Member


Date Joined Feb 2006
Total Posts : 105
   Posted 10/18/2006 8:54 PM (GMT -7)   

Hi, I guess it is true that the doctor can fit more patients in with med checks.  He could fit three appoinments at 20 minutes a peice into an hour.  Otherwise with therapy he can only schedule on appointment for the hour.  I know that they do spend some time after you leave charting.  That is why you usaully don't get the full 20 minutes or the full 60 minutes.

I also think part of the reason for the shorter appointments is that the pdoc can see more patients overall.  I mean my pdoc has a 2-3 week wait to get in, and I am a current patient.  The whole area that I am in has a shortage of pdoc's.  If you don't have one you might have to wait a month or two to get in.  Then there is the possiblity that some patients may not want the full hour either. Some patients might be content just to have med check appointments every so often.

I find with the med check appointments it is just too short to say anything.  Then if I do have anything important to say half the time I don't get a chance to say it.  I geuss I am the type of person that does not like to start with the heavy issues first.  Also, being that I am scheduling 2-3 weeks ahead I never really know if I might need to talk longer a few weeks down the road.


CounterClockwise
Veteran Member


Date Joined Jul 2006
Total Posts : 1529
   Posted 10/19/2006 12:01 AM (GMT -7)   
I think Warren has the system sussed! I wish I didn't think that he's right, but I just can't see a better explanation: to me the short appointments just make no sense medically, so it must be financial!

Jade, your reasons for booking hour-long appointments like you do are exactly what my own would be: I think everone finds the bigger issues harder to talk about, and, especially with something like bp, it is so hard to know how you'll be doing a couple of weeks down the line. It's always better to steer on the safe side with all this, and I think you manage it great -- and offer good insight to those just starting treatment or looking for it. :)

Rosie x
********************

People are not like fish: they do not work well battered.

When I'm not in my right mind, my left mind gets pretty crowded...

********************

 
Moderator, Bipolar Forum

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