How to choose a psychiatrist?

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Sunnivara
Regular Member


Date Joined Apr 2007
Total Posts : 115
   Posted 5/14/2007 1:14 PM (GMT -7)   
My PCP referred me to a psychologist. However, if I'm going to take medications I'd rather see someone who has experience prescribing them, i.e., a psychiatrist. I started to browse my local citysearch listing and was overwhelmed. There are a gazillion in the Seattle area. Is there a web site where doctors are rated by patients, preferably a free one? I know there are some sites that give doctor reports but you have to pay and that gives legal and medical history. I don't want that so much as information from patients about their experiences with the doctors, a place anyone can post a comment similar to the way drugratingz.com or askapatient.com works for drugs. Anyone know of such a site? Or do you have a better suggestion on how to choose a doctor?

els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 5/14/2007 4:43 PM (GMT -7)   
Very good step Sunnivara.  I have this link on my notebook and use it sometimes, I hope it proves helpful for you  http://webapps.ama-assn.org/doctorfinder/html/faq_patient.html  :-)   It is from the American Medical Association for finding doc's and looking up ethical violations. 

Elisha
Co~Mod: Depression
Moderator: Heart & Cardiovascular Disease
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Sunnivara
Regular Member


Date Joined Apr 2007
Total Posts : 115
   Posted 5/16/2007 12:03 PM (GMT -7)   
Thanks for the info, Els.
 
I just got off the phone with my PCP. I had called to ask if she had a referral for a psychiatrist rather than a psychologist and she tried really, really hard to discourage me from seeing a psychiatrist. She seems to really dislike them, saying they may be better able to address medical needs but basically they stink when it comes to just talking and CBT. They are often callus, indifferent, twice as expensive, and terrible at returning calls when you are in crisis. I'm not sure if that's a general issue with psychiatrists or if she's just had an unfortunate amount of bad luck with the particular referrals she's tried. But she recommened very strongly that I see a psychologist or even a counseler rather than a psychiatrist. So now I'm not sure what to do. Have any of you tried both psychiatrists and psychologists/counslers and had better luck with one over the other?

TexasJen
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Date Joined Dec 2006
Total Posts : 649
   Posted 5/16/2007 4:42 PM (GMT -7)   
I agree with your PCP. Phychiatrists these days manage the med side of therapy; phychologists/ counselors manage the talk therapy. I see a pain psychologist, and she told me the same thing. Her own mother is a Psychiatrist so they would know, right? :-)

As long as you're comfortable with the meds your PCP prescribes, I think you'll be well-covered by seeing a phychologist (probably would be best find one with a PhD) for the talk therapy. You can always consult a Psychiatrist later for advice on adjusting your meds if you don't see improvement.
Living in the Republic of Texas minus a gallbladder, a couple of cervical discs, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 5/17/2007 4:08 AM (GMT -7)   

Well, it would be hard to get around your PCP without a referral on that one due to insurance companies these days :-)  .  I have seen both and actually right now am seeing both a psychiatrist and psychologist (who is basically a counselor with an advanced degree minus the MD). 

The only problem with not being assesed by a psychiatrist is 1). your not going to know what your firm diagnosis is which is necessary to know when a doctor of any kind is prescribing medications. 2). you may run into a break down of communication between the psychologist and your primary doc since all of your psychiatric records are keep confidential even from your PCP.  Then 3). psychologists can make recommendations on what they see during your sessions and some may even recommend to you a change in medication but since they are not MD's they can not by law recommend a specific medication or what might work better for you during that time.  So in my opinion that is where psychiatrists very much out weigh the psychologist. 

Plus keep in mind that you dont have to see just one or the other, you can see both.  If you went to see a psychologist who is in a private practice you could always ask to see one of their psychiatrists for medication maintance.  Of course that isnt all they do for you but the psychologist could push your PCP for a referral once your in the door.  You have many options open to you here.

Please do keep us posted...Take care dear :-)


Elisha
Co~Mod: Depression
Moderator: Heart & Cardiovascular Disease
http://www.healingwell.com/donate


TexasJen
Veteran Member


Date Joined Dec 2006
Total Posts : 649
   Posted 5/17/2007 6:42 AM (GMT -7)   
One quick note: your psychologist's records are confidential only to the extent you allow. My psychologist gave me the option of releasing information to my PCP, LTD carrier, health insurance carrier, and my Pain Doc. All it takes is signing a piece of paper, and the psychologist can update your PCP, or anyone else you choose, on your condition. If something big changes in my therapy, I ask my shrink to send an update to my pain doc so everyone knows what's going on. It's worked very well for 2 years now.
Living in the Republic of Texas minus a gallbladder, a couple of cervical discs, appendix, uterus, and 18" of colon; but living with my wonderful husband, 2 dogs, 1 cockatiel, and 2 gold fish. 


els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 5/17/2007 8:45 AM (GMT -7)   

Your right TexasJen that you can sign a consent form to allow your Psychiatrist or Psychologist to release information to your PCP, or whatever doctor who may have interest in your care.  However, they would only receive diagnosis and a short summary explaining this not their full notes they take during your visit.  Plus once your doctors have received the initial notes usually the psych offices dont continue to update each visit.

As for insurance companies they are not allowed what so ever to have anything related to a mental health visit other than diagnosis and the related codes for billing these.  It is against the law for insurance companies to require or inquire the full visit notes that these doctors take. 

There is a law in place called HIPAA (health insurance portability and accountability act) which went into effect in 2003.  Granted there are like 8 or so states that dont provide coverage for HIPAA I believe?  But, you can research online if your state is covered under these provisions...if it is then your health information regardless is confidential and your psychiatric info is even more protected.  Here is a good link on it...

http://ajp.psychiatryonline.org/cgi/content/full/159/11/1809#SEC4


Elisha
Co~Mod: Depression
Moderator: Heart & Cardiovascular Disease
http://www.healingwell.com/donate

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