Re: Time to change Docs

[Guest guest]

FD, will your daughter's primary doc be willing to monitor her meds? Or

would you feel comfortable with that? Maybe you wouldn't have to use a

psychiatrist. <Just a suggestion>

My son's doctor had him see a psychiatrist from a well known Children's

Hospital (strangely, over a television set with video equipment), and a

psychologist to get an official diagnoses. But because the Children's Hospital

is so far

away (the reason for the TV set appointment), our doctor is monitoring the

meds. My son's doctor seemed to put more emphasis on what the psychologist said

for diagnosis, and just took into account what the psychiatrist said

concerning the medication.

It seems to me all a psychiatrist does is prescribe meds. They leave any

other treatment (and the diagnosis) to the psychologist, so why can't a doc just

prescribe the meds?! Anyway, that is how it seems to work here.

Insurance companies can be incredibly frustrating with their in-network

stuff. So often it seems the people we can see, are sadly, the bottom of the

barrel. I will say a prayer for you, FD, that you will get competent help.

BJ

[Guest guest]

FD,

This is not the best approach but it is one non the less. It is what we had

to do.

One of the ways we found around this insurance and finding the competent

doctor's was assistance from the local crisis center. We were told to use

the crisis line number when we as parents felt things were out of control.

(refusal to go to school, aggression, safety issues, severe tantrums etc.)

We had an inside tip...when a crisis team gets involved they can contact

insurance companies and recommend a competent doctor for the child's well

being. The insurance company has to authorize treatment at the crisis

centers recommendation. It may take 2 or 3 times of contacting them but it

may be a way to get the better doctors. Most crisis centers will provide

short term care, follow up care, counseling and assist with the insurance

issues. Crisis centers have a network of doctors that will see children on

a referral basis from the crisis unit.

This may be a useless tip but it may be helpful.

I do understand your feelings, insurance companies and incompetent doctors

are a soar subject to most of us.

Amy

_____

From: Dad of Two

Sent: Saturday, February 19, 2005 12:18 PM

To:

Subject: Time to change Docs

Warning - this is longer than I had intended.

I'm so disgusted with our mental health industry. It's so hard to

try to find the right help to help ourselves it sometimes feels that

it's easier just to give up and give in to the disorder rather than

to fight city hall.

Well, my wife & dd had a follow-up meeting with our soon-to-be-ex-

psychiatrist yesterday and to me it was a disaster. After 3 weeks

on 10mg of Prozac, dw expressed how there has been *no* change so

far. We aren't uneducated. We realize that these meds take time to

begin to work, and dw told her about my personal experiences with

the SSRIs and how much we were now educated on meds and OCD in

general. But that didn't seem to matter much.

Quick background - last summer we visited her for the first time.

We gave her so much history at that time that she had to kick us out

of our office for taking up 20 minutes of her precious 10 minute

appointment. At that time dd's OCD was focused on germs/hand washing

rituals, and her obsession with food contamination and food

expiration dates (textbook OCD). Since then it has morphed. But we

gave her the 6 year history of her disorder and the various ways OCD

has shown itself. We were, in fact, selling her on the diagnoses of

OCD. She agreed and started her on 25mg of Zoloft.

Eight months later she has changed her tune. Since 50mg of Zoloft

didn't work (much to her surprise), and the new 10mg of Prozac seems

to be ineffective, her " professional " opinion is that our dd is

simply playing us like a fiddle. She believes that our dd is all

about control. She asked dd if her behavior is consitent across the

board in all situations, and dd said that she believes her family is

always sick and will make her sick (and thus the O/C behaviors) but

she doesn't behave that way around her teachers and other adults

(unless they show obvious signs of being ill). The " doctor " said

that this isn't classic OCD. She said if it were true OCD,

*everyone* would be a risk, not just the family. Therefore she

believes that is simply trying to find ways to control us.

What a crock.

Given the fact that 8 months ago we showed her the classic OCD

history, and there is absolutely no doubt that she's textbook OCD

(substitute " her/his, he/she " with " " in Dr. Chanskey's book

and you will have our child), I was shocked that she believes it's

simply a control issue.

Mind you we were advised by our therapist 8 months ago that this

doctor had a reputation for incompetence and lack of medicating, so

we shouldn't be surprised. And thanks mostly to this group and the

resources contained, we understand that the doses she has prescribed

don't have snowball's chance in hell of making a difference. After a

sale's pitch by dw, the " doctor " (a disgrace to her credentials)

reluctently agreed to up her dose to 20mg of Prozac. But this is

the " absolute maximum " she will go. What a load of crap.

It's not that we really liked her and wanted to stick with her. But

we've really had an exhausting time finding a competent psychiatrist

who will both take our insurance and also sees children. So our

choices have been extremely limited. In fact, our insurance options

are to choose either her, or another one who has an equally

disturbing reputation.

Our insurance company has agreed to try to find an out-of-network

doc. But it seems that the demand is high, and the competent supply

is so low, that the good ones don't need to take anyone's

insurance. When there's a two-three month waiting list, why would

they need to accept a lower payment? So far we are 0 for 2 in the

negotiations with other docs and insurance. We have accepted that

we're going to have to pay out-of-pocket, but it's a hard pill to

swallow.

It makes me sick to my stomach what we have to go through to get

quality care. In the best health system in the world, why is it so

hard?

Thanks for listening,

FD

Our list archives, bookmarks, files, and chat feature may be accessed at:

http://health.groups.yahoo.com/group// .

Our list advisors are Gail B. , Ed.D., Tamar Chansky, Ph.D.(

http://www.worrywisekids.org ), Dan Geller, M.D.,Aureen Pinto Wagner, Ph.D.,

( http://www.lighthouse-press.com ). Our list moderators are

Birkhan, Castle, Fowler, Kathy Hammes, Joye, Kathy

Mac, Gail Pesses, and Kathy . Subscription issues or

suggestions may be addressed to Louis Harkins, list owner, at

louisharkins@... , louisharkins@... , louisharkins@...

..

[Guest guest]

FD,

This is not the best approach but it is one non the less. It is what we had

to do.

One of the ways we found around this insurance and finding the competent

doctor's was assistance from the local crisis center. We were told to use

the crisis line number when we as parents felt things were out of control.

(refusal to go to school, aggression, safety issues, severe tantrums etc.)

We had an inside tip...when a crisis team gets involved they can contact

insurance companies and recommend a competent doctor for the child's well

being. The insurance company has to authorize treatment at the crisis

centers recommendation. It may take 2 or 3 times of contacting them but it

may be a way to get the better doctors. Most crisis centers will provide

short term care, follow up care, counseling and assist with the insurance

issues. Crisis centers have a network of doctors that will see children on

a referral basis from the crisis unit.

This may be a useless tip but it may be helpful.

I do understand your feelings, insurance companies and incompetent doctors

are a soar subject to most of us.

Amy

_____

From: Dad of Two

Sent: Saturday, February 19, 2005 12:18 PM

To:

Subject: Time to change Docs

Warning - this is longer than I had intended.

I'm so disgusted with our mental health industry. It's so hard to

try to find the right help to help ourselves it sometimes feels that

it's easier just to give up and give in to the disorder rather than

to fight city hall.

Well, my wife & dd had a follow-up meeting with our soon-to-be-ex-

psychiatrist yesterday and to me it was a disaster. After 3 weeks

on 10mg of Prozac, dw expressed how there has been *no* change so

far. We aren't uneducated. We realize that these meds take time to

begin to work, and dw told her about my personal experiences with

the SSRIs and how much we were now educated on meds and OCD in

general. But that didn't seem to matter much.

Quick background - last summer we visited her for the first time.

We gave her so much history at that time that she had to kick us out

of our office for taking up 20 minutes of her precious 10 minute

appointment. At that time dd's OCD was focused on germs/hand washing

rituals, and her obsession with food contamination and food

expiration dates (textbook OCD). Since then it has morphed. But we

gave her the 6 year history of her disorder and the various ways OCD

has shown itself. We were, in fact, selling her on the diagnoses of

OCD. She agreed and started her on 25mg of Zoloft.

Eight months later she has changed her tune. Since 50mg of Zoloft

didn't work (much to her surprise), and the new 10mg of Prozac seems

to be ineffective, her " professional " opinion is that our dd is

simply playing us like a fiddle. She believes that our dd is all

about control. She asked dd if her behavior is consitent across the

board in all situations, and dd said that she believes her family is

always sick and will make her sick (and thus the O/C behaviors) but

she doesn't behave that way around her teachers and other adults

(unless they show obvious signs of being ill). The " doctor " said

that this isn't classic OCD. She said if it were true OCD,

*everyone* would be a risk, not just the family. Therefore she

believes that is simply trying to find ways to control us.

What a crock.

Given the fact that 8 months ago we showed her the classic OCD

history, and there is absolutely no doubt that she's textbook OCD

(substitute " her/his, he/she " with " " in Dr. Chanskey's book

and you will have our child), I was shocked that she believes it's

simply a control issue.

Mind you we were advised by our therapist 8 months ago that this

doctor had a reputation for incompetence and lack of medicating, so

we shouldn't be surprised. And thanks mostly to this group and the

resources contained, we understand that the doses she has prescribed

don't have snowball's chance in hell of making a difference. After a

sale's pitch by dw, the " doctor " (a disgrace to her credentials)

reluctently agreed to up her dose to 20mg of Prozac. But this is

the " absolute maximum " she will go. What a load of crap.

It's not that we really liked her and wanted to stick with her. But

we've really had an exhausting time finding a competent psychiatrist

who will both take our insurance and also sees children. So our

choices have been extremely limited. In fact, our insurance options

are to choose either her, or another one who has an equally

disturbing reputation.

Our insurance company has agreed to try to find an out-of-network

doc. But it seems that the demand is high, and the competent supply

is so low, that the good ones don't need to take anyone's

insurance. When there's a two-three month waiting list, why would

they need to accept a lower payment? So far we are 0 for 2 in the

negotiations with other docs and insurance. We have accepted that

we're going to have to pay out-of-pocket, but it's a hard pill to

swallow.

It makes me sick to my stomach what we have to go through to get

quality care. In the best health system in the world, why is it so

hard?

Thanks for listening,

FD

Our list archives, bookmarks, files, and chat feature may be accessed at:

http://health.groups.yahoo.com/group// .

Our list advisors are Gail B. , Ed.D., Tamar Chansky, Ph.D.(

http://www.worrywisekids.org ), Dan Geller, M.D.,Aureen Pinto Wagner, Ph.D.,

( http://www.lighthouse-press.com ). Our list moderators are

Birkhan, Castle, Fowler, Kathy Hammes, Joye, Kathy

Mac, Gail Pesses, and Kathy . Subscription issues or

suggestions may be addressed to Louis Harkins, list owner, at

louisharkins@... , louisharkins@... , louisharkins@...

..

[Guest guest]

Good for you for dumping that loser pdoc. Sometimes

" professional " care is worse than nothing. I have no

answers here, but plenty of sympathy. Blue Cross was a

complete nightmare for us - there are plenty of child

pdoc's in our area, but they had no qualified people

on their list. They finally got one guy - a complete

loser - and six months later they decided to deny

payment for him even though they had approved dd's

visits at the time.

We ended up switching to an HMO that has a great pdoc,

but doesn't offer ongoing individual therapy. So my dd

is in group therapy, which is very helpful but doesn't

address all areas of concern. She is also getting

excellent med management, which is important b/c the

usual SSRI's didn't work for her. However, she still

needs weekly therapy with someone who can help with

the OCD and mood problems. That would come out of my

pocket if I could afford it, which I can't. There's an

OCD clinic near here that sounds really good; if dd

gets worse I may ask someone in my family for a loan

to put her through their program.

It makes me mad that even parents who work and have

health insurance have to choose between financial

solvency and their childrens' health. After the same

strep infection that triggered my dd's ocd, she had

some heart problems. Everything was paid for, the

doctors, school, insurance people, etc. were wonderful

and supportive, and we had zero problems. But trying

to deal with the OCD and depression has been costly

and hearbreaking, and by and large people have very

little sympathy or understanding for dd's mental

illness.

If you have any answers, let me know. We're supposed

to have a parity law here in CA, but it doesn't seem

to do much. Our county, including the local mental

health department, is nearly broke - in fact, they had

to shut down for three weeks last year, libraries,

courts, police, and all. This, despite the fact that

we live in a university town where a large part of the

population has six-figure incomes and million-dollar

homes. If anyone out there has a solution, I'd love to

hear it.

PJ

--- Dad of Two wrote:

<Big Snip>

> It makes me sick to my stomach what we have to go

> through to get

> quality care. In the best health system in the

> world, why is it so

> hard?

>

> Thanks for listening,

> FD

__________________________________________________

[Guest guest]

FD,

You wrote:

" ..the good ones don't need to take anyone's insurance. When there's

a two-three month waiting list, why would they need to accept a lower

payment? "

In my opinion the " good doctors " would indeed accept lower payments.

A good doctor professionally speaking should also be a good

humanitarian. They should work with you in re: to financing so that

your child can be treated. Unfortunately it seems such doctors are rare.

We had the great fortune to have Dr. Wagner as our psychologist. She

knew from the start that we had a poor insurance plan, and assured me

that no child will ever be denied treatment due to finances; she can

work something out. I had a struggle with my insurance since Dr.

Wagner's out of network, and I know she had to battle them a little

over her fee, but in the end it worked out for us. Dr. Wagner has

lamented to me several times that the mental health side of insurance

is so far behind the game. Insurance companies just do not treat

mental health as seriously as physical health. It is a travesty.

You have my empathy, I hope somehow you can find that rare breed of

dr. who cares as much for the children as for his/her wallet.

nna.

NY

[Guest guest]

We also have had the " your son is making this up for attention " spiel

from his psychiatrist. Thus the trip to IA City. They said his

symptoms are classic OCD (and not schizophrenia or other psychosis as

our doc said!), and told us about a boy whose primary contamination fear

was his twin brother, which reassured that he is not so " freaky "

after all and reassured us that he is NOT making the " thing " up

for attention. When she reads their report if she does not change her

tune on this she may well be our ex- doctor as well.

Kim in IA

[Guest guest]

here too, the last time we saw the good doc he said maybe its time we stop

dancing to his beat?...oh yes, you went to school for that quote? HA!

Re: Time to change Docs

>

> We also have had the " your son is making this up for attention " spiel

> from his psychiatrist. Thus the trip to IA City. They said his

> symptoms are classic OCD (and not schizophrenia or other psychosis as

> our doc said!), and told us about a boy whose primary contamination fear

> was his twin brother, which reassured that he is not so " freaky "

> after all and reassured us that he is NOT making the " thing " up

> for attention. When she reads their report if she does not change her

> tune on this she may well be our ex- doctor as well.

> Kim in IA

>

>

>

>

[Guest guest]

> We have accepted that

> we're going to have to pay out-of-pocket, but it's a hard pill to

> swallow.

Hi FD-

I'm disgusted with right along with you...this doc is a disgrace to

the profession!...and SO sorry that you're having to deal with this

nonsense. We finally *did* go to a pay-out-of-pocket psychiatrist,

and it was most worth it. I think I posted before that the school

guidance counselor obliquely recommended him to us (she is not

supposed to give true recommendations, but she told me she

had 'heard' that Dr. S was a good doctor). We drive about 45-60

minutes to see him; he is very affirming and respectful of Anne's

feelings and opinions; he returns calls promptly; he called our home

after the initial visit to see how we were doing and if we had any

questions. He is also aware of cost issues, so he spreads out the

face to face visits as much as the FDA will allow, and instructs us

to call if anything is needed in between...so there *are* good docs

out there, it's just like finding a needle in a haystack sometimes.

Hang in there, FD.

Blessings-

(Ohio)

[Guest guest]

Hi FD,

Unfortunately, you're difficulty with the mental health system is not

unique. We had an extremely difficult time when my son was at his

worst a few years ago. What I did was try to work with the

insurance's behavioral health company first, when I felt I had

exhausted my options there, I contacted our state's office of Patient

Protection through the Department of Public Health. The woman there

contacted my insurance's behavioral health company and an ombudsman

was appointed to try to find a qualified doctor in our area. As time

continued to go by, and my son's OCD manifested itself in a fear of

choking so he was not eating, I contacted NAMI. I was given a number

of names/organizations that were thought to help including a number

of lawyers and legal advocacy groups. Eventually I found a wonderful

lawyer (free of charge) through the Mental Health Legal Advisory

Committee who became involved and threatened the insurance company

with triple damages if they did not authorize an out of network

provider and reimburse me the total amount of the psychologists fee

for each session. I was granted a single party agreement. I also

wrote letters to the CEO of Harvard Pilgrim and Value Options

explaining my son's plight and the difficulty I was having obtaining

qualified help. (I did receive responses from them through letters

and phone calls.) The challenge here was to get the pdoc that we

wanted to accept us as he was no longer accepting new patients. We

went through a research study at McLean with Dr. Geller so we asked

him to request this doctor see us. After a few e-mails and another

few months we finally got this doctor who has expertise in childhood

OCD. The whole process of getting my son diagnosed and then finding

a qualified therapist (and we saw a number who were clearly not

qualified) took almost two years! Don't give up, but fight when you

need to. Also, I would suggest keeping a journal, if you don't

already do so. I have a large three ring binder with all

assessments, testing, correspondence, etc. Good luck in your battle!

in MA

>

> Warning - this is longer than I had intended.

>

> I'm so disgusted with our mental health industry. It's so hard to

> try to find the right help to help ourselves it sometimes feels

that

> it's easier just to give up and give in to the disorder rather than

> to fight city hall.