Hi, middlepath, and great sympathies with your bipolar med management probs. I went round & round the drug rosy with my pdoc, after my diagnosis (and discharge from hospital).
My psychiatrist and I clicked--I was so lucky! I went back after a week and said things weren't working & said specifically why ... & it's been like that ever since. We have developed into a team, with a working relationship--the goal is to find the best possible meds for me ... not settling for what's just good enough.
Try to keep in mind that, while you are a patient, you aren't a victim. I think it's being a victim that keeps us from working as equals in a team relationship with any professional ... and that makes it easy for them to dismiss us, not care about us, and not do their best for us.