I do have limited access to mine via email and I see her every 4 weeks. She adjusts her schedule so that I can see her the same day I see my therapist who is 75 minutes from home on the way up to her which cuts the drive time a bit.

But to get this I drive 2.5 hours each way. If I could even find a medicare provider around here who isn't the one dr. I know takes Medicare but is an absolute idiot (professional experience) I would not have nearly the access. I also wouldn't change because my pdoc is excellent and I have a strong relationship with her and she cares and works hard to help even when helping isn't so easy. The last 2 months she's spent 2 hours each time with me, just trying to find something/anything that will really help me. So I make an effort on purpose (I also do not think I would find anyone nearly as competent with my hard to manage case as she is around here; I'm in the middle of nowhere and before I saw her couldn't find anyone who would even take a bipolar patient at all).

Since my pdoc took a new job and has cut her caseload drastically and doesn't see patients at all at least 1 day per week I can't get in early very easily between scheduled visits (at least not the one time I asked; I'd never asked before) but I know that if we were communicating and she thought I needed to get in she'd make time for me.

Until this year it's been easy b/c I had some leeway with dose adjustments with at least my AD. It used to be my AD and AP but my AP dose is maxed out and after I was on suicide precautions that included strict monitoring of my access to meds by my therapist for 2 1/2 years I lost some of that privelege. So now I have to contact her if I want to change things but there is only one thing to change (my AD dose and it doesn't have much variability allowed so there isn't much need to change it). I can also call and request something like today I requested a lower dose of hyrdoxyzine because it has been strangely sedating and her secretary takes care of that.

The other thing I get for going so far is that I'm a huge hospital with 58 pdocs and then another big bunch of residents. So if my pdoc isn't available and it's an emergency, like the time I took my bedtime meds in the morning b/c I just picked up the wrong pillbox, there is always some pdoc who can respond. (in that case I had to answer questions to prove I wasn't trying to overdose in the most pathetic way ever). That's let me develop a relationship with the IP dr (who is leaving tomorrow )as well as my own, which makes IP a lot better.

It's a long day with 5 hours of driving an a long appointment but totally worth it.