I also suggest finding a teaching hospital. So wouldn't that include Duke and UNC in the Raleigh area (don't know the geography that well so I may be way off there)? My hospital website lets you search for pdocs specializing in ______ and then you can request an appointment with whomever seems right for you. Sometimes it takes a while to get in but waiting has been worth it in the other departments (I followed my pdoc in from private practice so didn't have to wait for her). I totally agree you should have someone who listens. I had a pdoc like yours years ago and she cost me at least a year of treatment and misery because she didn't think it was possible to be as sick as I was in the job I had, so my "I am doing awful" was translated to "patient reports slight fatigue but is functioning normally". Functioning normally would mean going to bed in filthy scrubs and eating cold chef-boy-r-dee because I couldn't make meals. It was bad and when I finally realized how awful she was (she threw me into mania with an AD) I got into a clinical trial and then when that was over my pdoc. Clinical trials are also a good way to meet really good doctors and get referrals if you feel comfortable with it. I'm glad I did it but once was enough.