Should a pdoc truly get to know their patient?

I moved across country and was hooked up with a psych NP here. She asked about what I had experienced, but never did a full evaluation (at least not like I was used to). Since then, she only spends 5 minutes with me every couple of months (soon it will be extended to every 3) and just goes over the meds I'm on.

I'm used to 30 minute visits, both in California and Boston. The pdocs got to know me. We talked about how I was feeling and my life.

Do you think it's important for a pdoc to know you well? I think it's very important to know the patient at their baseline so that you can recognize when they're not, and can do targeted therapies for that person.

Just as an example, I'm a naturally fidgety person. I bounce my leg up and down, that's the way I am. Worse when I'm anxious. In any case, I don't want her to think that that's some indicated of hypomania. If you get to know me (and ask) you know that that's just my baseline; my hypomania's and certainly mania's are very different. I want her to be able to differentiate baseline from true depression or hypo/mania. How can she do that if she only sees me for 5 minutes??

What do you think?

I agree that the pdoc should get to know you, Mine has no idea that I suffer from PTSD or social anxiety or agoraphobia, etc. He only knows me from one 10 minute interview in which he asked my wife's name and if I was suicidal. It's no wonder I never see him anymore.

I think they should spend at least 15 minutes with you and more likely 1/2 hour.

15 minutes is the lower limit for my psych NP. The first visit was 90 minutes, followed by 2 visits that were an hour each (all two weeks apart), before dialing it back to a half hour 2 weeks apart, and a half hour a month apart, which is where I am now. She will only go to 15 if we both agree that I am stable. She didn't go to a month until I was also seeing a therapist. I was not new to a diagnosis; I had been in the denial part of the cycle I keep going through (and hope to break). My first diagnosis was 23 years ago and I have seen lots of pdocs and tdocs over the years. She still followed the new patient protocol because i was new to her.

I have 30 minute appointments, length of time between each varies depending on how I'm doing. My pdoc knows me pretty well. I like it like that.

I think it's important for the doc to get to know you, and 5-10 minute visits are definitely not enough time for that. Even if you're well-organized it's not enough time to describe your symptoms and for them to figure out how things are affecting your life.

At present I spend 1/2 hr with my doc, once a month. He bills my insurance for a med management visit and also for "psychotherapy." There's no therapy that happens during the visit, it's really just an extended med review visit. But it's enough time for me to say what I need and for him to organize the scripts to write. I think it's a good balance. I've been to docs before who do the 5-10 minute visits, and they've not been able to detect my crashing and burning under their care.

One thing I've found tremendously helpful is to write down my symptoms and the effect each med is having on me, and if I think something needs to be adjusted. I do this while I'm sitting in the waiting room before my appointment. During the discussion with my doc, I'm able to refer to the list and ensure we're covering each item. It's not extensive, just a back-of-the-envelope sketch of symptoms and meds. This can also help during a 5-15 minute med management discussion, as you can stick to your list and ensure you've discussed each item with your doc. I'd strongly recommend everyone do this. If I don't show up prepared, my doc and I tend to run down rabbit trails and side discussions, and we can run out of time before getting to everything, or I forget where I wanted to go with the discussion. It also helps ensure I get the refills I need, as I mark each one of those and make sure the doc knows.

Good luck with your doc. If you're not satisfied with their care, definitely open up the search to find someone who is a better fit.

My pdoc doesn't spend a lot of time with me--mainly goes over meds. But she does ask about me and knows me from reading the records from my therapist, who is in her same office.

Sounds like that pdoc could do better, I think.

My pdoc knows me like a book. I have 30 minute of more sessions once a month. My first appointment with him was almost an hour and a half

Yes, I think that not only should a PDOC get to know the patient, the patient should be encouraged to bring in people who know them well and get outsiders information on the patients behaviors. We need to reduce stigma to make this a more realistic option. I know in my case my mother, husband, children and my best friend I've known for almost 30 years would be willing to come answer questions and I think their information could be vital. Self reporting can be flawed. Doctors need to ask the RIGHT questions and they often don't. 15 minute appointments are not acceptable unless a person is stable on meds and it's just a check in.

Your 100 percent correct I have brought my wife to a few appointments so she can tell my pdoc her take on things because mine can be skewed at times.

In order for my son to be diagnosed with ADHD, it required not just my sons account, or our account.... but 2 teachers needed to fill out paperwork also. This was thorough and the best course of action. Not all people have someone in their lives who would be willing to come in though and the stigma currently in society makes many leery about talking to others about their issues. Reducing stigma would go a long way in helping people get the proper help and treatment.

My pdoc talks to me. I couldn't hold a conversation when I first met him. So I believe he is just making sure that I'm with it enough to communicate.

I believe that a pdoc can only help if they get to know their patient...

My original pdoc only spent a few minutes with me and I found most times those few short minutes were pretty unproductive. I take some responsibility for not helping those sessions be more productive but a few years back I searched out a pdoc that spends a bit more time each visit with me. We typically get at least 30 minutes to try and go over what is maybe new and different since our last visit. I've been told that a pdoc is not intended to be a therapist and a broader discussion of moods and such is done best in a psychologists office but I don't buy that. The one administering meds, your pdoc, needs to have a broader understanding of you and that can't occur in 5-10 minutes med checks every few weeks...or months.

My pdoc reads my therapists notes. I don't want to spend anymore time with that man than I have too. He sees me 4x a year for 15 min. appointments.

My pdoc meets with me for 45 minutes every two months when I'm doing good and once a month when I'm not. He asks and knows about most facets of my life and checks up on them each visit. For example, when my daughter started getting to the end of her senior year in high school, he knew I wouldn't handle her going off to college well and he was already making plans medication wise and talking with my tdoc. I really appreciate him. I'm very lucky.

My first pdoc was a lot like Jennifer's. The man had a memory like a steel trap and remembered everything about me, including what religion I am and my kids' names. I knew more about him than I probably should have, too, but he was always professional and there was no doubt about who was the doctor and who was not. My current pdoc is good too, and I think he knows his bipolar stuff better than the first one did, but he's very traditional---I don't even know if he has a family---and he NEVER talks about himself. He's also considerably older than me, which makes me worry he'll retire in a few years, but he's wise and very compassionate. I call him Dr. Goodenough in my blog.

I absolutely believe a pdoc needs to get to know you. I do not find them nearly as effective when they do not. Also, pdocs should not just treat you as if you are simply a diagnosis.....they should treat you as a person with a diagnosis. Look how unique and different we all are here. Not everyone with Bipolar is exactly the same.

The pdoc I had before my current one would forget a lot of important details about me. She would spend 5 minutes, write scripts, and then I was out. Her attitude wasn't the best either. She would rush and not listen. I cut people slack, since doctors are overwhelmed and see so many people. I don't expect them to remember so many things, but this pdoc never made much of an effort.

Luckily, my current pdoc is great. She shows a lot of interest in my life and goes above and beyond. I hope my insurance does not change where she'd be out of network. I couldn't ask for better.