[Inca1]

My experience with the new psychotherapist.

Saw him the first time in March. I had brought with me an outline of things that have happened in my life and gave it to him. I brought a list of over 20 medicines I have tried and gave it to him.
We talked about some of the things and just as the visit was ending he told me he wanted to take cheek swabs because there is a company that can tell what different medications should work for you, might work, and not to take. I asked if insurance paid for this, I was pretty sure they would not, he said don't worry about it.
I let him do the cheek swabs and then he put me in a room to take some type of test and handed me a couple of pieces of paper at the same time.

A nurse (?) told me when I was finished with the test to come out and give it to her, which I did and she showed me the exit.

On the way home I was thinking that I didn't make another appointment, but then I thought they would call me when the cheek swab results came back.
After three weeks of still suffering with crying uncontrollably and feeling down I called back.

I spoke to 7 different people, appointment desk, a few unknown people, got cut off twice and finally got his nurse.
I explained to her I was having problems, I cried during all of this, and needed to either see the doctor or get some type of help. She said the doctor only sees patients every 2 months, I asked about a cancellation list and at first she said they didn't have one, then she said she'd put me on it. I was transferred back to the appointment desk and got an appointment in 2 months.

When I got up the next day the more I thought about how I was treated the madder I got, so I looked up administration on the website and called a number.

I told the woman who answered what had happened and asked if she could help me or direct me to someone who could. She said she handled complaints and she would write up a report and present it to the board.

Later that afternoon the doctor's nurse called me and asked if I could come in two days later at 0745 (they don't open until 0830) I said I could.

When I went to my appointment I told the doctor everything that had happened and that it was bad enough I felt like no one cared, but to feel like the doctor I was seeing didn't care made it worse.

I asked him what happens if one of his patients has a problem and needs to get help sooner than 2 months, which is how I was told he say patients, only every two months.

He acted like that was news to him and asked who told me that and I said your nurse. He acted amazed and said that's not true, he would help a patient who called with a problem.

The visit ended with him telling me the results of the cheek swab test, which showed only two medicines would work for my depression. He game me some samples and a prescription and said to come back in six weeks.

I gave the medicine a chance to work because I knew it would take several weeks, but things didn't change so I called and asked the appointment desk to put me on the cancellation list.

They also have what they call a patient portal and I sent a request through it to be put on the cancellation list At the bottom it says if you don't hear from them in 24 hours to call a number they showed.
After 48 hours I called the number and the person told me I was on the list. A lot of good that did.

On the 4th day I sent what they call a "Secure message to your doctor" through the patient portal. I told them that I was basically in crisis and needed to find out what to do.

I didn't hear anything and after 2 days I called the woman I had spoken to before and told her all that had happened and how I have not received a response from anyone.
She said she would take care of it and later that day I received a call from the nurse who said the only appointment she has is at 245 on the 24th. I told her that wouldn't work because I have an 800 appointment with them on the 24th.

I told her I just needed someone to give me some kind of advice, and described what I had been going through and how not getting any kind of response from anyone just made things worse.
She said the doctor was out of the office and she would talk to him when he returned.

The next morning she called and asked if I could come in the next day and I said I could.

When I saw him he had already been advised of my complaint and so I didn't feel the need to go there.
We talked some, and to shorten this he prescribed a different medicine than what was on the cheek swab result and I questioned that since it said only two would work and he had tried those two. He said let me look it up and started to get on his computer, I told him you gave me a copy of the report, but somewhere in between this I can't remember what it was we got on a different subject and I never got my answer.

Oh, I almost forgot the papers he had given me on the first visit were explaining how much I would have to pay for the cheek swab test if the insurance didn't pay.

Would anyone continue to see this doctor or try to find someone else?

[Gavinandnikki]

You need someone caring and available. This person is neither IMO.

[Mactastic]

What a mess, I'm sorry you're going through this. Based on what's happened before I can't envision this scenario playing out in your favor. If you can manage it I would seek out another provider, possibly one that feels less like a corporation (his practice seems to have far too many patients and far too many people to go through to access help.)

Kudos for sticking up for yourself and pushing to get the attention you need. I could never do that, I'm too much of a pushover.

Best if luck finding the right guy (or woman!)

Sent from my iPhone using Tapatalk

[HazelGirl]

I have never heard of a "cheek swab" that will tell you what medications will work. This sounds like a quack job. And also you're seeing a psychiatrist, not a therapist.
Most psychiatrists don't do therapy, which is why he only sees his patients every two months. You need to find someone who will see you regularly for therapy, as well as a competent psychiatrist for medication.

[nottrustin]

I would find somebody new ASAP. It sounds like it is possible the T is a decent enough pdoc however, the company he works for makes it impossible for you to get the help you need.

[Perna]

That is W-A-Y too much run around and you are having to do more than the lion's share of the work to get what you need. I would definitely find another clinic/doctor and look into a therapist/social worker too to talk to.

[UnderRugSwept]

The cheek swab test is real:

http://www.healthcentral.com/depress...dna-treatment/

Psychiatric Pharmacogenomics | Psychiatric Times

Regardless, you need to find a dr. who is more accessible and more attuned to you.

[NowhereUSA]

my pdoc just mentioned the cheek swab thing to me this last appointment. i think it can show genetic variances that *may* help narrow down the list. there are apparently a few things that could possibly inhibit ADs from working. but i know my pdoc and trust him. he was open that my insurance would likely not pay for it though he would try to get them to. we haven't done it yet, but i'm certainly open and if i can get a cost ahead of time, my guess is it's around $100 (that's what all the fancy do it yourself genetic testing companies cost). so he's not totally off base though he doesn't sound like he's totally on top of it either.

i'd find someone else. this guy sounds overbooked and overworked with little time for you.

I have a talk therapist who practices ISTDP Intense Short-Term Dynamic Psychotherapy and I have none for EMDR. I feel like my talk therapist is a little more professional where as my EMDR is kind of new to the game. I will see where things go. EMDR is something I feel like it's not so bad whether she is experienced or not, as long as I can process my trauma.

[junkDNA]

Originally Posted by HazelGirl

I have never heard of a "cheek swab" that will tell you what medications will work. This sounds like a quack job. And also you're seeing a psychiatrist, not a therapist.
Most psychiatrists don't do therapy, which is why he only sees his patients every two months. You need to find someone who will see you regularly for therapy, as well as a competent psychiatrist for medication.

actually the "cheek swap" is a genetic test done to tell a lot about your DNA and what meds will help you the most. it tells you about how your liver breaks down the meds and if it might be breaking them down too fast or too slow. its new, but its not a quack job. i had one done. medicaid paid for it.

[UnderRugSwept]

Originally Posted by junkDNA

actually the "cheek swap" is a genetic test done to tell a lot about your DNA and what meds will help you the most. it tells you about how your liver breaks down the meds and if it might be breaking them down too fast or too slow. its new, but its not a quack job. i had one done. medicaid paid for it.

Did you find the results useful for you, if I may ask (sorry for the offtopic question).

[junkDNA]

Originally Posted by Elsewhere

Did you find the results useful for you, if I may ask (sorry for the offtopic question).

yes. i have a psychotic disorder and take antipsychotics. ive been on most all of them. it gave my pdoc a list of the APs that would help me the most. it also said that i have fewer serotonin receptors in my brain than average. i started on an AP that was listed and ive only heard voices for 2 days in the past 3 months. i was hearing voices every week before so this is amazing to me. i would recommend doing it. you can get a lot of info from it. im not sure about insurance though. if a private one would pay or not.

[UnderRugSwept]

Originally Posted by junkDNA

yes. i have a psychotic disorder and take antipsychotics. ive been on most all of them. it gave my pdoc a list of the APs that would help me the most. it also said that i have fewer serotonin receptors in my brain than average. i started on an AP that was listed and ive only heard voices for 2 days in the past 3 months. i was hearing voices every week before so this is amazing to me. i would recommend doing it. you can get a lot of info from it. im not sure about insurance though. if a private one would pay or not.

That's excellent, so glad you are much better now! Thank you for the response. I am going to ask my pdoc about the test. Meds don't work for me at all (MDD and terrible anxiety...plus insomnia). I have tried sooo many with terrible side effects or else they didn't do anything. (Sorry for offtopic again...)

[TheWell]

I have a psychiatrist who deals with my medications. I see him either monthly or very two months depending on how I'm doing on my meds.

I have a therapist that I see every week or every other week depending on if I am doing well or not.

Is this doctor just a med doctor like my first doctor? Therapy should be weekly or every other week or even twice a week if you are really struggling. I think you need to ask if this is therapy or just medications.

[Inca1]

Originally Posted by HazelGirl

I have never heard of a "cheek swab" that will tell you what medications will work. This sounds like a quack job. And also you're seeing a psychiatrist, not a therapist.
Most psychiatrists don't do therapy, which is why he only sees his patients every two months. You need to find someone who will see you regularly for therapy, as well as a competent psychiatrist for medication.

Thanks for the response.

The man I'm seeing is a psychotherapist and in the state I live in if a psychotherapist has a certain degree he/she is allowed to prescribe medications.

My opinion of him so far is he is one of those who think because they have a degree or two that only their opinion matters.
Unfortunately for him I say what I think no matter who or what position a person is/holds.

I am seeing my primary care doctor next Friday and hopefully she can recommend someone else, and she will never send anyone to this one again.
I did check out all I could find on him before I went, but you never really know until you meet the person.

[Inca1]

Originally Posted by Elsewhere

Did you find the results useful for you, if I may ask (sorry for the offtopic question).

I did find some of the results under Antidepressants to be true since I have taken quite a few different antidepressants.
There were only two listed as "Use As Directed" which I was told were the ones that would work for me.
I've been on both of them before and only one of the worked for a while, the other was hit and miss.

The third category is "Use With Increased Caution And With More Frequent Monitoring," and I've taken several of the ones listed. Two of them were the last ones I tried before I started seeing this doctor and one gave me memory loss and the other made me angry and feeling even worse about myself than I already did.

There were some other categories, Antipsychotics, ADHD Results (which I take one of the medications on the list and what their results were are true for me), Analgesic Results (I have taken six one the list and didn't find the results entirely correct).

There is a lot more, but some is above my head, however I didn't find the one I'm on now listed anywhere and at this time I can say it is not doing as well as I first thought.

[HazelGirl]

Thanks for the cheek swab info you guys. I had never heard of it. That's really interesting.

[Inca1]

Originally Posted by TheWell

I have a psychiatrist who deals with my medications. I see him either monthly or very two months depending on how I'm doing on my meds.

I have a therapist that I see every week or every other week depending on if I am doing well or not.

Is this doctor just a med doctor like my first doctor? Therapy should be weekly or every other week or even twice a week if you are really struggling. I think you need to ask if this is therapy or just medications.

I spend 45 minutes with this "Doctor" and there is talk, but I get irritated when I've told someone something and they ask a question that is one I have already answered or it something I have already told them.

I'm good at reading people, it comes from my previous job, and I think this doctor is one who believes that it doesn't matter what is going one with me or what has happened before I saw him, the only thing that matters is what he says and thinks, because he is after all, the doctor.

I'm sure most of us have come across doctor's who are like this, it doesn't matter what type of doctor they are, they believe what they say and want someone to do is the important thing. They don't even have to ask you any questions because that is they way they practice, they are smarter than you and anyone else.

[blur]

can you get a recommendation from someone other than your doctor who sent you to this guy? i guess i'd be a bit skeptical of that doctor's referrals after this experience. it sounds like you want a T that does weekly therapy as opposed to primarily prescribing meds and only meets with clients occasionally. that sounds more like what a pdoc would do even though i understand that this guy wasn't one.

[Inca1]

I got my insurance to send me a list, but they sent me a list of psychiatrists. I looked at some of the names and there is not one person on that list I would go to.
I'm going to go back on their website and try to pull a list of what I wanted, but couldn't find before I called them. If that doesn't work I'll try calling again.
I think part of the reason my primary care doctor sent me to this doctor was because of the concussions I've had and the last one was the one that made me different than I was.
Of course, this doctor and I discussed it, and he tried to tell me the research is new and there is not enough information. I told him what I had found, but he didn't want to hear it.
I'm just plain tired at this point.

[HazelGirl]

Originally Posted by Inca1

I got my insurance to send me a list, but they sent me a list of psychiatrists. I looked at some of the names and there is not one person on that list I would go to.
I'm going to go back on their website and try to pull a list of what I wanted, but couldn't find before I called them. If that doesn't work I'll try calling again.
I think part of the reason my primary care doctor sent me to this doctor was because of the concussions I've had and the last one was the one that made me different than I was.
Of course, this doctor and I discussed it, and he tried to tell me the research is new and there is not enough information. I told him what I had found, but he didn't want to hear it.
I'm just plain tired at this point.

You decided this based off their names? You can't expect to magically find a therapist or psychiatrist who works by finding a name you like. You have to go through the hard work of meeting them.

Also, a psychiatrist is only going to prescribe medication. Almost none of them do therapy. If you want therapy, you will have to find a therapist.

[Inca1]

Originally Posted by HazelGirl

You decided this based off their names? You can't expect to magically find a therapist or psychiatrist who works by finding a name you like. You have to go through the hard work of meeting them.

Also, a psychiatrist is only going to prescribe medication. Almost none of them do therapy. If you want therapy, you will have to find a therapist.

I researched the names of the ones that I knew I would be able to understand when they spoke to me and did not feel from patient reviews, their schooling, etc., that any of them were someone I would want to see.

I did not ask my insurance company for psychiatrist's only, I explained I wanted someone I could talk to and who had the necessary degree so they could prescribe medication, since psychotherapists in this state can prescribe medication if they have obtained a certain degree.

To me insurance companies are a bit like doctors, they hear only half of what you say and then do what they want to do.

[Favorite Jeans]

Originally Posted by Elsewhere

The cheek swab test is real:

How Genetic Testing Can Determine Which Antidepressant To Use - Medication - Depression

Psychiatric Pharmacogenomics | Psychiatric Times

Regardless, you need to find a dr. who is more accessible and more attuned to you.

Yeah the cheek swabs are real but there is no evidence to guide their use in day-to-day clinical settings. It's still basically a research tool. So I think this clinician is acting with a lot more confidence than he should be given the current state of scientific knowledge about psychiatric pharmacogenomics. That's unethical. He needs to tell patients that they are essentially participating in research, that this is not the standard of care in the profession and certainly as long as this is not the accepted treatment, neither patients nor their private insurance should be paying to have research done on them.

Regardless, I absolutely agree that the OP needs a T who can be present and provide the support and care they need. To me, the fact that this doctor has failed to set up his client with more support-- despite ample evidence that she needs it-- further suggests that this clinician is not meeting his ethical obligation.

From the second of the above-cited articles:

“I think the way to get the best quality evidence is to begin the study with groups of patients who are genotyped at the front end, so we know who is a slow metabolizer and who is likely to respond to one drug or not,” Mrazek said. “These studies are just beginning to be done.” - See more at: Psychiatric Pharmacogenomics | Psychiatric Times

[Inca1]

Originally Posted by Favorite Jeans

Yeah the cheek swabs are real but there is no evidence to guide their use in day-to-day clinical settings. It's still basically a research tool. So I think this clinician is acting with a lot more confidence than he should be given the current state of scientific knowledge about psychiatric pharmacogenomics. That's unethical. He needs to tell patients that they are essentially participating in research, that this is not the standard of care in the profession and certainly as long as this is not the accepted treatment, neither patients nor their private insurance should be paying to have research done on them.

Regardless, I absolutely agree that the OP needs a T who can be present and provide the support and care they need. To me, the fact that this doctor has failed to set up his client with more support-- despite ample evidence that she needs it-- further suggests that this clinician is not meeting his ethical obligation.

From the second of the above-cited articles:

“I think the way to get the best quality evidence is to begin the study with groups of patients who are genotyped at the front end, so we know who is a slow metabolizer and who is likely to respond to one drug or not,” Mrazek said. “These studies are just beginning to be done.” - See more at: Psychiatric Pharmacogenomics | Psychiatric Times

I agree with everything you said, this so called "doctor" does not support me, I don't know about his other patients, but I'm someone who will not hesitate to say something if I feel something is wrong.

I had a LCSW that I saw shortly after I started seeing a psychiatrist when I had my accident in 2002, but after a couple of months it felt more like we were friends.
Since this was the first time I saw anyone I was not sure it should be like that and I started to feel I really wasn't getting anything out of seeing her.

She recommended a doctor in another town and I saw him until the end of last year, when he said I'd just have to keep trying different medicines until one of them worked. After trying over 20 and having a bad reaction to the last two I wasn't willing to do that, and I'm still not.

I'm tried of trying, it's all gotten out of hand and I truly don't feel up to basically trying different doctors until I find the right one.

As for the cheek swab, I said some of it was true, however I don't believe it should be used as a tool when deciding which medicines to prescribe unless the patient can tell what they have taken that is on the list and if it worked or didn't.

The charlatan I saw these past few months is history as far as my ever seeing him again, but I may still bring some more things to a person I spoke with when I made the complaints on him.

[TheWell]

I would recommend a new prescribing doc, one who actually listens to your concerns. I would also suggest a separate therapist. Your therapist does not need to be able to prescribe and actually I think you are better off if they can't prescribe.

A psychologist has a PhD, doctorate, but can not prescribe.