[Simcha]

<font color="purple">
Hello all.
I really like this forum that I found. You are all very supportive and welcoming here. I'm sorry if this seems long, but I can't shorten it and get the same story through.

PDOC is older than 80, which is relevant to the story. It was my third (and last) visit with this PDOC, the first one being intake, and the second being followup, which was months ago. The PDOC never prescribed anything, as in our 2nd appointment, which was over a month later, my panic attacks went away and I only returned at the PDOC's request.
My remission of the panic attacks is from the work I do with my T. Fortunately, I have an excellent T. Needless to say, he was appalled and shocked himself.

PDOC asked some detailed questions about what I was seeing him for that day... I told him because since I was returning to work, I wanted to keep my anxiety at bay, and my T had recommended that I talk to him about a low dose of anti-anxiety meds so that my anxiety/panic attacks doesn't flare up again. PDOC asked me about the asthma that I have--

"Does it hurt/more difficult to breathe in, or out?" I told him "I don't know, it doesn't hurt, per se. Sometimes more difficult to breathe in, sometimes out, it depends on the severity constriction..." PDOC said to me in an annoyed voice "That doesn't sound like asthma to me; you should have more problems breathing OUT... I don't think that's asthma. "
This was very annoying to me, because I had been through hell recently with attacks that required 3 ER visits, so the last thing I needed was for my PDOC to attack me, attempting to invalidate my asthma diagnosis, implying that it was all in my mind and ignoring what I was telling him the problems were. My response was that I had been diagnosed by both my pulmonologist and my allergist, and I had recently had several asthma attacks.
PDOC even started turning red with anger, fuming...it was almost scary even...
PDOC went on to tell me that he thought that the stimulant I take for ADHD was too high (different doctor prescribed the stimulant), and he also went on to tell me that the stimulant was the cause of my anxiety and/or panic attacks. This was an area that PDOC and I had discussed before, both on the first and second visit. As I told him at the first appointment, I have taken the stimulant at the same dose for an entire YEAR PRIOR to having any anxiety problems or panic attacks. I also told him that I knew the EXACT SOURCES of my anxiety and panic attacks, which I discuss weekly with my T, and I have had good results with my T.

I went on to tell him that he can contact my T if he doesn't believe me, but I have very good results with the stimulant, and like many with ADHD who take a stimulant, it actually makes me CALMER (my thoughts don't race, I am able to focus, less fidgety, less hyper, etc.).
PDOC said "How do you KNOW the stimulant isn't causing the panic attacks/ anxiety?!!!!??? I believe I do know a thing or two more than you do, and I think I'm qualified to know the difference!!!!."
Meanwhile, I'm sitting there very calmly in my chair, trying to process what the hell happened that my PDOC would freak out on me.
PDOC then accused me, in his own words of "telling him what to do" and repeated the bit about knowing more than I do as evidence that he must be correct about the stimulant (in the same accusatory, hostile manner of course).

My shocked response, while sitting calmly and speaking calmly was "What? I in no way told you what to do, what on earth are you talking about? I was just answering your question. You can speak with my T if you don't believe me."
I told him that I agree that in some people and at some doses, stimulants CAN make peoples anxiety worse, but that isn't the case with me.

I also told him how I had tried an immediate release formulation of a stimulant before that caused a really fast heart rate and added to my anxiety a few months ago, but I stopped it because of the fast heart rate and lack of response to the ADHD symptoms, just to prove to him I wasn't some sort of an addict to the ADHD medication (which is what I think he was getting at).
FYI----I did not respond in kind, and even though I was very annoyed and confused with his behavior, actually---absolutely in SHOCK and DISBELIEF at what was occurring and how I was being spoken to... I did NOT behave the same way he did.
PDOC got up from his chair, and said "Well now, I don't think I can be seeing you as this isn't appropriate, I will NOT be having you telling me what to do!! I am not going to provide the treatment you want, and I'm not just going to do things your way!!! I think you'd better leave!!!"

So yes, I took him up on his "offer" to leave, and I up and sped out of there as fast as I possibly could while he yelled after me that he wasn't going to bill me.
My thoughts were immediately that he had dementia. I've worked with elderly persons with dementia in a professional capacity, and that is exactly what it reminded me of. I cannot think of anything else that would change the personality like that, with exception of some type of Alzheimer's. Thoughts anyone? Anyone else have any horror story PDOC or T stories that are similar? I've never heard of something like this before... I don't even know what to do about it, if anything.
I'm definitely not going to forget this anytime soon, and I don't think I'll be seeing any other PDOCS in the future either. </font> </font>

Whoa - he definitely sounds like he has SOME kind of issue!

But give yourself a huge pat on the back for how you handled it. It sounds like you were assertive and stood up for yourself without getting drawn into his argument. That's awesome!

Sorry you had to deal with that, though.

[Simcha]

Thanks for being supportive earthmama, as it sure threw me for a loop.

I don't really know what his issues really were, but clearly he simply wanted me to agree with him... I'm not really into placating people for the heck of it I guess.

My T was absolutely appalled, and will not recommend him to anyone in the future.

[sunrise]

Simcha, wow, that's one wild tale. You sure handled it well.

I am glad you talked to your T about it and that he will not be making referrals to this guy anymore. But it's still worrisome that he is practicing medicine and subjecting patients to his inappropriate and unprofessional behavior.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I really like this forum that I found. You are all very supportive and welcoming here.

</div></font></blockquote><font class="post">And a big welcome to you! (Stop by sometime and visit the ADHD forum.)

[Kiya]

WOW!!!
My MD is truly wonderful, always asks me my *opinion* after explaining things to me, and then gives me the right to choose or change any meds.
I think this guy you saw just provided a great example of the opposite of a really good dr.
Luck to you in finding someone better to work with! Glad he let you leave!!!
Kiya

[gardenergirl]

I agree with you about it possibly being dementia. I also work professionally with older adults, many with dementia, and what you describe could fit. The issue of continued competence as clinical professionals age is a tough one. You might want to consider reporting this incident to the licensing board. They can take it from there, but at least you would have provided a data point that may or may not turn out to be something requiring action.

Aside from that, it sounds like a very distressing interaction. Good for you for staying grounded and responding calmly and logically. That's really hard to do when someone is railing at you unfairly.

gg

[Simcha]

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sunrise said:
Simcha, wow, that's one wild tale. You sure handled it well.

I am glad you talked to your T about it and that he will not be making referrals to this guy anymore. But it's still worrisome that he is practicing medicine and subjecting patients to his inappropriate and unprofessional behavior.

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I really like this forum that I found. You are all very supportive and welcoming here.

</div></font></blockquote><font class="post">And a big welcome to you! (Stop by sometime and visit the ADHD forum.)

</div></font></blockquote><font class="post">

I should visit the ADHD forum. It's hard to find others with ADHD that can focus enough to participate though ... lol

I don't know what to do about the PDOC, and I wish I had indication of his behavior at the very beginning, but I didn't. It is worrisome that he is practicing, but my T says that this PDOC is very conservative in doling out medications. For that, we can be greatful, if nothing else.

[Simcha]

I'm glad I was only there 20 minutes. Whew...

[Simcha]

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gardenergirl said:
I agree with you about it possibly being dementia. I also work professionally with older adults, many with dementia, and what you describe could fit. The issue of continued competence as clinical professionals age is a tough one. You might want to consider reporting this incident to the licensing board. They can take it from there, but at least you would have provided a data point that may or may not turn out to be something requiring action.

Aside from that, it sounds like a very distressing interaction. Good for you for staying grounded and responding calmly and logically. That's really hard to do when someone is railing at you unfairly.

gg

</div></font></blockquote><font class="post">
<font color="blue"> The really scary part here gardengirl, is the possible outcomes of a patient he sees--- I don't have Major Depressive Disorder (or any other mood disorder), but what if I was severely depressed, maybe even suicidal? This really could have tipped someone over the edge. You are coming to them for help, usually in a situation where you are at your most vulnerable... and you are placing your trust in them to help you.
Now, I'm not suicidal and I don't have depression, but... what if?????

It's really hard to know what to do in this situation. I do think the public needs to be protected from PDOCS and T's who are abusive, unprofessional, and/or inept.

The problem I have is that it is really stressful the way that you have to report the PDOC to the licensing board. They will do an investigation, but in my state, you have to file a report with your name. The PDOC then knows not only who reported you, but then... so does everyone else, because they publish those on the state licensure website. A certain amount of your personal life would then become public. The process can also take a year, sometimes more. I'm too stressed out as it is. I certainly have some thinking to do.

It should be interesting to see what his version of events are when he writes his report on me for that visit... I shudder to think of it. </font>

[sunrise]

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Simcha said:
<font color="blue">It should be interesting to see what his version of events are when he writes his report on me for that visit... I shudder to think of it. </font>

</div></font></blockquote><font class="post">So are you going to request your records so you can see what he wrote? He did say he wouldn't charge you for the visit, so I wonder if he just won't record anything. It will be as if your office visit never occurred.

[ECHOES]

ugh. Sounds like the old "God" issue some docs have. I think his age is a factor in that years ago these docs had a different role in health care; today docs are more like partners in our care, rather than dictators. He sounds like he has some prejudices that are influencing his 'care' of you. I hope you can find someone who appreciates your self knowledge and will work with you the way you. Challenging the way things are is fine and can lead to even better treatments, but the way he takes it personally would infuriate me and make me feel like his issues would interfere in my receiving good care. I would not be going back for a 4th visit.

[Simcha]

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ECHOES said:
ugh. Sounds like the old "God" issue some docs have. I think his age is a factor in that years ago these docs had a different role in health care; today docs are more like partners in our care, rather than dictators. He sounds like he has some prejudices that are influencing his 'care' of you. I hope you can find someone who appreciates your self knowledge and will work with you the way you. Challenging the way things are is fine and can lead to even better treatments, but the way he takes it personally would infuriate me and make me feel like his issues would interfere in my receiving good care. I would not be going back for a 4th visit.

</div></font></blockquote><font class="post">
Having a "God" complex could be a possibility, but it would have to have been hidden from me really well the first two visits. He certainly never showed this sort of behavior before, and in fact, he was quite a likable older gentleman (or so I thought) at first. I never would have returned had he exhibited behavior like this before. I'm never going back to another visit with him, that's for certain. I think I'm done with PDOCS for awhile, as I can't think of one visit with one that has been very good (although none have ever been as distressing, abnormal, and bad as this one).

I think I can actually handle my anxiety with my T alone at this point, and my T agrees, as the anxiety has lessened over the last week. My T told me that he thinks it highly likely that due to the age of the PDOC in question, and the lack of knowledge even in professionals with adults and ADHD, that the PDOC did not have any training in ADHD, and it is unlikely that he was very educated about it and had a shallow knowledge base about it.

I've never been yelled at or berated by a PDOC (or any doctor) before, but now the challenge is going to be to stay positive about myself, and to not allow myself to become biased against psychiatrists in general now.

I will discuss this with my T next week, as this experience definitely affected me, and is related to some other recent happenings with my asthma. For instance, I have some atypical symptoms of asthma (which my regular pulmonologist is aware of), and when I saw a PA and an ER doc on one occasion recently, they both tried to tell me it was all in my head, and the PA tried to tell me that it was also a sinus infection (it wasn't).
I had an appointment with my pulmonologist after that, and I know it's not all in my head, and not related to a sinus infection. It is very invalidating, frustrating, and condescending to be invalidated just because your issue is more complicated than what they were taught in school. The ER doctor was actually very nice, but aside from the breathing treatment, he also gave me Ativan to settle me down, thinking that the asthma attack wasn't an asthma attack, but anxiety. In that instance, the asthma attack had brought on the anxiety... but his error in thinking was that the Ativan was going to correct the problem.

I appreciate his effort... but still, very frustrating to have this all happen in the week where I saw the senile PDOC. I think he had some type of dementia. Dementia would account for the personality change... otherwise, it's something else, with a little bit of God Complex mixed in. UGH is right.

[ECHOES]

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Having a "God" complex could be a possibility, but it would have to have been hidden from me really well the first two visits.

</div></font></blockquote><font class="post">
Maybe, or maybe it showed itself when he felt challenged... unworshipped.

I'm glad your T is helpful with the pdoc issue and that your anxiety is better. The experience with the pdoc sounds like it was startling, unnerving. Yelling at a patient is never okay. Not for revenge or vengence, but as a valid concern about his competency, have you considered reporting him to the licensing board? He might need some help deciding it's time to retire.

There are good pdocs out there. I don't have one any longer but the one I had for nearly 10 years was a great guy. Very good listener and valued my self knowledge, was still interested in new findings and new meds, very upbeat and positive we would keep working until we found the meds that helped the most. If I had a problem with a med, like hangover effect that wouldn't lessen or go away and I couldn't deal with, he would find something else or a combination of meds that might work better. He even offered to do therapy with me when I was not happy with my T (the T later was arrested and lost his license for having an affair with his client!). Anyway, my pdoc was a gem and always made me laugh about something during the visit. He ended every visit with a handshake, a smile, and I always left smiling and feeling lighter. There are good pdocs out there, Simcha.

I know some who take some Benadryl (without decongestant) for as-needed help with anxiety. Also, I have been helped with (along with T ) by doing relaxation CD's daily--it helps during anxious times and it helps preventatively too.

[Simcha]

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ECHOES said:
</font><blockquote><div id="quote"><font class="small">Quote:</font>
Having a "God" complex could be a possibility, but it would have to have been hidden from me really well the first two visits.

</div></font></blockquote><font class="post">
Maybe, or maybe it showed itself when he felt challenged... unworshipped.

I'm glad your T is helpful with the pdoc issue and that your anxiety is better. The experience with the pdoc sounds like it was startling, unnerving. Yelling at a patient is never okay. Not for revenge or vengence, but as a valid concern about his competency, have you considered reporting him to the licensing board? He might need some help deciding it's time to retire.

There are good pdocs out there. I don't have one any longer but the one I had for nearly 10 years was a great guy. Very good listener and valued my self knowledge, was still interested in new findings and new meds, very upbeat and positive we would keep working until we found the meds that helped the most. If I had a problem with a med, like hangover effect that wouldn't lessen or go away and I couldn't deal with, he would find something else or a combination of meds that might work better. He even offered to do therapy with me when I was not happy with my T (the T later was arrested and lost his license for having an affair with his client!). Anyway, my pdoc was a gem and always made me laugh about something during the visit. He ended every visit with a handshake, a smile, and I always left smiling and feeling lighter. There are good pdocs out there, Simcha.

I know some who take some Benadryl (without decongestant) for as-needed help with anxiety. Also, I have been helped with (along with T ) by doing relaxation CD's daily--it helps during anxious times and it helps preventatively too.

</div></font></blockquote><font class="post">

Benadryl really knocks me out. I'm very sensitive to Benadryl, so I only take it for allergy problems at night, and then, infrequently.

I'd mentioned somewhere here that I had considered reporting the PDOC, it is, however, just my word against his, and secondly, my state's licensing board makes your reporting of the PDOC (and any doctor or clinical psychologist) public, and it is posted on the website. It can also take a year or more to investigate and provide relief (if any relief is to be given).
I think it might be too stressful for me, considering everything else I have going on right now.

Let's say that the PDOC was like your X-Therapist, who was later found guilty of sleeping with his clients... with something like that, I would most definitely have no qualms about reporting ASAP. This issue with my senile PDOC though, isn't as cut and dry as that, so I doubt anything would even come of it, even if I did put the energy toward reporting him.

Luckily, I don't think I need a PDOC for anything at the moment, and I'm handling my anxiety in another way.

[gardenergirl]

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Simcha said:

<font color="blue"> The really scary part here gardengirl, is the possible outcomes of a patient he sees--- I don't have Major Depressive Disorder (or any other mood disorder), but what if I was severely depressed, maybe even suicidal? This really could have tipped someone over the edge. You are coming to them for help, usually in a situation where you are at your most vulnerable... and you are placing your trust in them to help you.
Now, I'm not suicidal and I don't have depression, but... what if?????

It's really hard to know what to do in this situation. I do think the public needs to be protected from PDOCS and T's who are abusive, unprofessional, and/or inept.

The problem I have is that it is really stressful the way that you have to report the PDOC to the licensing board. They will do an investigation, but in my state, you have to file a report with your name. The PDOC then knows not only who reported you, but then... so does everyone else, because they publish those on the state licensure website. A certain amount of your personal life would then become public. The process can also take a year, sometimes more. I'm too stressed out as it is. I certainly have some thinking to do.

It should be interesting to see what his version of events are when he writes his report on me for that visit... I shudder to think of it. </font>

</div></font></blockquote><font class="post">

I agree, what if someone in crisis or with severe symptoms went in and he acted that way? You didn't deserve to be treated that way, and in addition, you didn't get the help you need. But I can understand your hesitation about reporting given the requirements in your state. That's awful! What ever happened to patient privacy? That's a really good area for advocates to take on to get the rules changed. I hope there are folks working on that in your state on behalf of the public.

In the meantime, it's hard to know what to do. Is there a local medical association or state medical association that is not associated with the medical licensing board? Maybe they could take a complaint either anonymously or confidentially. Or perhaps you could report it to your insurance company. They want to know that the docs on their panels are competent. (I'm trying hard not to snicker as I say that, as there are way too many "phantom panels" and outdated panels, but anyway...).

Of course the most important thing is that you are protecting yourself from him as best you can, and that's good. Sounds like you've got better boundaries than he does.

Take care,

gg

[Simcha]

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gardenergirl said:
</font><blockquote><div id="quote"><font class="small">Quote:</font>
Simcha said:

<font color="blue"> The really scary part here gardengirl, is the possible outcomes of a patient he sees--- I don't have Major Depressive Disorder (or any other mood disorder), but what if I was severely depressed, maybe even suicidal? This really could have tipped someone over the edge. You are coming to them for help, usually in a situation where you are at your most vulnerable... and you are placing your trust in them to help you.
Now, I'm not suicidal and I don't have depression, but... what if?????

It's really hard to know what to do in this situation. I do think the public needs to be protected from PDOCS and T's who are abusive, unprofessional, and/or inept.

The problem I have is that it is really stressful the way that you have to report the PDOC to the licensing board. They will do an investigation, but in my state, you have to file a report with your name. The PDOC then knows not only who reported you, but then... so does everyone else, because they publish those on the state licensure website. A certain amount of your personal life would then become public. The process can also take a year, sometimes more. I'm too stressed out as it is. I certainly have some thinking to do.

It should be interesting to see what his version of events are when he writes his report on me for that visit... I shudder to think of it. </font>

</div></font></blockquote><font class="post">

I agree, what if someone in crisis or with severe symptoms went in and he acted that way? You didn't deserve to be treated that way, and in addition, you didn't get the help you need. But I can understand your hesitation about reporting given the requirements in your state. That's awful! What ever happened to patient privacy? That's a really good area for advocates to take on to get the rules changed. I hope there are folks working on that in your state on behalf of the public.

In the meantime, it's hard to know what to do. Is there a local medical association or state medical association that is not associated with the medical licensing board? Maybe they could take a complaint either anonymously or confidentially. Or perhaps you could report it to your insurance company. They want to know that the docs on their panels are competent. (I'm trying hard not to snicker as I say that, as there are way too many "phantom panels" and outdated panels, but anyway...).

Of course the most important thing is that you are protecting yourself from him as best you can, and that's good. Sounds like you've got better boundaries than he does.

Take care,

gg

</div></font></blockquote><font class="post">
I can handle other persons freaking out, and other persons crisis situations really well. I'm just glad I wasn't in a crisis situation when I saw him because I'm not as good at calming myself down as I am at calming others down (my job deals exclusively in crisis situations).

His poor office staff had no idea, and are probably asking themselves why that nice young person the other day basically ran out of the office with the senile PDOC yelling behind me "I won't bill you!!" How awkward.

I'm happy his specialty isn't surgery, but this can be just as dangerous. I don't know of any other regulatory panel, and the last thing I'm going to do is speak to my insurance company. There is no such thing as privacy when you have insurance. At least I have group insurance and not individual insurance, as I have a bit more privacy than if I have individual insurance.
I think this is just one of those situations that I will have to let go for the sake of my sanity. I'll be speaking further about it with my T soon, and I'll have to see what he says.

[gardenergirl]

Sounds like good thinking about this. What an awful experience.

gg

[Simcha]

<font color="purple">The same PDOC told me on my first visit that Hashimotos Thyroiditis was cancer... We were discussing my medical history and I told him how I was once misdiagnosed with Hashimotos Thyroiditis (I had several subsequent doctors say I didn't have a thyroid disorder and all my labs were normal)...

Hashimotos Thyroiditis is absolutely not cancer---- it's a thyroid disorder where your thyroid hormone levels can fluctuate, but it certainly is not a cancerous condition, and is seldom extremely harmful to where it causes permanent damage. I didn't bother to correct him on that issue, thinking it a harmless mistake that he mixed one condition up with another that wasn't related to my care.

In retrospect, I see this as further evidence that the PDOC was senile, and that was a red flag I ignored. </font>

[Simcha]

I have an update that really aggravated me.

I received a letter and a bill for an allegedly past due $10 copay (that I need to confirm) from my former (and probably senile), unprofessional, and incompetent PDOC today. I quote in full:

"This letter is to inform you that as of today I no longer accept responsibility for your medical condition."
<font color=" blue"> That's a pretty bold statement on his part. I have all of my records from my previous two visits with him, and he never diagnosed me with anything, nor did he provide treatment of any kind. He took a history that was inaccurate at parts because he didn't listen, but it's fortunately really benign. He continues with this really hilarious part:</font>

"I DO BELIEVE THAT YOU NEED CONTINUED TREATMENT (emphasis mine). I suggest that you seek treatment from a qualified psychiatrist either at (XYZ) hospital, or in private practice. I will be available over the next six weeks for any emergency that may occur. This should give you plenty of time to be enrolled in another medical practice."

<font color=" blue">This from the man who told me that Hashimotos Thyroiditis was a cancerous condition (it's an autoimmune disease, not cancer). So tell me, Almighty Grand Wise Doctor, what basis do you recommend that I need "continued treatment" for? I wanted to put this issue to bed and toss it aside as just another unfortunate experience that I'm lucky didn't cause real lasting harm. When he stirred the pot by sending this letter, it made me agitated at it all and made me think that maybe this shouldn't just be left to rest. Here's options I've thought of, and please tell me your opinions:

1)I could send a short, concise letter requesting for the remainder of my records (which would include only that last and 3rd visit), saying that I'll pay a nominal fee for any copy charges. Primarily this would be to see if anything inaccurate and inappropriate was written. He did say he wasn't going to charge me for the session, but it doesn't mean he didn't write anything.
2) If he did use "creative writing" and made a record of my visit, pursue options for filing a complaint.

Thoughts? Other ideas?
Thanks!

Simcha,
I noticed a few patterns in this PDOC's unprofessional comments. I thought I would share my thoughts, but know that I'm not sure if I'm close to the truth or far away from it. Based on your Title, I see that you might be searching for a reason for his behavior. I do this obsessively which can be helpful at times and can be unproductive at others. I hope that this is a time in which it is helpful.

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I told him because . . . and my T had recommended that I talk to him about a low dose of anti-anxiety meds so that my anxiety/panic attacks doesn't flare up again. PDOC asked me about the asthma that I have--

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..." PDOC said to me in an annoyed voice "That doesn't sound like asthma to me; you should have more problems breathing OUT... I don't think that's asthma. "

</div></font></blockquote><font class="post">

The pattern that I notice from this interaction and from subsequent actions is that your PDOC seems to be triggered when he perceives that your comments are questioning his authority. First, he should know (should) that he is not qualified to diagnose asthma. I wonder if the above incident was triggered by your mentioning that your T recommended a course of action, if your PDOC felt threatened that someone else was "telling him what to do".

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I went on to tell him that he can contact my T if he doesn't believe me

</div></font></blockquote><font class="post">

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"How do you KNOW the stimulant isn't causing the panic attacks/ anxiety?!!!!??? I believe I do know a thing or two more than you do, and I think I'm qualified to know the difference!!!!."

</div></font></blockquote><font class="post">

Your PDOC's insecurity is showing here. Again, maybe he felt threated by you mentioning your T? He asks you how do you know the stimulant isn't causing the panic attacks/anxiety. My question is how does he know that it is?
You are the only person that can answer that. His answer further supports my suspicion that he is defensive when he perceives others as questioning him. My T frequently tells me not to idealize him, that he can and has been wrong at times. Your PDOC's response goes against this idea, which I believe is a cognitive distortion. Again, your PDOC *should* know this and should be aware of his subconscious motives, if that is the case here.

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PDOC then accused me, in his own words of "telling him what to do" and repeated the bit about knowing more than I do as evidence that he must be correct about the stimulant (in the same accusatory, hostile manner of course).

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I will NOT be having you telling me what to do!! I am not going to provide the treatment you want, and I'm not just going to do things your way!!! I think you'd better leave!!!"

</div></font></blockquote><font class="post">

This may be dementia or Alzheimers, but I don't think the pattern that I see would be so blatant if that was the case.
I notice that in spite of all of the evidence that you question your perceptions/feelings/thoughts -- I totally indentify with you! I still don't have the ability to trust myself yet. I hope that will come with time. Know that my perceptions in regard to his behavior are exactly in line with yours. This was unprofessional and you didn't deserve this.
My explanations of a possible reason for his behavior are an attempt to make you feel validated and to let you know that his actions and what I perceived as being anger were not proportional to the situation. My perception of the situation is that this clearly was not you!
I have no idea as to what to tell you about your course of action. Have you asked your T what he thinks? I hope you are able to resolve this difficult unnerving situation. I wish you the best of luck - keep us posted. Take care.

[sunrise]

It sounds like it might be a form letter, to discharge his obligation and cover his *** in case you need medical attention in the next 6 weeks (so you couldn't sue and say your pdoc refused to see you when you had an emergency and caused irreparable harm). I doubt he is doing this just to stir the pot, but for legal reasons.

If it were me, I too would want to see my medical records from this guy. I see nothing wrong with requesting them. You don't need to offer to pay copying charges, as patient's requesting their records is standard. I would wait a couple of weeks to let his entry (if he made one) make its way into your file.

Best of luck. Hope you can put this guy out of your mind. He's not worth your time and energy.

[CareGiver2]

Hi. I am new here, and was reading your post. Although your Pdoc, perhaps because of his age, could have handled the situation better, he think he may have a a point. Anyone who is prone to anxiety/ panic attacks need to avoid stimulants. I have been banned from all .. including Lucozade and any sinus medication (and my sinus allergies give me hell). These are also things that I used to take before with no problem, but under the current circumstances I can't.

I went through timelines and realised that certain meds do increase the attacks, and many of them resemble asthma (one ER thought it was adult onset asthma). I cannot do anti-depressants anymore, because they do increase the attacks. They appeared to make me feel calmer but the incidents of panic increased. I am stuck with benzos. Since I have stopped anything with stimulants, my attacks have decreased dramatically.

From my own experience, I think your pdoc may have a point, however, he could have expressed this in a better manner.

[serafim_etal]

This is definitely a form letter. It is almost word-for-word the same as letters I have been asked to send out when I was working in medical billing. This is the generic discharge letter...patient being discharged for non-payment, personality conflicts, failure to show-up at scheduled times (on a regular basis), or no particular reason at all. There is a much more strongly worded letter for patients being discharged for things like theft, drug-seeking, and violence, etc. THAT letter contains words like "trespassing", "police", etc...it still gives 6 weeks to find a new doctor though...that is the CYA part! I would not worry about the letter at all. The PDOC probably told someone in his staff that he would not be seeing you again, and that staff person had to send out "the letter".

As for filing a complaint...is it possible for your T to file it for you? This would keep your name out of it.

[Simcha]

Welcome to the forum. It's the most interactive, supportive, and informative one I have ever been involved in.
</font><blockquote><div id="quote"><font class="small">Quote:</font>
CareGiver2 said:
Anyone who is prone to anxiety/ panic attacks need to avoid stimulants.

</div></font></blockquote><font class="post"> I'm not sure what you mean by "prone to anxiety/panic" but I'm not prone to anything.
To reiterate so that you don't misunderstand--I know exactly what the sources of my anxiety and panic attacks are, which I work on with my therapist weekly. I've been making good improvement. My anxiety stems from specific situations.

I should also mention that in ADHD, the right dose/type of stimulants produce a paradoxical effect; that is to say that they do not cause over-stimulation, rather they make a person with ADHD CALMER, MORE RELAXED, AND MORE FOCUSED. Psychiatrists who are educated about ADHD know that. Unfortunately, many psychiatrists are completely uneducated about ADHD (especially in adults).

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I went through timelines and realised that certain meds do increase the attacks, and many of them resemble asthma (one ER thought it was adult onset asthma). I cannot do anti-depressants anymore, because they do increase the attacks. They appeared to make me feel calmer but the incidents of panic increased. I am stuck with benzos. Since I have stopped anything with stimulants, my attacks have decreased dramatically.

</div></font></blockquote><font class="post">

It is well documented in the medical community that panic attacks/high anxiety/strong emotions/stress can cause an asthma attack. Even laughing can cause an asthma attack. It is a well known trigger of an asthma exacerbation.It is also well known that if you have an asthma attack, you can possibly go into a panic attack (it's not hard to see why is it?). However, they are clearly distinct events, and this PDOC was not in the position, nor did he have the knowledge or do the diagnostic testing required to tell me that I don't have asthma. It was also, beside the point. I wasn't having a panic attack in his office either, so there is no correlation between your example and what actually occurred.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
From my own experience, I think your pdoc may have a point, however, he could have expressed this in a better manner.

</div></font></blockquote><font class="post">
No, he didn't have a point that I didn't specifically address. He was argumentative because in his distorted mind, I was challenging his "authority."

As I said, I told the PDOC that while I agree and it is commonly known that stimulants MIGHT cause the side effect of increasing anxiety in SOME people, that I am not one of those. I discussed with him during the previous two appointments, the first one being over an hour (and he was calm as a duck in water). I also told him that I have been on the same dose of stimulants for an entire YEAR, with no anxiety or panic attacks until the specific stressors popped up.

My anxiety stems from specific incidents completely unrelated to asthma or stimulants. Don't confuse the issue either, because stimulants were the focus of his theory, not the asthma (which he claimed it didn't "sound like" I had anyway).

[Simcha]

[b]Hi Soliaree!!

</font><blockquote><div id="quote"><font class="small">Quote:</font>
your PDOC seems to be triggered when he perceives that your comments are questioning his authority. First, he should know (should) that he is not qualified to diagnose asthma. I wonder if the above incident was triggered by your mentioning that your T recommended a course of action, if your PDOC felt threatened that someone else was "telling him what to do".

</div></font></blockquote><font class="post">
I believe you are absolutely correct!!!!! When I relayed what happened to my T, his first thought was that the PDOC was paternalistic, authoritarian, and seemed to only like patients who would subject themselves to the PDOC's mercy. His theory was that when PDOC was in training, they taught PDOCS to be authoritarian and paternalistic. My T told me that some other patient this week had a problem with him, and T reiterated he wasn't going to recommend this PDOC to anyone ever again.
</font><blockquote><div id="quote"><font class="small">Quote:</font>
your PDOC seems to be triggered when he perceives that your comments are questioning his authority. First, he should know (should) that he is not qualified to diagnose asthma. I wonder if the above incident was triggered by your mentioning that your T recommended a course of action, if your PDOC felt threatened that someone else was "telling him what to do".

</div></font></blockquote><font class="post">
I think so, Soliaree. I don't think the PDOC cares for psychologists either. No one else can POSSIBLY know as much, or more, than the Authoritative PDOC, right? Fragile ego.
</font><blockquote><div id="quote"><font class="small">Quote:</font>
Your PDOC's insecurity is showing here. Again, maybe he felt threated by you mentioning your T? He asks you how do you know the stimulant isn't causing the panic attacks/anxiety. My question is how does he know that it is?

</div></font></blockquote><font class="post">Exactly!
</font><blockquote><div id="quote"><font class="small">Quote:</font>
His answer further supports my suspicion that he is defensive when he perceives others as questioning him. My T frequently tells me not to idealize him, that he can and has been wrong at times. Your PDOC's response goes against this idea, which I believe is a cognitive distortion. Again, your PDOC *should* know this and should be aware of his subconscious motives, if that is the case here.

</div></font></blockquote><font class="post">The PDOC is acting out on a cognitive distortion. Even though I wasn't questioning him, his inability to listen to anyone once he has his mind made up further illustrates your points.
</font><blockquote><div id="quote"><font class="small">Quote:</font>
I notice that in spite of all of the evidence that you question your perceptions/feelings/thoughts -- I totally indentify with you! I still don't have the ability to trust myself yet. I hope that will come with time. Know that my perceptions in regard to his behavior are exactly in line with yours. This was unprofessional and you didn't deserve this.
My explanations of a possible reason for his behavior are an attempt to make you feel validated and to let you know that his actions and what I perceived as being anger were not proportional to the situation. My perception of the situation is that this clearly was not you!

</div></font></blockquote><font class="post">
Yes, your right that I don't entirely trust myself yet. There are specific reasons for that, and it's because of the specific situations that are the cause of my anxiety in the first place. I always seem to second guess, but part of that is because if I am the cause of something bad, I want to fix it. But, you along with my T and everyone else have solidified in my mind that it wasn't me that had the problem.
</font><blockquote><div id="quote"><font class="small">Quote:</font>
I have no idea as to what to tell you about your course of action. Have you asked your T what he thinks?

</div></font></blockquote><font class="post"> I haven't discussed reporting the PDOC with him, although I did tell him that if I didn't have so much more going on it would be something I'd look into doing, but that is all I really said about that.
</font><blockquote><div id="quote"><font class="small">Quote:</font>
I hope you are able to resolve this difficult unnerving situation. I wish you the best of luck - keep us posted. Take care.

</div></font></blockquote><font class="post">

Thanks!