Meeting with Psychiatrist for Dx - Big Letdown

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Joined: 9 Nov 2008
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08 Jul 2010, 10:16 pm

Doctors care about one thing: Money. Where's the money? Drug company kickbacks. The more pills they push, the more money they make - pure and simple. What I don't understand is why people are surprised at this behavior.

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MtnMojo
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09 Jul 2010, 9:13 am

I think it takes a really special person who can see the whole child for who she/he is. I have found it useful to encourage my son to ask questions such as 'this is what happens - do you have any ideas as to what I can do to help David .......................' or 'to what I can encourage others to do to assist David in..................' (David is my grandson).
It was recommended at one point to try a certain medication. However I had read that the long term trials were only 12 weeks in length and the drug wasn't tried on children under 6....so I steered my son to read this for himself (he is a high spirited individual himself) and to point this out to the professional who recommended it. My son did so and at that point, the professional worked with my son on behavioral interventions and adaptations.
Soooo, I think 'professionals' can be considered as 'resources' or 'partners' (depending on the severity of the symptoms) And, there is absolutely no reason why one can't be fired if your needs aren't getting met.
My two cents.

Elise

gardengirl414
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14 Jul 2010, 9:51 pm

Chronos wrote:

It didn't used to be like this. The profession used to have validity and integrity. Doctors were interested in their patient's well being. They recognized that it was not always appropriate to medicate and that there were other means of treatment. It's rare that one will find a real psychiatrist today, who is not a walking pill dispenser.

I heard this interview on NPR a couple of days ago and wondered if anyone has read this book? I think I may pick it up after I finish the three Asperger's books that arrived today (more for my "interest" than anything else. Outside of the Asperger's reading I've been doing lately, I have an interest in the medical profession in general)

Unhinged: The Trouble with Psychiatry — A Doctor's Revelations about a Profession in Crisis
By Daniel Carlat

http://www.npr.org/templates/story/stor ... =128107547

PunkyKat
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15 Jul 2010, 3:22 am

I recently had a phycatrist say I was bipolar and needed to be on Abilify litteraly as soon as he walked in the door. He said I grew out of autism and that my diagnosis needed to be changed. He threatned to comit me if I did not take Abilify. He claimed his son has AS but I didn't believe him. Phychatrists are nothing more than glorified drug dealers.

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cyberscan
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24 Jul 2010, 11:48 pm

Hear it in her own words
http://www.youtube.com/watch?v=Fn0yZKbifAs&feature=related

She says the same thing, "It'll wreck your health insurance!"

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Alien_Papa
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25 Jul 2010, 12:40 am

lilliansmom wrote:

So, I finally got in to an initial meeting with a psychiatrist so I could get an official diagnosis for my daughter. My main motivation is to have the tools I need to effect changes at school. I know a psychiatrist is usually there to write prescriptions - at least in my limited experience, but I was told by my insurance and their office that if I want an official diagnosis, I need to start with a psychiatrist. So we are rushed in with a pile of paperwork that I'm half completing in the session, the Dr. is completing a pile himself and we are talking about everything in front of my daughter which I hoped wouldn't happen. But, i can sense I've only got a few minutes to get started so we just rush through, he asks about 30 or so questions, I fill out a few papers with about 30 or so rating type questions that I can easily see are to determine ADHD and depression. Then he says "Your daughter is majorly depressed with ADHD, probably has Aspergers, OCD and social phobia". Now, he has no history on her other than what we talked about in a 20 minute session. She said she didn't like her life and felt shy (so that equals major depression and social phobia). Since she looses everything and is disorganized, so she has ADHD. Since she likes to chew on things therefore she's OCD. Oh and probably Aspergers but he's not sure since she doesn't talk about things at length - to the point of boring everyone. We need to increase her medication since she's so depressed (keep in mind this has been diagnosed from a few questions.)

So, yeah, right, I'm not even sure what to do other than be stunned at this first meeting. I guess I should start over with someone who will actually talk to us. And, BTW - I think it's insane (excuse the pun) that our mental health system has divided itself into one Dr. that writes prescriptions based on very little evidence and another that actually spends time getting in depth information about a patient.

Unfortunately I'm with Kaiser and I can't make an appointment with anyone, I'll have to find someone else in their system.

Any advice is appreciated!

That sounds like a very stressful and disappointing experience.

In our case, I spoke to the doctor fairly briefly on the phone prior to our first meeting, he sent us a bunch of background forms and questionnaires to be completed (by us and by 1-2 teachers who knew her well) prior to our meeting, then we had an intense 2 hour interview, received more questionnaires, then he met my daughter for one hour, and then we met for a one hour follow-up.

The meeting with our daughter seemed insightful. He showed her pictures and asked her what was happening in the picture. Apparently it's a very old-fashioned psychiatric test, but it seems useful in diagnosing AS. Does the child comment on the concrete details of the picture or demonstrate any emotional insight into the feelings of the people in the picture? He also asked her to teach him a particular thing she knows well and he feigned ignorance to test her reaction. Was she sympathetic to his difficulty or did she become frustrated?

The doctor gave a diagnosis of Aspergers. He did not seem particularly concerned about depression event though I was. He said that a more complete evaluation of my daughter (costing something like $5000) was unnecessary since she very clearly met the Aspergers diagnostic criteria.

I feel that a clear diagnosis was helpful in getting some informal accommodations from her teachers.

As you search for a new doctor I suggest asking about the process they will use to evaluate your daughter. If it seems rational and thorough then that's great. If it seems rushed and spontaneous (as you experienced) then that's bad.

Good luck.

Aspie1
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25 Jul 2010, 3:51 am

Alien_Papa wrote:

He also asked her to teach him a particular thing she knows well and he feigned ignorance to test her reaction. Was she sympathetic to his difficulty or did she become frustrated?

This reminded me of a psychology joke:
A mother takes her son to a child psychiatrist for an evaluation. The psychiatrist asks the mother some introductory questions, then proceeds to work with the child. He tries to get him to open up by engaging him in conversation about animals.
"Do you like cats?"
"Yes."
"Can you show me how big a cat is."
"This big." (holds his hands about 18 inches apart)
"Can you give me examples of what color cats are?"
"Black, white, striped, or many colors."
"What shape are a cat's ears?"
"Triangles."
"How many eyes does a cat have?"
At this point, the child turns to his mother, and asks: "How is it possible that this man never saw a cat before?"

Jokes aside, I can explain why your daughter became frustrated. There's a good reason, and it's not necessarily AS-related (or maybe it is, but keep reading). Let's say your daughter decided to teach the doctor about horses. I think it was perfectly reasonable to her to expect someone with an M.D. to know at least something about horses. Depending on the way the doctor acted, if he feigned complete ignorance, she easily figured out that he was testing her, and probably thought the test was stupid, so no wonder she became frustrated. After all, if there's one thing kids can't stand, and especially aspie kids, is an adult not acting genuine and/or trying to fool them; in my opinion, there's no room for sympathy there. Your daughter knew the doctor was basically pretending to be dumb, and it didn't sit well with her. It wasn't about not being sympathetic, it was about her knowing that it was all an act. And hey, she was in a medical office, not a theatre; hence, the frustration.

Tassie
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26 Jul 2010, 12:16 am

gramirez wrote:

Actually this is a total myth.

The average doc doesn't make any money from drug companies, aside from the odd handful of free pens or post-its.

Where the money is made is by very senior doctors being paid to speak at conferences, or put their names to studies that they had no part in and that are mostly ghostwritten by drug company PR departments. You have to be very well-known in the profession to get these types of payments - the company wants Dr Black, the world-famous cardiologist, not Dr Grey, the unknown from some Texas backwater, on their side.

Drug companies do not pay individual doctors to prescribe drugs - there is no benefit in it, it's too small scale. They want big names to speak persuasively, and increasingly what they do is give large sums to 'patient interest groups', because people who know little about clinical trials, statistical risk, error margins etc are likely to be even more easily persuaded to voice the drug company line. Don't believe me? Go google what happened with Herceptin.

The other place the money goes is to advertising, because they know you'll only look at the big shiny coloured page, and not bother with the two following pages of small print information.

Yes, some doctors are pill-pushers, often because they're burned out, and it's easier to hand over a script than try and talk someone out of it. I spend hours every shift trying to persuade parents that their child doesn't need another course of antibiotics for what is clearly a virus. Sometimes I just want to throw the script at them and scream "There you are, you got what you wanted, now get out of here and don't come back until your kid ends up with drug-resistant meningitis". As soon as they realise you're going to give them drugs, they're suddenly all smiles and 'thank you, doctor'. Withold the meds and you are highly likely to get a torrent of abuse instead. Sometimes, I just don't have the emotional resources to deal with That.

pgd
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26 Jul 2010, 10:06 pm

http://www.pbs.org/wgbh/misunderstoodminds/

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