|
I Got Diagnosed, But I "Can't" Help Others
I understand your frustration in more ways than one. I'll try to make this as short and sweet as I can, without boring everyone! I am a physician trained in pediatrics with a subspecialty in adolescent medicine. Several years ago the pediatric practice where I worked insisted that I attend a training workshop to learn more about ADHD. I'll confess, I didn't really want to do it, since the ADHD patients take so much time...but I'm glad I did. I heard Dr. Hallowell speak, and realized that I had so many of the characteristics of ADD myself. At the time I had been through so many stressful events that I had become depressed, and was on an antidepressant prescribed by a local psychiatrist. Needless to say, I then approached the psychiatrist after I read Sari Solden's book, "Women With Attention Deficit Disorder," and asked my doctor if we could consider treatment for ADD. She was reluctant, and referred me to a psychologist for further evaluation. That's a story in itself, because I got lost on my way to the psychologist's office (which was in another city) and was 30 minutes late! He reprimanded me, then began asking a series of questions more related to impulse control rather than inattentiveness and distractibility--things like "Do you drink?" (No.) "Do you gamble?" (No, but I have relatives who do all those things.) He surmised that I did NOT have ADD, to which I retorted that I thought he was wrong, and that he would be missing a lot of patients who could be potentially helped with that attitude!! (I guess I was a little impulsive then when I responded that way! That was my low frustration tolerance manifesting then!) Anyway, the psychiatrist then decided to switch my antidepressant to something like Effexor, which made me nervous, jittery, and sick as a dog when I came off it. Finally, I went to my family medicine doc, who really listened to me, and decided to try me on Adderall--the perfect fit.
After a move to another city and a couple of job changes, I ran a private practice for adolescents and young adults for almost 6 years before the insurance companies stopped making regular timely payments, forcing me to close it down due to cash flow problems this past November. During that time I saw numerous patients with ADHD/ADD/learning problems, etc. In fact, most of my new patients were referred by counselors or therapists who recognized these symptoms, but either the patients were not being medicated appropriately or were not being helped by their other PCP's. Often I had questions from the parents of the kids I saw about where they could go for help themselves. So many of them were also on antidepressants (which, like my own medication in the past, may have helped a little at first, but was no longer helping) or anti-anxiety meds which made them feel too sleepy. After I had to close my other office, I was so burned-out on trying to collect payment for the work I had done that I was ready to throw in the towel and no longer practice medicine at all. Thankfully, a dear colleague who is a therapist invited me to share office space with her and some other therapists and manage mental health medications. I will tell you that I have now seen several adults as new patients, and they have lamented over and over that they felt they had nowhere else to go to be treated for ADHD. The psychiatrists in our area usually have waiting lists up to 3 months out, and sometimes it is really hard to get appointments. Many of the family medicine or internal medicine docs recognize that there could be some type of other issues (like ADHD) with their patients, but they, too, are having so many problems getting paid by insurance companies for spending extra time with their patients that they feel they can't adequately address the issue. Now that I am no longer operating as a primary care physician (rather, I'm considered a specialist), AND I no longer file insurance (rather, people pay for my services themselves, then file their own claims for reimbursement), I am able to see more patients to help them with their ADHD and let their other docs work on diabetes, hypertension, etc. I also have a volunteer faculty appointment with our local teaching hospital, which allows me to give lectures on ADHD, mood disorders, etc. on a regular basis. This has helped as far as letting the community know that I'll gladly work with these patients and/or help other docs if they have questions about medications.
I understand that this may not help you, Jim, but perhaps you could find another M.D. (even a non-psychiatrist) in your area who understands ADD/ADHD more than most, and who would be willing to expand his or her services to help patients in this way. It's been very rewarding for me to finally be able to help the ones who have struggled so long. Yet, I'm not sure that I would be so helpful to them or so sensitive to their needs if I had not navigated the usual healthcare system myself. I wish you the best!
Quote
|
10 Mar 2009 @ 2:35 PM
11 Mar 2009 @ 4:08 PM