Stubborn doctor: what can I do?

[The Cat Lady]

Hello. I’ve been seeing the same doctor for almost two years now. I thought I had gotten to a point where we were on the same page about my meds; however, the past 4-5 appointments, it seems like she has not been receptive to changing my medications. I was prescribed 30mg of Adderall IR and 20mg XR; she finally raised the XR to 30mg, but lo and behold, I’ve still been feeling like a rotten sack o potatoes. Not functional. I’ve clearly identified that the Adderall XR has not been beneficial to me, partly due to it being an insufficient dose (I’ve taken a higher dose of both, and was doing much better until a substitute provider cut my dose back.) I noticed that I felt markedly “different” upon taking the XR: slightly out-of-it, dizzy/clumsy, and extremely anxious. Very unpleasant. Also, I’ve found that it makes me feel super shitty physically: substantial muscle fatigue, randomly tensing of my shoulders/neck/legs/whatever. I’ve made it clear to her that I feel worse when I take it. My quality of life suffers. I’ve felt very depressed and anxious. Basically, none of the perks with all of the side effects. I’ve emailed her AdditudeMag articles, brought it symptom checklists, brought the Weiss Impairment scale, and it’s like all of that means nothing to her. She maintains that she “really thinks the medication is helping”, and she doesn’t believe my muscle tension/weakness is being caused by the XR. Wait, what???????? Even after I brought you all this proof?! I feel like she doesn’t *hear* me. Like she’s already made up her mind about what I have to say even before we speak. I feel like I’m not being taken seriously as a patient. I’ve been doing very poorly, and on top of that I stay at home with my four year old twins. She hears it like I’m just being hard on myself. I have been frustrated to tears with this woman. I’m somewhat reluctant to find a different doctor, because I’m afraid that they might know even less about medicating ADHD patients. It blows my mind how little education/experience most doctors have about ADHD. I really thought that she knew more about it than the average doctor, but I feel like I can’t be any more clear with her about how poorly I’ve been feeling. Does anyone have advice on being more assertive with doctors who don’t take you seriously? It is terrifying to me that I don’t have more control and more say in which medications I take and how much I really need to be taking. How can I make her understand?! Every day is a struggle for me.

[quietlylost]

It sounds like you’ve already been doing a lot to try to advocate for yourself. She may just be too set in her own opinions to hear your voice. A lot of doctors view themselves as the experts and don’t trust us to know our own needs.

Some questions that you may ask her if you haven’t already:
– What would be a sign to you that I wasn’t doing well?
– You say that you think the medication is helping. What do you think it is helping with? From your perspective, what have you noticed that’s better? What have you noticed that’s worse?
– I’m having a real hard time with the pain and muscle issues that I’m facing. If you don’t think a medication change is warranted, what would you suggest as alternatives?
– Hypothetically, if we were to change medications, what would my options be? Do you think any of them would be worth trying? We could always go back to the current medications if they don’t help.
– I feel frustrated. I feel like I’ve been trying to express concerns to you but I don’t feel like those are being validated or truly heard. It would be helpful to me if you would reflect back to me what my concerns are as you understand them, and also if you would be willing to work on alternative ideas to help me.
– I understand the things you’re saying about being kind to myself and trying to do the other things you suggest. I am doing those, but I’m still having these issues. What else can we do together to address this? The things I’m doing on my own aren’t enough. And I don’t know that the medication is where it needs to be to make things easier.

I’m guessing you’ve tried variants of most of that. In the end, you may not be able to change the doctor’s mind. You may have to look for an alternative provider. But at least you can be direct about your feelings, your wants, your needs, and your expectations.

[Penny Williams]

I think you’ve already done all you can and it’s now time to find a new doctor. You can’t change someone who is not willing to change.

Penny
ADDitude Community Moderator, Parenting ADHD Coach & Author, Mom to teen w/ ADHD, LDs, and autism

[AdeleS546]

I agree with Penny. As frustrating as it is to have to find a new provider, she is giving you no other option. I switched primary care physician after 20 years. I had some serious health concerns, and she did not take me seriously.

[The Cat Lady]

Ok. Thank you for your feedback. I just wish there was some way I could hold her accountable for basically keeping me strung out and dys-functional for over a year.

[Author]

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