Posted by Racer on November 5, 2007, at 18:08:35
In reply to Problem: Old Doc thinks new Doc is WRONG?!, posted by sometimesblue on November 5, 2007, at 13:08:27
Obviously, I don't know what's going on here, but here are a few things I wonder about after reading your post:
>
> So my old doc calls me back and says the NP really shouldn't be prescribing something for ADD and that i should see a psychiatrist.In a perfect world, that's absolutely correct. Psychopharmacology is a specialty, and most nurse practitioners probably don't have much training in it. In the real world, of course, insurance coverage counts. Personally, I hate it when reality interferes with a perfectly good theory.
> So I asked her to call my ins. co. and ask them if with a referral i can see a pdoc.
EXCELLENT plan. On our insurance plan, doctors can get pre-authorization for certain treatments which would not otherwise be covered. Good luck with that.
>
> But here's the part that p**ses me off...she said it like this: "you know, we've been messing around with your drugs for sometime now, you compalined about this and that, what makes you think it's ADD now?"Here's a reality check: ADD is often treated with highly abusable drugs, and that means that a fair number of people would very much like to be diagnosed with it for that very reason. ADD = psychostimulant = drug seekers. That obviously isn't true in all cases, but it happens often enough that many doctors will be understandably skeptical of anyone who makes a self-diagnosis of ADD.
> And the last time i went to see her because the AD wasn't working she came in and said "are you messing with your drugs again"...which is why i decided to start seeing the nurse practioner in the first place.
It sounds as though you and this doctor may have a history which is influencing this exchange. I don't know what sort of "messing with your drugs again" this doctor is referring to, but that sort of thing isn't great for building a good relationship with a doctor. That relationship is a two way street, we have to work at it as much as the doctors do -- and since a good relationship is more to our benefit than the doctor's, it's probably wise for us to work a bit harder than perhaps seems fair to us.
Part of our responsibility in building a good relationship with a doctor is discussing changes in medication with the doctor. Obviously, ask questions, and don't necessarily believe everything you hear -- but remember that the doctor has something we don't: a context for the information involved. No matter how much any of us reads online about medications and conditions, we don't have the full context for the information. That context is what medical school provides, an understanding of the interrelated systems of the body.
If you can't form a working relationship with this doctor, it's probably worth finding another with whom you can. But I do hope what I've said has been of some help to you in your future relationship with your next doctor.
poster:Racer
thread:793438
URL: http://www.dr-bob.org/babble/20071104/msgs/793470.html