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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 44. Go back in thread:
Posted by ed_uk on January 25, 2006, at 12:52:11
In reply to Re: Psychiatrists who don't have time to talk, posted by TylerJ on January 25, 2006, at 11:07:37
> I usually get 7-10 minutes, but he still gets paid for a full 15 mins.
That doesn't seem right. He doesn't sound too bad though.
Ed
Posted by ed_uk on January 25, 2006, at 12:54:12
In reply to Around here, they use sheep entrails » ed_uk, posted by Racer on January 25, 2006, at 12:02:04
Hi Racie
Bad therapy can be worse than no therapy at all.
I hope Buspar starts to work.
Ed xx
Posted by shasling on January 25, 2006, at 14:09:20
In reply to Psychiatrists who don't have time to talk, posted by ed_uk on January 25, 2006, at 9:55:44
I wasn't looking for this, just opened my home page MSNBC and there it was.
By Ceci Connolly
Washington Post
Updated: 5:09 a.m. ET Jan. 25, 2006
Declaring that the pervasive influence of drug industry money is distorting doctors' treatment decisions and scientific findings, a prestigious panel of medical experts called on their colleagues yesterday to adopt far-reaching new conflict-of-interest policies.
In an article in the Journal of the American Medical Association, the group said that voluntary efforts to limit corporate inducements have failed, resulting in the overprescribing of some medications and the withholding of negative discoveries about others. Highly publicized cases involving the anti-inflammatory drug Vioxx, antidepressants for children and spinal implants made by Medtronic -- all occurring while voluntary guidelines were in place -- highlight the need for stricter measures, they said......Spokesmen for the pharmaceutical industry said the extra steps are unnecessary and could deprive physicians of valuable information...
...'The problem has gotten worse and worse'
From their first rounds as residents, doctors travel in a world increasingly dominated by drug company salespeople proffering meals, office supplies, entertainment and even cash to speak at conferences or sit on advisory boards.
Some physicians have been paid lucrative consulting retainers for no specific work; others are paid to put their names on articles ghostwritten by industry employees. One congressional inquiry cited in the report found that pharmaceutical executives steer research grants to doctors and schools that promote their firms' drugs."The problem has gotten worse and worse and worse," Cohen said. The relationships can prompt doctors to order unnecessary tests, prescribe more expensive medicines or advocate adding certain medications to a hospital's list of preferred drugs, he said.
Although most doctors say their relationships with drugmakers do not affect medical decisions, numerous studies suggest otherwise.
"There is solid evidence it isn't the size of the gift, it's the gifting itself that creates a sense of loyalty and indebtedness," said Sharon Levine, associate executive director of Kaiser Permanente's Northern California group practice. The 6,000-doctor practice and the Yale University School of Medicine are among the only institutions in the nation to implement policies similar to those outlined in JAMA.
"The industry is spending $13 billion per year on direct-to-physician promotion," she continued. "That wouldn't be happening if it weren't resulting in changing patterns of utilization. It doesn't necessarily mean patients are getting bad care, but it does mean their influence is out there."
We are perhaps not paranoid or cynical.Suzie
Posted by john berk on January 25, 2006, at 14:18:12
In reply to Re: Around here, they use sheep entrails » Racer, posted by ed_uk on January 25, 2006, at 12:54:12
Hi Ed,
i second that, bad therapy will do much more damage than none, i just got back from my 15 minutes of {fame?]with my pdoc, she told me she cannot see me anymore unless i use a therapist in her network, lol, i think i may spend extra time on the alternative board these days.
i asked her about campral, and she said "why give yourself more side-effects", translated,- "i haven't the foggiest", lol!!
take care...john
Posted by willyee on January 25, 2006, at 14:25:11
In reply to Psychiatrists who don't have time to talk, posted by ed_uk on January 25, 2006, at 9:55:44
I agree sooo much,also personaly i feel like when in some cases they DO address an issue they huff and puf and act as if they are doing u a favor,BUT let tha bill go unpaid and well,you know
Posted by willyee on January 25, 2006, at 14:32:04
In reply to Psychiatrists who don't have time to talk, posted by ed_uk on January 25, 2006, at 9:55:44
Oh and then,were told NOT TO DO ANYTHING WITHOUT OUR P-DOC INVOVLED,so i guess were complete iddiots,either that are they are scare we might actualy learn more info is out there than the PDR .
I do like my p-doc but i refuse to be at her mercy for something as serious as my mind,im fighting for my life here and having a 10 min med talk is simply not enough when they so many other resources,this one being one of the best,available to me.
Many time i qouted facts from this board to my p-doc on new meds etc,and she looked at as clueless
as child being asked the meaning of life.
Posted by john berk on January 25, 2006, at 14:34:52
In reply to Re: Psychiatrists who don't have time to talk, posted by willyee on January 25, 2006, at 14:25:11
Hey, right on willyee,
today was the first time my pdoc smiled, she has pissed me off so many times when i inquire about new meds, she tells me i should stay off the computer, lol!! they really do act as though they are doing you a favor, it was no problem though for her to raise my fee today by $50.00.
i guess my health is entirely her business, in more ways than one!! take care..john
Posted by linkadge on January 25, 2006, at 14:53:53
In reply to Psychiatrists who don't have time to talk, posted by ed_uk on January 25, 2006, at 9:55:44
My doc had an initial 1/2 appontment, and the subsequent, 3 minaute 35 second appointments, therafter.
Linkadge
Posted by ed_uk on January 25, 2006, at 15:00:27
In reply to Re: Around here, they use sheep entrails » ed_uk, posted by john berk on January 25, 2006, at 14:18:12
Hi John
Campral can be helpful to maintain abstinence. Are you interested in trying it?
Ed
Posted by ed_uk on January 25, 2006, at 15:03:33
In reply to Re: Psychiatrists who don't have time to talk, posted by willyee on January 25, 2006, at 14:32:04
Hi Willy
>NOT TO DO ANYTHING WITHOUT OUR P-DOC INVOVLED
The last pdoc I saw treated me like an idiot. I didn't see him again. I didn't appreciate being treated like a naughty school boy!
Ed
Posted by ed_uk on January 25, 2006, at 15:05:23
In reply to Re: Psychiatrists who don't have time to talk, posted by linkadge on January 25, 2006, at 14:53:53
Hi Link :)
>3 minaute 35 second appointments
I assume he was knowledgeable about your progress after such appointments?
Ed
Posted by ed_uk on January 25, 2006, at 15:09:34
In reply to Re: Psychiatrists who don't have time to talk » willyee, posted by john berk on January 25, 2006, at 14:34:52
Hi :)
>she tells me i should stay off the computer
Ironically, many pdocs could learn a lot on the computer. You can learn a lot here. Go Dr. Bob!
Ed
Posted by shasling on January 25, 2006, at 15:12:30
In reply to Re: Psychiatrists who don't have time to talk » john berk, posted by ed_uk on January 25, 2006, at 15:09:34
They should all be required to spend an hour here a week. Not only learn of meds, but just maybe learn to understand and appreciate the true depth our experiences. Cause they certainly don't get it now.
Posted by ed_uk on January 25, 2006, at 15:18:53
In reply to Re: Psychiatrists who don't have time to talk » ed_uk, posted by shasling on January 25, 2006, at 15:12:30
We could call it Bobducation
Ed
Posted by shasling on January 25, 2006, at 16:22:14
In reply to Re: Psychiatrists who don't have time to talk » shasling, posted by ed_uk on January 25, 2006, at 15:18:53
Posted by john berk on January 25, 2006, at 16:32:32
In reply to Re: Psychiatrists who don't have time to talk » shasling, posted by ed_uk on January 25, 2006, at 15:18:53
Hi Ed, my pdoc would be lost at "Bobduction," she wouldn't understand the "technical jargon", lol!!
but great idea!! As for campral, i am on it now, works well, but i got it from my primary care doc, i guess i will have to get him to prescribe it again, another not so small fee...john
Posted by ed_uk on January 25, 2006, at 16:44:46
In reply to Re: Psychiatrists who don't have time to talk » ed_uk, posted by john berk on January 25, 2006, at 16:32:32
Doctors and prescriptions are too expensive!
Posted by Phillipa on January 25, 2006, at 18:08:13
In reply to Re: Psychiatrists who don't have time to talk » john berk, posted by ed_uk on January 25, 2006, at 16:44:46
Ed, I guess I'm not alone!!!! But to pay for the full 30minutes and only get l0? Love PJ O ps please become a pdoc!
Posted by Phillipa on January 25, 2006, at 18:09:58
In reply to Re: Psychiatrists who don't have time to talk » john berk, posted by ed_uk on January 25, 2006, at 16:44:46
About six years ago it wasn't like this the pdoc did some theraphy too. It worked out better that way but mine said he was sick of theraphy so he hired therapists to do his job. Fondly Phillipa
Posted by willyee on January 25, 2006, at 21:16:44
In reply to Re: Psychiatrists who don't have time to talk » willyee, posted by john berk on January 25, 2006, at 14:34:52
> Hey, right on willyee,
> today was the first time my pdoc smiled, she has pissed me off so many times when i inquire about new meds, she tells me i should stay off the computer, lol!! they really do act as though they are doing you a favor, it was no problem though for her to raise my fee today by $50.00.
> i guess my health is entirely her business, in more ways than one!! take care..johnLol mine is ALWAYS running late,and tells me as we head to her office.This may sound like a joke,or may sound very sorry,but i leteraly ppepare for a visit,how to apporach my words,in fact in bad situations ive brought famly members which does seem to help.
I too got the dont go on the internet jive,i should tell her ill stop when u dont talk to sales people no more and get ur info from them!.
All in all ive been through many docs,and although my current has theses same issues,i finaly believe she does care about my health,she told me flat out that if i asked for something she felt comfotable to give it,unless she had reason not.She said shed never prescribe parnate,she trusts me and i usualy get what i ask for after some huffing and puffing.
But its only because imexperianced in this mess,i could imagine the way she handles a new patient.But like i said,when she found out i had taken a turn for the worse,and was waiting on insurance,she took it upon herself to open her closet and give NUMEROUS samples of klonopin wafers.
Also after saying no to xyrem,my anger was subsided as she hand me a brown paper bag filled to the rim with rezarem.Lol one time she handed me the white paper and said i dont usualy give this out but i know u will read it.
Lol.
Here are some tips if u are desperatly seeking a doctor to take more time with you,they are not fool proof but at times they work......
1. Bring a relavitive or friend with you,you might be in a vulernable spot being sick and kinda let yourself get bullied,sometimes the mere presence of a family memeber listening will prevent the p doc from trying to pver power you.2. Try to have in order what u need or problems are,you know they are fast,so try to cordinate what you will say,even practice.
3. No matter how muc u want to,save the attitude for when it just simply is over,let them have there attitude,just and this is important keep hopping,they cut u off politly cut them off,be polite but persisent,every time they think there done present ur case again.
Last not least,this is for more veterans.....if you have found a p-doc that you find suitable,wehtehr ur 100 percent happy,or 50 here are some things that have helped me built trust.
If a medication is working,call and leave a message,tell them u just wanted to keep them updated.
If a medication was risky,definatly do this.Bring back samples if a medication dont work.
LAST,DO NOT EVER EVER CALL IN EARLY DUE TO A BENZO BEING USED UP.
If this is the case,do whatever you can to wait to your appt,explain how helpful the benzo is,and ask if you can have the dose highed.
These are just my tips,from personal dealings over 9 years,very doc and situation is different.
P.S Still looking for anyone in the 757 area code,would enjoy having someone to meet and know going through the same stuff.
Posted by shasling on January 25, 2006, at 22:07:17
In reply to Re: Psychiatrists who don't have time to talk, posted by willyee on January 25, 2006, at 21:16:44
Willyee,
Two things:> I too got the dont go on the internet jive,i should tell her ill stop when u dont talk to sales people no more and get ur info from them!.
>
---HAH! really did make me laugh out loud. Thanks for that. This whole thread has been repeatedly very amusing, you guys are killing me.>>
> 1. Bring a relavitive or friend with you,you might be in a vulernable spot being sick and kinda let yourself get bullied,sometimes the mere presence of a family memeber listening will prevent the p doc from trying to pver power you.--This is genius. We shouldn' have to do things like this to get treated with any dignity from them, but I'm betting this works wonders. Would never have thought of it.
Thanks for all the tips. You definitely sound like you've been with them long enough to have them all figured out. Unfortunately.
If I were in 757, you totally sound like someone I'd like to meet. You make me laugh sometimes.
Posted by 4WD on January 25, 2006, at 22:21:35
In reply to Psychiatrists who don't have time to talk, posted by ed_uk on January 25, 2006, at 9:55:44
> Am I missing something here? I was always under the impression that psychiatrists were supposed to TALK to their patients. I keep hearing of 'meds only' psychiatrists who apparantly perform 10 minute 'med checks'. Would someone please tell me how a psychiatrist is supposed to choose an appropriate medication if they haven't even talked to their patient for long enough to understand what their problem is?
>
> Ed
>I think my old pdoc had a list of meds. (Seriously). He'd start at the top and go down the list. But first we'd have to try various doses of the first one and then next visit, try adding an augmentation to it, then next visit try a different dose of one or the other (the med or the augmenter) and then next vist, switch to a different augmenter and so on and so on.
I got the distinct feeling that the whole process was simply designed to keep me coming back for those $160 med checks as long as possible. He was perfectly happy to have the process last as long as possible. Never mind that I'd go in for a vist, he'd make a minute change and consign me to another month of hell. He'd never change two things at once (he said it would be too hard to tell which was causing the effects). Finally after almost a year I gave up on him.
Marsha
Posted by shasling on January 25, 2006, at 22:36:14
In reply to Re: Psychiatrists who don't have time to talk » ed_uk, posted by 4WD on January 25, 2006, at 22:21:35
> I think my old pdoc had a list of meds. (Seriously). He'd start at the top and go down the list. But first we'd have to try various doses of the first one and then next visit, try adding an augmentation to it, then next visit try a different dose of one or the other (the med or the augmenter) and then next vist, switch to a different augmenter and so on and so on.
>
> I got the distinct feeling that the whole process was simply designed to keep me coming back for those $160 med checks as long as possible. He was perfectly happy to have the process last as long as possible. Never mind that I'd go in for a vist, he'd make a minute change and consign me to another month of hell. He'd never change two things at once (he said it would be too hard to tell which was causing the effects). Finally after almost a year I gave up on him.
>
> Marsha
>-- aaghgg. Thats so aggravating. How much of that kind of docting can be taken care of over the phone??? Like 100%?
Another thought: Last doc I had I went in with all the ideas, and I'm thankful she'd give me just about anything I'd ask for (NOT the MAOI, don't even ask!), but why was I paying her? For the last two years I was doing ALL the thinking. Can't say it isn't going to be a little bit sweet to go back and tell her the MAOI was the one that worked...
Posted by Dr. Bob on January 26, 2006, at 0:23:02
In reply to Re: Psychiatrists who don't have time to talk » ed_uk, posted by shasling on January 25, 2006, at 15:12:30
> They should all be required to spend an hour here a week. Not only learn of meds, but just maybe learn to understand and appreciate the true depth our experiences. Cause they certainly don't get it now.
It's not an hour a week, just 90 minutes once, but maybe that's better than nothing? :-)
Everyone here is invited to a workshop at the next annual meeting of the American Psychiatric Association, in Toronto in May:
http://psych.org/edu/ann_mtgs/am/06
The idea is for members of this group to teach the psychiatrists who attend about their experiences with this type of resource:
http://www.dr-bob.org/babble/psycho/20050901/msgs/550329.html
And that weekend will be our birthday party:
http://www.dr-bob.org/babble/admin/20060111/msgs/601949.html
To consolidate discussion, I'd like to ask that follow-ups regarding the workshop be posted to the earlier thread and those regarding the party to the latter. Thanks,
Bob
Posted by yxibow on January 26, 2006, at 12:42:52
In reply to Psychiatrists who don't have time to talk, posted by ed_uk on January 25, 2006, at 9:55:44
> Am I missing something here? I was always under the impression that psychiatrists were supposed to TALK to their patients. I keep hearing of 'meds only' psychiatrists who apparantly perform 10 minute 'med checks'. Would someone please tell me how a psychiatrist is supposed to choose an appropriate medication if they haven't even talked to their patient for long enough to understand what their problem is?
>
> EdMy psychiatrist is both a "meds only" psychopharmacologist for some patients in clinical practice, and a prescribing psychiatrist/psychologist for a few patients like myself. I'm lucky I can get that combination because my current illness knows no bounds.
But when I had prior dysthymia and various low grade diagnosis, they would be the standard 2 week or one month visits. This has been my experience throughout my life. So I can definately sympathise with those who feel left out in the dark. I would encourage to be as proactive as possible, write down everything you feel in the 2 weeks, one month, whatever, and present it at the session and use the time as valuably as possible. Its become compartmentalized -- you could blame the psychiatrist, or you could look towards one's HMO which is probably where it all started.
And a psychologist's hour is 45 minutes :/
Some are 50 :) Though that "hour" is no different from other billable services like my gym trainer -- 50 minutes. And lawyers, etc...
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Dr. Bob is Robert Hsiung, MD,
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