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Dr. Bob is Robert Hsiung, MD,
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Posted by saturn on June 23, 2007, at 15:34:41
I'm curious if anyone has thoughts about or experience with expensive psychiatrists. Several hundred dollar initial consultation, cash only, but good reputation and credentials.
My suspicion is that you may largely paying for fluff. Or might such docs who may give you more time and attention actually have better outcomes? I'm talking strictly pscyhopharm, not therapy.
Thanks...Peace...Saturn.
Posted by Phillipa on June 23, 2007, at 15:40:54
In reply to Expensive docs, posted by saturn on June 23, 2007, at 15:34:41
Saturn I think I'd trust those with insurance more as the insurance companies have to approve their credentials. Interesting topic. Love Phillipa
Posted by Squiggles on June 23, 2007, at 15:43:52
In reply to Expensive docs, posted by saturn on June 23, 2007, at 15:34:41
IMHO, the only reason i can see for
justifying high costs, is overhead
and equipment--if the psychiatrist has
to run a private office. As for counsellors,
they have little overhead if they use their
home, and i have heard of some with a Masters
degree in Social Work, charging more than a physician.I think that if you want a "cheap" psychiatrist
you should use the hospitals, government agencies, and public clinics. They are just
as good and have access to medical colleagues and
specialists, if required, such as endocrinology.Squiggles
Posted by Racer on June 23, 2007, at 18:59:56
In reply to Re: Expensive docs » saturn, posted by Squiggles on June 23, 2007, at 15:43:52
My current pdoc is one of those expensive psychopharmocologists, and I think he is worth it. The inital consult was about $700, but has gone up now. That was two and a half hours, because we went over, and then I had to come back again because we still didn't cover everything.
Now follow ups are $250, we pay and then submit the receipt to our insurance. It's expensive, but considering my previous experiences with pdocs, I consider it to be a bargain.
He is well thought of, specializes in both TRD and reproductive issues, and has a good relationship with our marriage counselor, so there's some communication that can go on which I find reassuring. (I'm the first pt he's shared with my individual T, but she gets a report after every appointment, so if something looked wrong to her, I'm sure she'd communicate with him.)
Then again, a former Pdoc was also quite expensive, quite well regarded -- and I think I spent far too long continuing with him, and wish I had trusted my gut when it started to say, "LEAVE!"
So, I guess my answer is a resounding "it depends..." ;-)
Posted by missjulie on June 23, 2007, at 20:17:32
In reply to Expensive docs, posted by saturn on June 23, 2007, at 15:34:41
Just went to one in Beverly Hills a couple weeks ago. $400 initial hour visit; $200 followups, doesn't deal with insurance besides providing receipt.
Could not tell the slightest difference between him and the many others I've seen. He said very little. WAS willing to prescribe Parnate which no one else had been, so mission accomplished, I guess.
This BH dr. came highly recommended by a friend who is really all over the map bipolar but I can't say I noticed ANY difference. (the best "psychopharm" I ever had was my gp as a teenager. He was the only one who communicated any caring, willingness to keep trying, encouragement, out of the box thinking, and this was the 80s, before they had many drugs - he was depressed too, so he understood)
I saw this bev hills guy as a last resort before traveling to NY to see Dr. Ivan Goldberg, as he deals with my problem (TR depression) or even the Amen clinic (not convinced brain scans really help, but I find some of the information in his books valuable, and some people swear by them). Think I will end up seeing one or the other or both... I DO still believe in specialists.
Posted by rvanson on June 23, 2007, at 20:46:14
In reply to Expensive docs, posted by saturn on June 23, 2007, at 15:34:41
> I'm curious if anyone has thoughts about or experience with expensive psychiatrists. Several hundred dollar initial consultation, cash only, but good reputation and credentials.
>
> My suspicion is that you may largely paying for fluff. Or might such docs who may give you more time and attention actually have better outcomes? I'm talking strictly pscyhopharm, not therapy.
>
> Thanks...Peace...Saturn.
There are good Pdocs and bad ones and it matters little which one, unless you go to county/public Pdocs.They tend to be very conservative about time spent and most are benzo-phobic
and havent a clue about TRD , but then neither do most Pdocs.Its a toss of the coin, really.
Posted by med_empowered on June 23, 2007, at 21:30:51
In reply to Re: Expensive docs, posted by rvanson on June 23, 2007, at 20:46:14
I think I had good experiences with a college shrink. I mean, some of his prescribing was...odd, but he had a goal: to keep students functioning. Shrinks I saw after then were kind of..just medicating; they saw symptoms, I suppose, but they didn't really see the POINT, which is that patients have things to do and drugs need to help make pulling everything together a little less difficult.
From what I've seen and read, it just seems like super-expensive docs are more willing to go for benzos and stimulants and maybe other off-label stuff (like opiates for depression), and they're probably more responsive to patient's problems. Other than that...I don't see how paying more can really give you more, since shirnks don't do much more than write srips.
Posted by Jenn_SD on June 24, 2007, at 20:33:55
In reply to Re: Expensive docs, posted by med_empowered on June 23, 2007, at 21:30:51
Wow, I guess I'm lucky. I have Blue Cross and my Pdoc only charges me my co-pay. $20/visit and she is the best!
Posted by stargazer2 on June 25, 2007, at 9:38:15
In reply to Re: Expensive docs, posted by Jenn_SD on June 24, 2007, at 20:33:55
Many really good pdocs have dropped out of the insurance arena due to low reimbutrsement rates and only take patients who pay out of pocket and I am told do very well with rich patints that can
afford this and do not want a record of a psych disorder leaving a trail on their medical history.I'm currently on Cobra for another 6 months or so at $615/month with a $30 copay, but i've been told by an insurance person I will not qualify for personal health care when Cobra runs out unless my psych history stablizes and I get the weekly visits down to every few months or so. I've been trying to do this but for the first time in my life not succeeding in doing this.
Perhaps at some point I will need to start paying for my visits out of pocket and show that my depression has stabalized as my medical history will not reflect any visit I pay for out of pocket although I suppose they can request any medical records from my doctor. I wonder if the records I pay for out of pocket can be obtained from the insurance underwriters or only those visits that I submitted to my insurance company.
My goal is to get well enough to work again and get insurance through work, which is th eonly way to get coverage for psych in a group policy, although many part time jobs will not even provide health insurance today. It's a real mess and I live in fear of having to pay for my health care out of pocket if no one will insure me because of my long and protracted psych history.
I only see my pdoc for 15 minutes and his chanrge is $90, which works out to $360/hr. MOst times 15 minutes is enough since I talk fast and cut to the chase unless there are BIG roadblocks, like being suicidal or really hopeless, which has kind of gone away for awhile, since being on Emsam and now Nardil.
Stargazer
Posted by Princess777Vegas on June 25, 2007, at 23:36:03
In reply to Expensive docs, posted by saturn on June 23, 2007, at 15:34:41
LOL.. I am looking for a new doctor.. not a psychiatrist but a psychologist as my previous therapist moved almost a year ago and I've been to busy to find a new one..
I found someone online and he seemed to be great (from his Web site). Well, I talked to them today and he charges $225 a session (every time!!) and takes no insurance.
I said "NO THANK YOU" !!!
Ridiculous!!> I'm curious if anyone has thoughts about or experience with expensive psychiatrists. Several hundred dollar initial consultation, cash only, but good reputation and credentials.
>
> My suspicion is that you may largely paying for fluff. Or might such docs who may give you more time and attention actually have better outcomes? I'm talking strictly pscyhopharm, not therapy.
>
> Thanks...Peace...Saturn.
Posted by Cecilia on July 2, 2007, at 16:21:08
In reply to Re: Expensive docs, posted by Princess777Vegas on June 25, 2007, at 23:36:03
I read recently that pdocs get more money from pharmaceutical companies than any other specialty. Cecilia
This is the end of the thread.
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