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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by StellaMella on October 13, 2012, at 10:30:26
I'm starting my search for my new PDOC... I've already posted about that (she moved). I have two interviews scheduled
I have an appt at the same clinic she was at with someone i've never heard of. Have no idea if its even of good fit, but it is a research hospital. I think the culture there is a little benzophobic which I'm darn tired of dealing with. However, its consistent and I know the system there.
I also have another appt scheduled with a private practice pdoc. He came recommended by a therapist i used to see. he knows my meds and said he is comfortable prescribing them. He doesn't take any insurance and you deal with him directly on all things. I would pay out of pocket, but it's not too horrible.
I've never done private practice before and it makes me nervous. Where is the support network if something happens? I've been stable for a good number of years, but ya know... There's always that "what if" in the back of my mind. It seems like w/private practice there is TOO MUCH leeway, and you could really find yourself out in the cold if they just close down or decide to fire you as a patient. Seems like they "cherry pick" their patients.
I have OCD, GAD, PD. Take Namenda 20 MG and Klonopin 1mg
Thoughts????
Posted by herpills on October 13, 2012, at 11:38:37
In reply to Med Management - Private practice or clinic?, posted by StellaMella on October 13, 2012, at 10:30:26
Could you talk to the new doctor at the clinic, find out if they have any problems continuing with the meds you are already on? If they don't, maybe the clinic is the better choice since as you said there is some security there. Otherwise I would say private is a good choice too if you can afford it. Your doctor would not have any prescribing restrictions really. I prefer private practice, but I can't afford that right now. There are advantages to a clinic, for example I meet with a nurse first, check my vitals and talk to them for a minute before seeing the doctor. I was glad to have this as for awhile did not even have a primary care doctor. It sounds like you're being thoughtful about your choice and I'm sure whatever you choose will work out! Good luck! herpills
Posted by Christ_empowered on October 13, 2012, at 12:20:26
In reply to Re: Med Management - Private practice or clinic? » StellaMella, posted by herpills on October 13, 2012, at 11:38:37
It surprises me that 1mg Klonopin is that big a deal. Maybe its a location issue, as well as the subculture within the type of practice (clinic versus cash only private practice) ?Around here, docs vary in benzo usage. Older docs, particularly female ones..its not a big deal. My experience has been that as long as you keep it at or below 2mgs/day Klonopin or equivalent (but everybody and their Mama seems to take Klonopin, anyway), not a big problem. That's why I'm curious as to why getting a Klonopin and dopamine agonist prescribed is such a big deal where you live. OCD in particular sometimes responds well to benzos, especially with other stuff in the mix...I had a friend who lived around here on 4mgs/day Klonopin for severe OCD.
Anyway, back to you: I think herpills is right on. Call the clinic, speak to somebody, see if maybe you can get a feel for their prescribing culture. Weird thing is, the same docs who might hesitate to give a reasonable benzo dose to an adult who just wants to function in society probably wouldn't think twice about an amphetamine for a kid or teenager. Strange world, huh?
Good luck.
Posted by StellaMella on October 13, 2012, at 18:23:57
In reply to Re: Med Management - Private practice or clinic?, posted by Christ_empowered on October 13, 2012, at 12:20:26
It's the upper midwest... Conservative, even in the metropolitan areas. I think it's the daily usage of the klonopin that freaks some pdocs out. I know 1 mg is a small daily dose. I take it ONLY as prescribed, never misuse it, and i've never escalated in dose. The crap just works for me. What can I say??? It's fr*gg*ng frustrating. I already hate that I need meds to function like a normal person.... To worry whether or not I will be able to get them makes it even more infuriating.
Posted by phillipa on October 13, 2012, at 20:43:44
In reply to Re: Med Management - Private practice or clinic? » Christ_empowered, posted by StellaMella on October 13, 2012, at 18:23:57
Seriously I'm almost envious of you that you can afford private practice. Here the very best of best go the cash only Practice. I know one here that left a group and went on own and he has no room for others this guy is great. And in private you will not have problems with a doc trying to change what works for you. I almost get passionate about this. This is NC and good pdocs are very hard to find. It's that you are stable that makes it so easy for the doc also. Phillipa
Posted by phillipa on October 13, 2012, at 20:45:50
In reply to Re: Med Management - Private practice or clinic? » Christ_empowered, posted by StellaMella on October 13, 2012, at 18:23:57
As example google Scott Lure or Lurie in Charlotte NC. He's private cash only. I will check. Phillipa
Posted by Christ_empowered on October 13, 2012, at 20:50:23
In reply to Re: Med Management - Private practice or clinic?, posted by phillipa on October 13, 2012, at 20:45:50
...how ridiculous it is that shrinks are the gate keepers to drugs? And how where you are, who you are, how much money you have, and who your doc happens to be all affect your standard of care?
Just seems to me that in certain medical fields--psychiatry and pain management come to mind--there's a whole lot of total BS going on. Maybe always has been.
Posted by StellaMella on October 14, 2012, at 4:50:55
In reply to ever stop to wonder..., posted by Christ_empowered on October 13, 2012, at 20:50:23
t's so sad. i'm lucky that i'm making an okay wage and have a flex account and stuff. this private practice i'm looking at isn't too bad, and i've paid out of pocket before when i was in college and my insurance was a joke. i've been doing some research online and each have drawbacks. i don't want to go to a private practice doctor just cause he or she will never say no to me.... i want someone who is going to treat me and do what is in my best interest clinically.
here's what it seems so far.... hospital doctors are more interested in their research and less in you as a patient. you're an afterthought... something they have to do as part of their job. clinic and community docs see sooooooo many patients that it's unreal. they're overloaded and micromanaged. private practice docs seem to be a favorable choice in terms of collaboration and taking time with you... but you WILL pay for it. which evil do you choose to get the best care possible? what about those who don't have a choice? it is unfair and wrong...
Posted by jono_in_adelaide on October 15, 2012, at 0:47:55
In reply to Re: ever stop to wonder..., posted by StellaMella on October 14, 2012, at 4:50:55
Are public practice doctors prevented from prescribing benzos in the US?
This seems exceptionaly strange, given thier utility in anxiety disorders - there realy isnt a substitute for them
Posted by StellaMella on October 15, 2012, at 18:53:46
In reply to Re: ever stop to wonder..., posted by jono_in_adelaide on October 15, 2012, at 0:47:55
No, they can prescribe them. it depends on the culture of the clinic though. many tend to be extremely cautious and just assume everyone is abusing. i've never abused my prescription EVER and yet I still feel like a criminal addict sometimes. i'm even afraid to ask questions about the amount of refills and stuff, because i'm afraid it will look like i'm "drug seeking." The meds that treat my anxiety GIVE me anxiety. it's BS. i don't doubt its a problem, but jeez. where are you jono? they dont have the same problems where you are?
Posted by jono_in_adelaide on October 15, 2012, at 22:30:47
In reply to Re: ever stop to wonder... » jono_in_adelaide, posted by StellaMella on October 15, 2012, at 18:53:46
I'm in Australia - GP's/PCP's have benzophobia here, but most psychiatrists are a lot more relaxed provided you arnt stupid (ie, stick to the prescribed dose, dont try and escelate the dose, dont run out early etc)
That might be because psychiatrists here will only see people with a referal from a PCP, so they are screened somewhat from pill seekers?
Posted by Christ_empowered on October 16, 2012, at 15:36:43
In reply to Re: ever stop to wonder... » jono_in_adelaide, posted by StellaMella on October 15, 2012, at 18:53:46
I've never been given a controlled rx from a public health doc here. I assumed they were off limits. Maybe I'm wrong (southeastern US here) ?
Posted by herpills on October 20, 2012, at 21:46:33
In reply to Re: ever stop to wonder..., posted by Christ_empowered on October 16, 2012, at 15:36:43
> I've never been given a controlled rx from a public health doc here. I assumed they were off limits. Maybe I'm wrong (southeastern US here) ?
I imagine it varies by state, or even county? I get benzos from a community clinic in the midwest. But I was already prescribed them by another doctor when I was admitted into this clinic, so that certainly helped I guess. I'm sure if I had not been on any meds and said I was anxious I would have been given Buspar or Vistaril before a benzo. This clinic also treats substance abuse. I have a feeling they probably do not prescribe stimulants as that seems to be a problem around here... herpills
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