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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Deneb on September 26, 2005, at 17:46:41
OK, I did some snooping about and I found out when my p-docs graduated from medical school and for how long they had been practicing psychiatry for.
It turns out that the p-doc who is on maternity leave has been practising psychiatry for approx. 7 years whereas this new guy I'm seeing has been practising for...get this, approx. 24 years! Yikes...that's longer than I've been on this Earth.
OK, obviously I haven't seen enough p-docs to generalize the difference between old and young ones, but so far I've discovered that my younger p-doc is much more into the psychotherapy stuff and this new guy is much more trigger happy with the prescription pad.
Is this consistent with how psychiatry has evolved throughout the ages?
What other things should I expect from an older pdoc? Wow, 24 years seems like forever to me!
Deneb
Posted by rainbowbrite on September 26, 2005, at 20:03:53
In reply to Differences between young p-docs and old p-docs, posted by Deneb on September 26, 2005, at 17:46:41
He has 17 years more experience than the other one. I would look at this as a good thing. I don't think it is necessarily an age thing but a personal preference with meds versus therapy.
Posted by Emily Elizabeth on September 26, 2005, at 20:35:24
In reply to Differences between young p-docs and old p-docs, posted by Deneb on September 26, 2005, at 17:46:41
Actually, I'd say that the opposite is probably true: b/c pdocs are so overworked today they are primarily focused on meds, and leave psychotherapy to psychologists, counselors, and social workers. In the past psychotherapy was considered a more integral part of psychiatry.
Old pdocs and young ones have different advantages and disadvantages. It sounds like the experience levels of the ones you mention are both in a good range. Not so young that she wouldn't know what's up and not so old that he'd be out of the loop.
It's always a leap of faith though. Hope all is well.
Best,
EE> OK, I did some snooping about and I found out when my p-docs graduated from medical school and for how long they had been practicing psychiatry for.
>
> It turns out that the p-doc who is on maternity leave has been practising psychiatry for approx. 7 years whereas this new guy I'm seeing has been practising for...get this, approx. 24 years! Yikes...that's longer than I've been on this Earth.
>
> OK, obviously I haven't seen enough p-docs to generalize the difference between old and young ones, but so far I've discovered that my younger p-doc is much more into the psychotherapy stuff and this new guy is much more trigger happy with the prescription pad.
>
> Is this consistent with how psychiatry has evolved throughout the ages?
>
> What other things should I expect from an older pdoc? Wow, 24 years seems like forever to me!
>
> Deneb
Posted by JenStar on September 26, 2005, at 20:43:49
In reply to Differences between young p-docs and old p-docs, posted by Deneb on September 26, 2005, at 17:46:41
hi Deneb,
I wouldn't call it snooping...you have a right to know those things! But in general, I'm not sure that the trend these days is to LESS medication. I think there are MORE meds available now, and they are quite frequently prescribed. In fact, some researchers say that quite a large percentage of the population is on some kind of mood-altering medication! In the "old" days I think Freudian-style psychotherapy was the "in" thing.Of course there are also many more branches of therapy these days, different techniques, etc. It may just be personal preference on the doctor's part on whether to prescribe meds, talk therapy, or both.
But the more experienced doctor might have seen more patients respond positively to this drug b/c he's been in practice so long. Do you trust him?
JenStar
Posted by Sarah T. on September 26, 2005, at 21:03:54
In reply to Differences between young p-docs and old p-docs, posted by Deneb on September 26, 2005, at 17:46:41
Hi Deneb,
It is not "snooping" to research where your doctors were educated or how long they've been practicing medicine. I think that's vital information that patients should know. It's important to be an educated consumer. Both my talk therapist and my psychopharmcologist write and publish extensively in medical journals, and I like to read what they've written. I wouldn't have known how prolific they are if I hadn't "done my homework" (i.e., if I hadn't "Googled" them and "PubMedded" them).
I tend to prefer doctors that are a bit older and have been practicing longer because there's no substitute for experience; however, overall, I think you just have to judge one individual at a time. It's very important for you to feel comfortable with your doctors, regardless of their age or yours. You need to have rapport whether it's with a talk therapist or a psychopharmacologist. So far, I haven't found the ideal psychiatrist who is equally adept at talk therapy and psychopharmacology. I have a different doctor for each. Both are M.D.'s, but each is specialized, perhaps too specialized. You know that saying about, "You can't be all things to all people"? Well, at this point, I think that might apply to psychiatrists as well. Each of my doctors does what he's good at. Although I complain a lot about having to go to two psychiatrists, I think it's probably better this way.
Posted by Deneb on September 26, 2005, at 21:08:30
In reply to Re: Differences between young p-docs and old p-docs » Deneb, posted by JenStar on September 26, 2005, at 20:43:49
Hmmm...you guys are right, there definitely are more people now on mood altering drugs. I don't know much about what p-docs learn though.
> But the more experienced doctor might have seen more patients respond positively to this drug b/c he's been in practice so long. Do you trust him?Right now? I would have to say no. I don't trust the guy. I keep thinking that maybe he wants to harm me. Why would he give me a powerful antipsychotic after seeing me for only 30 mins? My real pdoc said I didn't need drugs. It's kind of scary actually, I don't know why he wants to harm me, maybe it is because I said crazy stuff. :-(
But, the thing is, it's illegal for him to harm me on purpose.
Deneb
Posted by JenStar on September 26, 2005, at 21:15:52
In reply to Re: Differences between young p-docs and old p-docs » JenStar, posted by Deneb on September 26, 2005, at 21:08:30
hi Deneb,
Why on earth would he want to harm you? Doctors take an oath to protect patients, and I don't think any decent doctor would deliberately harm a patient!Deneb, it's NORMAL for doctors to prescribe medicine after seeing patients for only 30 minutes, sometimes even 2 minutes! Think about various infections and flus, pneumonia, rashes, etc -- docs prescribe meds after the typical 15-min office visit.
P-docs are not THAT different. Instead of looking at your skin or in your throat, they're reading your personality. I mean, I can't say that I'm 100% comfortable with a 30-minute diagnosis for every case, but it's certainly OK for a starting point in most cases, I think. Since most people have to adjust meds anyway over time to get the right dosage/mix, it makes sense to get started promptly.
In your opinion, how long would long enough be, for him to make a diagnosis?
What exactly do you think he is doing to harm you?
JenStar
Posted by Deneb on September 26, 2005, at 21:27:52
In reply to Re: Differences between young p-docs and old p-docs » Deneb, posted by JenStar on September 26, 2005, at 21:15:52
> hi Deneb,
> Why on earth would he want to harm you?I don't know. :-(
I just started to think that maybe he wants to harm me. He wants to give me diabetes and turn me into a zombie. I just don't trust him. There is just something about him now that I think about it, I don't know if I'm just getting paranoid. :-( I think maybe he was *too* jovial.
I think maybe there are evil doctors out there...who become doctors just to harm people.
> In your opinion, how long would long enough be, for him to make a diagnosis?
I dunno, a year? My p-doc didn't even give me a diagnosis until I saw her for 3 years.
Deneb
Posted by Emily Elizabeth on September 26, 2005, at 22:15:12
In reply to Re: Differences between young p-docs and old p-docs » JenStar, posted by Deneb on September 26, 2005, at 21:27:52
I don't know if this will help or make it worse, but new pdoc almost certainly has access to old pdoc's records. His decision was likely based on his interview PLUS her years of experience with you. Also, perhaps he saw that you were still suffering and wanted to take your treatment in a new direction to try to make you feel better. Give him a few more appointments to figure him out. When do you see him next?
Best,
EE
Posted by JenStar on September 26, 2005, at 23:30:59
In reply to Re: Differences between young p-docs and old p-docs » JenStar, posted by Deneb on September 26, 2005, at 21:27:52
Deneb,
do you seriously - in your heart of hearts -- when you're being MOST rational -- do you really think he wants to harm you? If someone said you had to guess if he wants to harm you or not, and if you guessed correctly you'd win a million dollars -- so it's a serious thing now -- would you STILL say he wants to harm you?Yes, there may be a handful of horrible harm-minded doctors. But I think they mostly exist in novels by whats-his-name...the doctor who writes thriller stories. In real life I've never met a bad doctor, or met anybody who HAD met a bad doctor.
The thing about diagnoses -- they're usually based on a set of behaviors that have been observed or described. If your behavior has been pretty constant for a while now, and it seems that it has, it wouldn't necessarily help to have a longer "get to know you" period with the doctor.
I think you should revisit the diagnosis in your upcoming sessions, in case you have changed, or in case you were not completely forthcoming during your first visit. If new revelations come out, if you behavior changes, then the diagnosis might change, too.
I think your post did sound paranoid to me. I hope you're doing OK. Have your paranoid feelings gotten any better on this new med?
I hope you're doing ok!
JenStar
Posted by Phillipa on September 27, 2005, at 20:01:26
In reply to Re: Differences between young p-docs and old p-docs » Deneb, posted by JenStar on September 26, 2005, at 23:30:59
I've tried all ages and the young ones are benzophobic and want to use antipsychotics instead. The older pdoc I have isn't benzophobic. But she's getting old and doesn't do any psychotheraphy. Fondly, Phillipa
Posted by Shortelise on September 28, 2005, at 1:01:18
In reply to Differences between young p-docs and old p-docs, posted by Deneb on September 26, 2005, at 17:46:41
Is it possible that the younger the doc, the less cynical s/he is?
If I were a pdoc, had seen what they see for 25 years, I would know a lot, would be able to make some leaps from experience. SOme of those leaps woul dbe right on target, some would be a little askew.
My T is a psychiatrist, praticing for about nine years, I think, and tried to get me to take meds for the first four years I saw him, and when I finally did - in the face of crisis - I began to feel better. He was right. I don't know if it was the right time and place for me to start meds or if I would have felt better years before if I had taken meds. A lot happened at once. But that's when I started to feel better. He is also a great therapist.
My husband's psychiatrist taught him to meditate, is very into the psychological side of things, too. He is not too keen on meds unless they are necessary. He's about 75 years old.
There's my contribution to your research! :-)
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