Wednesday, August 20, 2014

How Hard Is It To Find a Psychiatrist? Tell me your stories!

One of the concerns I have about funneling our resources into programs for involuntary treatment is that I believe it's difficult for those who want help to get it.  Some assume that those who don't recognize their need for help are society's sickest patients, and that resources should go to them first.  So I want to hear your stories of looking for a psychiatrist.

So let me ask you, how hard is to find a psychiatrist here in the United States?  If you found one easily --- say a morning's worth of phone calls and appointment within a reasonable time -- just say "Easy" and please tell me what part of the country you live in and if you live in an urban/suburban/rural area.  If you had a longer story, I'd love to hear that as well, with the same demographics.

Thanks so much!


Steven Reidbord MD said...

I imagine additional data would be revealing. Did the psychiatrist-seeker have private, public, or no insurance? Were they able to pay out of pocket? Did they use an online referral service (ZocDoc, Psychology Today, etc)? Did others (family, social worker) help in the search? From what I've heard of patients' experiences, these factors — in addition to geography — can make a big difference. Good luck with your book.

Nathan said...

I'll speak for my sibling's recent story now. Two weeks ago, he tried to seek emergency and in-patient care after a psychotic episode led to legal problems. He went to a well respected hospital in the big city he lives in. I went with him. After being committed, he was held for only 30 hours. He was told to abruptly stop almost all his medications (4 of 5 meds) he has been on for 15 years. There were no beds available for the inpatient program at the hospital nor at others, and non-hospital programs would not accept him because he was psychotic. He was then told by the attending psychiatrist to seek outpatient programs.

Again, I am not a fan of much psychiatric treatment, but when someone tells you that they are experiencing safety issues and having psychotic experiences beyond their capacity to deal with, who wants a place to to feel safe for a while, has good enough insurance, and is willing to try inpatient care, it was a real blow to have him told to just stop his meds, leave the hospital without a plan nor in condition to get into any care, and basically talked out of in-patient care. He has had poor experiences with mental health professionals in the past, but was willing and excited to seek help after a rough time, and what he got out of this experience was that he should not seek in-patient care when he is feeling unsafe and that doctors are dumb and trying to get him into more trouble by trying to destabilizing him (taking him off meds abruptly).

As for me. I have used relatives/friends who are mental health professionals or know many to get referrals. I don't recommend this, as it hasn't worked well for me. The only folks I could get appointments with were folks who were cash only and folks who encouraged concurrent psychotherapy. It had been difficult for me to have financial conversations with psychiatrists as I had previously believed that I should trust doctors judgement and pursue the best care they recommend. I have since learned that I have no way to pay cash only psychiatrists for such work for any meaningful length of time, leading to disrupted and care that left me very dissatisfied. I'd like to think that doctors just don't take financial considerations in their recommendations and try to recommend the course of treatment they think would be best, but I now feel they also recommend the courses of treatment that make them the most money. My takeaway is that I am a much better advocate for my own care, needs, and limits, and willing to challenge a psychiatrist;s perspective from these experiences.

oh, just anonymous today said...

Moderate. Rural. Social services helped me (I had case management at the time). Medicare. Did not use an online referral service (I'm not sure local docs are even in those services). I was lucky doc was taking new patients - previously, this doc wasn't. I drive 50 miles one way to see this doctor. Closer docs not taking new patients.

Anonymous said...

Not easy.

Without insurance -- no clinics
With insurance, easier if you have a PCP affiliated with a hospital who can refer you to psychiatry.

You can not get into see a psychiatrist--even a trainee--at one of the teaching hospitals without a PCP in their system. I tried.

The advice I got from someone wise when I was in crisis was to get an appointment at one of the teaching hospitals with a PCP and say you are self-pay. Go to the appointment and ask for an urgent referral. Immediately apply for financial assistance. (That was before health reform and near-universal insurance).

Even fully cash practices are often booked. Private practices are hard to navigate even if you have a PPO with an out-of-network benefit.

I happened to get a great resident with whom I've stayed since he finished his training, but that was just luck.

I'm in Eastern MA, and we are supposed to be overrun with psychiatrists, but it's still hard to get one.

R. said...

I've moved a few times and lived in a variety of types of location. My experiences were as follows.

1) College at large university in midsized college town: easy, went to college health center, got refered to psychiatrist and had an appointment in maybe 2-3 weeks
2) Larger, east-coast city moderate difficulty. It took a couple days (spread out over a few weeks since that's what I had the energy for) to find someone who took my insurance, had opening in a reasonable time, and didn't give me a weird vibe.
3) small-medium sized town in the southwest: Very hard. I would of had to drive 1-1.5 hours to see someone, and even then I had maybe 2 or 3 options. I was only living there temporarily and was fairly stable at the time, so I just found a general practitioner to continue prescribing medication that the doctor in location 2 put me on.
4) medium sized city in the midwest: Easy. I found a therapist who I clicked with after 2 phone calls and had an appointment within a week of calling him. At my second appointment I asked him for names for psychiatrists, he referred me to someone and I had an appointment within 2 weeks. I don't love my psychiatrist personally (I don't think I would like her as a therapist if she did that for example), but she has done good things for me medically and we can have a working relationship. And I can get appointments (in the evening!) within a week or two if I call her, between appointments, which occasionally happens since she tends to prefer to space her follow up appointment our further and have people call if something comes up before then. In fact, that probably plays into her availability, but might not work well for someone who needed more intensive monitoring or wasn't proactive in their own medical care.

Anonymous said...

I have never tried to find a psychiatrist, so not sure if my experience counts. All takes place in the southwest region of the U.S.

1.) Therapist contacted a person from a psychiatric clinic geared toward the indigent who came and assessed me at the therapist's office and referred me to a psychiatrist at that clinic. I didn't have insurance. Rural area. Don't remember the wait, I'm sure whatever the wait was it didn't seem long enough as I didn't want to see a psychiatrist. I went about two times and ran away.

2.) Therapist kept badgering me to see a psychiatrist. Saw a psychiatrist through the student health center at the university I sporadically attended. It was through the student health center so I think it was covered in the fees, or maybe there was a small co-pay. Don't remember the wait. Same rural area. Went a few times and then ran away.

3.) My internist referred me to a psychiatrist. Had health insurance at the time. Don't remember the wait. Same rural area. The psychiatrist took my insurance, did psychotherapy and medication. I ended up a drugged zombie, with repeated hospitalizations. Psychiatric treatment fail.

3.) Moved to a large city in the southwest. Cold turkeyed off all the psychiatric medications my previous psychiatrist had me on and landed in a psychiatric ER. No health insurance, no job, no nothing. Psychiatric ER referred me to the outpatient psychiatrist. Saw a psychiatrist for a few visits just long enough to wean off of the psychiatric medications. The psychiatrist was paid by county or possibly state funds? I paid a small sliding scale fee.

4.) Stayed in contact periodically with my therapist from the rural area where I used to live. She has been relentless in insisting that I see a psychiatrist. I said no way for years until finally giving in. I finally agreed to see the psychiatrist she referred patients to. She made the appointment with the psychiatrist for me, because I wouldn't have done it. I travelled 8 hours back to the rural area to see this psychiatrist. Almost didn't show up, but I did. I've seen him for the past 3 1/2 years, and it was the first time I got real help. I saw him in person a few times in the first couple of weeks before going home, and then had phone appointments. When I wasn't doing well he insisted that I come back, so I flew or drove back to see him and had more frequent phone visits. Now that I'm doing well, I see him in person about once a year, and talk to him by phone every couple of months. He doesn't take insurance, and I'm in a stable job so I can afford to pay out of pocket. He does med management only.

There are lots of psychiatrists in the area where I live, and I could pay out of pocket to see someone here but I didn't want to see a psychiatrist and wouldn't have known how to go about finding a good one. The psychiatrist my therapist referred me to was well known to her and she had referred several patients to him with good results. I'm glad my therapist was so persistent.


A therapist in Boston said...

Two weeks ago, I asked the receptionist at the clinic I work for what the waiting list for psychiatric appointments was like. We only provide psychiatric med management for patients of therapists at this clinic, and a patient has to have seen a therapist here twice to get a referral to our psychiatrists. So as of Aug 6th, if you had already gotten through the therapist waiting list (I think about 6 weeks) and seen your new therapist twice, you would be able to see one of our psychiatrists maybe as early as October. (This is in Boston, MA, and we take Medicare, Medicaid, and Romneycare insurances for the indigent.)

Anonymous said...

Northern California College Town:

Hard in the town itself

Easier if you could go to the State Capitol (but that required a car--cow town was navigable by bike)

Student Insurance would not pay for care by residents which made the university medical school problematic

Stephanie King said...

Easy for me. I have had the same pdoc for 15 years but I did have a two year period where I had to stop seeing him (due to losing insurance) I went to a clinic that accepts uninsured patients and got my first appt within a week or two. Now I'm back with my original pdoc, wasn't very satisfied with the clinic services. I'm in Florida in a mid sized town. I was able to get an appt quickly when I returned to my pdoc but I'm sure that was because I had already been his patient previously.

Liz said...

my story is a bit different from what you are looking for--before my release from the state psych hospital, they wanted me to make an appointment at the community mental health agency. i had no insurance so this is the only care that i could "afford". that appointment was just a week or so away. the hospital gave me a month's script or so of geodon to tide me over. but upon getting to my appointment with a counselor, i found out before getting a psychiatrist appointment, i had to see the counselor four times or so. and appointments themselves were booked out a couple of months. i tried to get the counselor to find a way to help me get in sooner, but from what he said, this was an inflexible rule and i was stuck. i got a couple weeks from psych emergency to tide me over and even THAT had run out. i had a family member give me money (over 100 bucks) to see a psychiatrist in the community as a one time thing to try to tide me over as well, and despite me explaining the situation on the phone, she said she took my money and time and said she was uncomfortable prescribing me anything given my history. i was in tears in her parking lot. it ended up taking around four months before i was able to see a doctor at the community mental health agency, and by then, i had withdrawn from all medications cold turkey. i ended up cancelling the community agency appointment and have stayed off the meds since then. thank GOD withdrawal wasn't terrible for me. that so seriously could have ended tragically. i live in the midwest in a suburban area.

Jill said...

Several experiences, all in NYC. Finding a psychiatrist on my own via my insurance - found after a few days of calling. She died, and this never happened again.
Over the years, either the shrinks weren't taking new patients or I met with them and they were crazy (waited 2 hours for a 3 hour intake visit in which she paused to eat her lunch and took other calls, plus her policy was to not make any med changes for the first the point of going was to make a med change). When I was discharged from a voluntary inpatient hospitalization, they just discharged me to the first name on my insurance list, a woman who was a bad fit in every way possible. At that time, most psychiatrists I spoke to said I was too sick because of the voluntary hospitalization for suicidal ideation to work with me (dx = major depression). At one time ,I used up my savings to see a psychaitrist who did not accept insurance twice a week. Currently, I found my psychiatrist-who-does-therapy through a long and convoluted tale. She does not accept insurance but uses a sliding scale. My insurance reimburses some and I make up the difference. We talk about it when something comes up or when she raises her rates. I am constantly aware that I am so lucky to live in NYC and have a good therapist who works with me to make therapy affordable. I believe that is very rare for cases of long term, atypical depression.

Sarah G. said...

Easy. I live in Seattle and have health insurance that covers mental health costs including unlimited visits for biologically based disorders such as bipolar (me) and schizophrenia.

Anonymous said...

I practice in an out of network group and we do not overbook and we see people for a real time 25 or 50 minute appointment and we generally run on time (ie if late max is 10 minutes late).

We average a 4-6 week wait to get in because our intakes are for 90 minutes so it is harder to keep a 90 minute slot open each week. We hate having to make people wait.

That being said, some weeks I do have 1 or more openings for a new patient but no one calls and/or the scheduled patients prefer to keep their scheduled appointments rather than come in for an earlier intake.

In addition, if I have immediate openings and a new patient calls and I offer the appointment for that week, it is rare for the new patient to accept it! No kidding. They often have other appointments they cannot move.

Dinah said...


Thanks, Nathan. Did sibling already have a doc prescribing the meds of 15 years? What part of the country?

Just anon: is it the usual for people to drive 50 miles to see a dermatologist or GI doc?

Anon in Mass--thank you.

R :thank you

P-K: this is exactly what I'm looking for.

Boston therapist, Northern CA, Stephanie, Liz, Sarah and anyone else I missed: Thank you

Last anon doc: how many patients don't schedule when they hear you are out-of-network?

oh, just anonymous today said...

It is the usual to drive 50 miles for a GI doc. I was told that psychiatry, GI and rheumatology are in critical shortage in our area. Other specialists rotate in to see people every week in the local clinic, which is 15 miles away. I can see that our local clinic seems to be phasing out primary care doctors and force people to see PA's now - over half the "doctors" are PA's and almost none of the MD's are taking new patients.

I sincerely doubt there are any cash only doctors in my area.

I know this has been blabbed about before, but in reference to Jill, that she was too sick for the doctors to take her on, I do find that offensive unless they were psychoanalysis docs or something. Perhaps those ortho docs shouldn't patch up people who were in a serious car crash, either. I think this trend where psychiatrists are ditching medicaid and medicare patients is alarming because virtually all the patients with schizophrenia and perhaps half with bipolar just got dumped, then. I get it from the doctor's point of view, the horrible, horrible red tape, but the people with serious mental illness, where else are they supposed to go? And this comment of Jill's addressed that forced care issue, too - the people who end up under involuntary outpatient commitment usually have schizophrenia, but the doc doesn't want to deal with Medicaid, so. . .

Sarebear said...

When looking for a new psychiatrist, I generally have to call 10 to 20 before having any luck, it is HARD to find one taking new patients, or that wasn't modulated in the insurance directory, ie, one I called apparently was only specializing in geriatric patients so shouldn't have been listed under General psychiatry in my opinion.

Obviously since I was calling off an insurance list that already restricted my choices.

I found my current shrink because one of the shrinks I called heard how discouraged I was getting after calling so many and she took a minute out of being with a patient to get me the phone numbers of several shrinks she thought were taking patients.

I know many would probably criticize her for taking two minutes from a patient but even now I'm tearing up when I remember how d I discouraged and desperate I was getting, and as I remember that unexpected deep kindness this shrink showed me.

This is a big reason I've stayed with a shrink I've come to loathe over the years, that and I no longer have insurance and the p e rain who is paying my shrink Bill I'm not sure I could easily get a new one paid for, it's complicated, but my current shrink has just done something that has me about ready to give up on psychiatrists altogether.

I'm so sick of her crap, but it would be so look hard to find a new one, and who would want to take on an uninsured patient with a weird method of payment that even I m not entirely sure about?

It is monumentally difficult to find a psychiatrist for me, and Salt Lake City is our state's capital, with a major university and a associated hospital, in fact a slew of the shrinks I remember on the last list I called on were associated with the university, but I had to avoid those at the time due to a huge double mri Bill in the u university healthcare system that we couldn't pay that there were snafus with the insurance. Basically no one in that system would see me with that Bill outstanding, so that was part of the problem.

The bill is no longer an issue, they looked at all our finances, bills etc and wrote most of it off, eventually, after we spent a year appealing the insurance company decisions.

Even so, psychiatrists around here tend to have full practices, but some surely must not.

My first shrink I got in because I knew someone. The other two all took a lot of calling, number two I did ask for recommendations from my therapist off the insurance list I had, and I found one that way, th a t he'd gone to college with. He wasn't great, rambled for over an hour quite often. Even about experiments on prey ant rats in college.

I have found, then, that t he ones whose practices are not full up, it is possibly because there are some glaring flaws. That seems to have been the case for me.

I live ten minutes north of salt lake so could find shrinks in both an urban or suburb a n environment.

Anonymous said...

I live in Salt Lake City. I see a psychiatrist 45 minutes away because he is awesome. He takes my insurance. His practice is full right now and the two nurse practitioners that work with him have 8 month waiting lists. Most of the private practices in the area are full or have very long waiting lists. For patients able/willing to see someone at the university, they have more options but even then, sometimes it takes an inpatient admission and a social worker to get an appointment.

Ellie said...

Easy, but I've also had good insurance consistently, and currently see someone who doesn't even take insurance (which in this case means he has a smaller patient base, is never "full," and also does psychotherapy).

First psychiatrist (~15yrs ago) - referral from a family friend.
Second psychiatrist - insurance company website.
Third group of psychiatrists - through my educational institution (at the student behavioral health center). Here, I got a new psychiatrist q2months due to staffing issues until they hired a permanent psychiatrist, who I saw for the last 2 years of my schooling.
Fourth psychiatrist - Recommendation from the previous psychiatrist, who I stopped seeing because I finished my degree and couldn't keep using the student clinic.

Therapists were a whole different story. I used primarily my insurance company's website, which was a total hit-or-miss. Many therapists whose name I grabbed out of the insurance company's hat seemed more unstable than I was, but one was a huge success and I feel lucky to have chosen her name by chance. Nowadays my therapist and psychiatrist are the same person, which I strongly prefer (but I worry that this isn't sustainable, as I have to pay out of pocket with about 50% insurance reimbursement). I imagine that in the future, if I can't afford my current psychiatrist or if I move, I will seek care at a resident clinic, because they seem to offer more opportunities for having the same person do both psychopharm and psychotherapy.

Anonymous said...

Hi Dinah,

It's Tigermom, I am the most recent anonymous. I am in the middle Atlantic region. I am also not ever full since I have a smaller patient base. Sarebear mentioned that connections got her one into one of her doctors and that is sad but true. I go out of my way to accommodate patients of therapists or internists, etc. with whom I work a lot.

The people who do not come in because I am out of network:

- some older folks on fixed incomes
- some younger folks on lower incomes
- some "rich" people because they prefer to go in network

People who do see me:
- some older folks on fixed incomes
- some younger folks on lower incomes
- lots of "middle class folks" ie teachers who cannot really afford to
- some "rich" people
- government employees with fabulous out of network reimbursement
- people who tried going in network but want longer visits with their psychiatrist

In other words, I still see a variety of people and the people who complain about my fee are almost always "rich" people.

Anonymous said...

I'm in the Mid Atlantic, large city. It's been hard and I have good private insurance. My difficulty has been finding in-network shrinks that are not over 75 years old (I can estimate because my insurance directory lists their year of med school graduation), that speak English clearly, that are good listeners, and that inspire confidence in their abilities. Nothing scares me more than a shrink who consistently presents options for different meds, or dosages, and then says, "what do you want to do?" Um, isn't it your job to at least tell me what you recommend before asking my opinion?!?! You're the one who went to med school, not me.

The three shrinks I have seen since college have ranged from mediocre to poor. All were from the insurance directory. Anytime I have switched, it's taken hours of phone calls because the majority aren't taking new patients. The wait for an appointment has ranged from 4-12 weeks. I know that's considered pretty good, but I still find it ridiculous. What other specialty requires hours of phone calls to determine which ones are even taking new patients and are still in practice because directories are notoriously inaccurate.
I finally gave up when I switched to a new shrink and began seeing one that doesn't take insurance, a referral from another doctor of mine. He's good, but makes me mad that he feels the economics have pushed him to go this route. And $175 an appointment hurts.

Anonymous said...

I am a psychologist who works as faculty at a state university in an area that is medically underserved. I attended the school I am working and am diagnosed with ADHD so I can share a bit about trying to find a psychiatrist, as well as difficulties I saw some clients struggle with while I was doing clinical training.

As a student, fortunately I could see the on-campus psychiatrist. The first year I was year they had a full-time psychiatrist on staff, and he relocated. A nurse practioner who was a faculty member and licensed counselor replaced him, but only part time. She was really helpful and good at her work, but only there limited hours.

Trying to find good psychiatrists to refer clients to was difficult. Folks who work in mental health gave me usually five or six names, and indicated that only one was really helpful. This is a state where psychologists with appropriate training can seek prescription privileges. A couple of those were excellent and only part-time. Others I have encountered have been okay. For the mediocre to bad docs, both the psychiatrists and the prescribing psychs either had poor boundaries, were rigid and unbending with the treatment regimen they prescribed, or interpersonally challenged. For folks who didn't have insurance, they were pretty limited with their choices at a local clinic, and there was a long waiting period to get in. There was one psychiatrist who was really good about coordinating care for one of the clients I saw, but he was frequently booked up. One of the sites that provides medical and behavioral health here is able to get people in fairly quickly and sees folks who are considered indigent, but they only get to spend a few minutes with a psychiatrist or prescribing psych.

Since I no longer use the university health center for my medical needs, trying to find a psychiatrist to prescribe my ADHD medication was difficult. Many that I contacted were booked way in advance (more than a month out), not taking new patients, or had office staff that were rude. In terms of office staff, I called one morning to reschedule the appointment I had due to having a horrific cough (which was evident during the call), and the staff person was cold and reminded me that I could only call on the same day to cancel once. I understand why some practitioners have such policies, but the manner in which it was communicated was cold. I finally found someone I like, but think she is really eager to prescribe meds for minor complaints of stress.

For the year I did my postdoc at a university in a community that was small and rural, there seemed to be only a couple of psychiatrists locally. Many of the clients I saw through the university worked with doctors or PAs at the student health center, particularly for mild to moderate anxiety and depression. For more serious cases they were referred to a local psychiatrist who had frequent openings and usually got people in within a week or two, or would consult with medical staff at the univ health center if he couldn't.

Anonymous said...

I see this was written back in August, but hope I can still comment.
I've been extremely depressed for several months and unable to find a doctor.
I have Medicare, and was in arizona before now in Oregon. In AZ there were no Pdocs, except by teleconference, and some local, unqualified PNPs. Next city 175 miles away. In Oregon, I've called everywhere without success. No one's taking new Medicare patients, and most never call back. I'm scared and desperate, getting worse every day.
In the SW, I was taken involuntarily from my home TWICE DUE TO WRONG INFO, while I pleaded with them to leave me alone. Both times traumatized me by their vicious treatment, handcuffed, no shoes, taken to ER demanding illegal drug testing, injecting meds, holding me overnight, and sent home after doc realizes I did not belong there. I NEED a good Psychiatrist to adjust my meds, and treat the depression I've been proactive in managing throughout my life, and yet I can't even get in to see ANYONE!

Anonymous said...

Stay away from Seattle.

I moved to Seattle from D.C.. I used to live in California. I have found it impossible to find a good psychiatrist in Seattle. There is a long lead time (in some cases several months) to get in to see a doctor in the first place. Places where you normally look for a reference (psychology today, GPs, other specialists) have not provided any references at all. Psychiatry is practiced by the multitude of psychiatric nurses and psychologist, who, in my opinion don't know anything about the big three diseases. These people are used by overworked psychiatrists as filler to alert the psychiatrist when they think someone needs help. However, in my limited experience, the psychologists think there is something wrong when it's not and vice versa. They also are incredibly unprofessional and petty, thinking only to protect their own ego. As long as you are well, they will see you. However, if you try to educate them on your illness, they become defensive, thinking they know everything there is to know.

Other than the long wait, the docs I've seen are the worst in the business. I wonder whether any of them actually have a medical degree. My current doc just fired me because I used too much of his time because I got sick on his watch, and I was trying to nip a problem in the bud. I managed to do it myself because my doctor did not answer my calls. I'm not going to go into detail about this particular doctor, but he then spent a solid hour and a half reaming me out about how I had used too much of his time. He said that I didn't have problems, and my previous doctors were wrong. He was livid. Because he had set up the appointments, I was truly surprised. It would have been funny if it wasn't impossible to find doctors here, much less good ones.

He said that he never sees patients more than once per week, even if they are in such crisis they ultimately get sent to the hospital.

So...that said, I'm planning on just up and leaving this horrible city and moving to So. Cal. I've already contacted a few doctors there and they said they could see me in a matter of days. In Newport Beach, no doctor would be caught dead reaming out a patient, because you never know who a patient is.. they could be rich and famous. The problem is that I'm not stable enough to make the move at this point.

Paul said...

I have an 8yr old bipolar child who is suicidal. it took 18 months to find a pediatric psychiatrist that could take him. We just moved to Tucson, Arizona and it looks like we're in the same boat. the only one that said they're taking patients was scheduling a year out. the others were emergency inpatient centers for when he's a danger to himself or others and needs sedated.

Anonymous said...

Earlier in this forum, I posted about doctors in the Seattle area. My recommendation is still the same: don't move here if you have one of the big three diseases.

The doctor I wrote about earlier in the forum dumped me after I got slightly sick on his watch. He was miffed because he had to see me three times in one week to get things back to normal after he made a mistake and put me up on one of my meds. I just wouldn't move to Seattle for mental health care. If you are a "binge eater" there are plenty of doctors who will help you out. (How this ever made it in to the DSM manual, I have no idea. Basically it's a description of what most overweight and obese people in Seattle do: overeat. I guess docs want the easy cases these days.)

For good psychiatry, I would recommend So. Cal, D.C., and New York as possibilities.

Anonymous said...

More about Seattle...I finally ended up using a fee-for-service. The wait time was two months. The doctor seemed friendly and approachable, however, he refuses to see patients except once every three months. I don't get it. Even a fee-for-service doctor is not accessible.

Nothing I've tried in Seattle works. Nothing. The GPs are just as terrible. I went to a G.P. (one of Seattle's best) to get a physical. It took him two months to get back to me to tell me my thyroid is low (really outside the normal range.) Because proper functioning of the thyroid is key to helping depression, I was really shocked it took him so long. He referred me to an endocrinologist. She was just out of med school and told me that, by looking at me, I didn't have anything wrong with me.

It seems unethical for doctors to treat their neediest patients this way. The message I received from my new psychiatrist was "don't bother me with your problems." I received the same message from my GP. It's worse than dealing with Kaiser.

Could health care in Seattle be this bad? Seattle is a very cliquish place. So I'm wondering whether you have to be part of the "inner circle" to obtain decent medical care. There's just no excuse for the problems I've had with the doctors here. The doctors here don't seem to want to be bothered. I'm hoping that Southern California is the same as I remember seven years ago. I don't feel I have the money for another move, but my health is more important.

mollia jewett said...

It has been incredibly difficult to find a psychiatrist and the challenge continues as I have been repeatedly unsuccessful in my search. My psychiatrist retired a year ago. I live in rural Northern California and currently have private insurance. I have searched in areas up to 100 miles away even though traveling that distance is not the ideal. I saw my previous dr for over ten years, drove 45 minutes each way, and payed out of pocket. I was seen for medication management every four weeks and eventually every six weeks. MY insurance at that time only reimbursed for a percentage of the costs and I never made any claims. My prescriptions were covered and I paid their co-pays. The county I live in only has one psychiatrist who sees patients through the county behavioral health program. When I was without insurance I could not access services. Can't with private insurance either. I have been told only MediCal is accepted. Private practices are overwhelmed with patients because there aren't many of them. I see a great deal of public health care psyches who work for one or more county behavioral health departments and other public service agencies. And it goes on and on. I'm out of mess even though I had stockpiled them for this situation. My previous Doctor couldn't really recommend anyone. They just aren't out there...and if they are, they take way too long letting you know if they will take you on. I have been waiting 3 weeks for a doctor 60 miles away to verify that my insurance is legit. If they accept me, I will have a three month wait for appointment. They just hired a psychiatric nurse practitioner and that would only be a 1.5 month wait. Appeals to me and expressed interest in seeing that professional. My mother doesn't get why I don't have a doctor yet. She is managing her own issues with probiotics, church, and all kinds of expensive treatments...we both saw the same previous Doctor. It takes a lot of time to do the research and then become a patient. It was drilled into me for years to respect psychiatry as it was the only medical profession that required in depth study of psych meds and saw first hand how they did and didn't work. Now I doubt everything I thought was true. I can see why so many patients lose their trust in mental health treatment. I am losing mine even though I cannot imagine living in this world without treatment. I am 48, former teacher, former reporter, former shell of myself.