How Does One Choose a Psychiatrist?
The other day I was searching for a hairstylist. My hair is hard to keep up, very challenging for a stylist and thus, very expensive, so if I leave the salon with anything but exactly what I want, I’m more than a little peeved. I’m the client and I want what I paid for.
And as I was looking at various salons and considering which stylists might do a good job, it occurred to me, I’m spending more time on this than most people spend on finding a psychiatrist.
So how does one choose a psychiatrist anyway?
Choosing a Hairstylist
First, let’s consider how you might choose a hairstylist (stay with me men). In order of usefulness, you might:
- Ask for referrals from friends.
- Research stylists on something like Yelp.com
- Look at salon websites for information
- Pick one due to location or price
Of course, asking friends generally works out best, but some of us just end up picking whoever is around. Likely, the more work you do up front though, the happier you will be with your choice.
Choosing a Psychiatrist
Choosing a psychiatrist is exactly the same, actually.
- Ask for referrals from friends or another doctor – let’s face it, no one knows a psychiatrist like a patient who has been treated by him or her, so this is often the best way to find good doctor. Of course, this isn’t always possible for a variety of reasons, like, for example, you don’t know anyone seeing a psychiatrist (whereas most people have hairstylists). Asking a trusted doctor, like you GP, for example, can also work.
- Researching psychiatrists online – this is something everyone should do. There are many sites out there dedicated to rating doctors and while these ratings should be viewed with caution, they do give a general idea of how patients feel about individual psychiatrists.
- Look up information on the psychiatrist – again, this is something you need to do. You can find out if your psychiatrist is published, their points of view, their specialities and so on. This is important because you don’t want to see someone who has a fundamentally different viewpoint than you and it would be nice to find someone who specializes in your disorder (just like finding a hairstylist who specializes in coloring).
- Picking a psychiatrist due to other factors – of course, sometimes it can’t be avoided that we must pick a psychiatrist based on other factors such as insurance coverage or location. This is OK, but that doesn’t mean the above steps should just be skipped. Even if you have to have a particular doctor due to insurance limitations, doing research on the doctor will still let you know valuable information that can help you in your treatment, such as their treatment perspective.
And as with hairstylists, if you leave the psychiatrist’s office without meeting your goals, you might be peeved. You are the client, you pay the doctor, they work for you, and you deserve to get what you pay for.
Hairstylists vs. Psychiatrists
Like with hairstylists, you may have a long relationship with your psychiatrist so who you choose really matters. And yes, of course, your health matters a lot more than your hair. Your hair will grow back, your health will not, so I suggest you take your time about picking who is right for you. And if you’re stuck with someone you don’t like, do your research, find someone else and ask for a referral. Not all psychiatrists suit all patients and that’s OK. If you’re me, what matters is that I find someone who can work with red curls, oh, and someone who can work with treatment-resistant bipolar disorder à la Natasha.
My first psychiatrist was the only one on my insurance plan, whose office was within a 60 mile radius of my house (and I live in a big city). She did not listen to me, and possibly over medicated me, as I spent most of 2 years in bed, waiting for “the next drug to work in 6-8 weeks”. The clinic docs I have gone to (without insurance), have no referrals. I found one other decent doctor in these 10 years, but he closed to focus on something else. My Primary Care is doing very well now, managing my current meds. I hope this works.
And…my hair dresser is across town. She’s the one I’ve gone to for over 10 years. One of the longest relationships in my life. :)
with the exception of the one I had as a child, my experience with psychiatrists and specifically LICSW therapists has been rotten. Currently, however, I have been seeing a psych nurse practitioner and her difference in obtaining her credentials vs the former two made the overall meeting feel more comfortable. I see her twice a month and she does my CII meds when needed but we work on issues with that as well.
Therapists will lie to my face and call my doctor accusing me of being manic often and then I drop them. One boundary I set, if you feel I am having issues and there is no delusions or psychosis involved, address it with me or else I will not be your client anymore. I found that pattern and the “shut up or we’ll throw you in the hospital” line to get old. I stumbled upon her on accident and she has ended up being the best yet…
My first psychiatrist was an evil horrible man. After telling him how I felt and how hard it was to just keep living, he told me that it was completely normal and that there have been a lot of people that want to seperate themselves from society.
He told me that my best bet was to find a cave in the woods and live there so I could stop making my family so miserable! He told me how horrible of a person I was and that I was hurting my family.
It was sickening to hear someone say that to me.
It took 7 and a half months and a lot of coaxing from my family doctor for me to pick myself up and get confidence enough to see another one. And all I can say is wow!
It was like night and day with my new psychiatrist. He actually cared about how I’m doing and he just doesn’t talk to me during our visits, more importantly he listens and understands how I feel which is a blessing. Since my family just can’t comprehend what it’s like to live with this horrible disease. It’s nice to know somebody is all ways there for me if I need it.
All I can say is that you’ll know when you found the right psychiatrist. So just don’t give up or give in. Keep checking out different doctor’s until you find the one that’s right with you. And it might seem impossible but just keep trying.
and… don’t forget
3. Is he/she within a 100 miles and accepts my insurance?
or
4. Is he/she within a 100 miles and accepts people with NO insurance and provides a sliding scale fee?
5. If he/she accepts my insurance, and is within 100 miles, and the co-payment isn’t outrageous, do I have to secure the prior authorization for services or does he/she?
I think part of the problem is that often when you are first visiting a psychiatrist you are in crisis, so the main criteria is who you can see at that moment. The first time I went to a psychiatrist I stopped going after 2 visits and ceased the meds, making her the wrong psychiatrist for me. The second time I was referred to a psychiatrist I got lucky and found someone who I like and work well with. At neither occasion was I in any fit state to investigate who might be good.
Hi Ellen,
I agree with you completely. We can only do the best we can at the moment. I completely get that.
That doesn’t mean research and change isn’t worthwhile after the fact though. It can still be useful.
– Natasha Tracy
In my experience, it is a lot easier to find a good hairstylist than a good psychiatrist. Then again, I’m not that fussy about my hair.
I got lucky. I was seeing a psycologist who diagnosed my bipolar. He set me up with my psycharist. They are a good team and the three of us work well together.
DEAR NATASHA…ANOTHER WONDERFUL PIECE WHICH IS STRAIGHT FORWARD AND TROUBLESOME TO ME…I AM THE GUY WHO IS A PATIENT AT THE NORTHPORT, NY MEDICAL CENTER AND GO TO THE EAST MEADOW MENTAL HEALTH CLINIC EVERY 3 MONTHS…MY
PSYCH TOLD ME STRAIGHT TO MY FACE THAT ZYPREXA CAUSES DIABETES BUT WE ARE TREATING YOU FOR IT…WHO CA I TURN TO?.. ZYPREXA IS PRESCRIBED LIKE CANDY TO A CHILD AND FOR THAT I HAVE DIABETES FOR THE REST OF MY LIFE…I CANNOT BELIEVE WHAT THIS 10MG PILL HAS DONE TO ME…WE STARTED OFF WITH 10MG IN 2001..WENT TO 20MG FOR AWHILE AND THEN 15 AND BACK TO 10MG…IN 2003 I WAS DIAGNOSED WITH DIABETES AND OBVIOUSLY STILL HAVE IT TO THE PRESENT AND PROBABLY TO THE FUTURE. I AM STILL WAITING FOR MY APPEAL TO GO THROUGH THE REGIONAL VA OFFICE IN NYC STILL HAS SITTING ON SOMEONES DESK..I THINK NTHEY ARE WAITING FOR ME TO KICK THE NBUCKET SO THEY CAN SAY WE TRIED TO HELP THE POOR FELLOW VETERAN..THE CASE HAS BEEN THERE SINCE OCT15,2010…25 MONTHS..SOME WAY TO TREAT A PATIENT AND THE SYSTEM STINKS..SUCH IS LIFE..I WILL CONTINUE TO READ YOUR WONDERFUL AND EDUCATING BURBLES AND I LOOK FORWARD EVERY DAY TO HEAR FROM YOU..I WISH YOU NOTHING LESS THAN THE BEST AND GOD BLESS YOU ALWAYS..WE NEED MORE LIKE YOU..MAYBE SOMEDAY I WILL ASK FOR ASSISTANCE IN THESE ISSUES I FACE AND NATURALLY ANYTHING YOU TELL ME WOULD BE MUCH APPRECIATED..WELL, UNTIL THE NEXT TIME A HAPPY AND BLESSED 5THANKSGIVING TO ALL. I DO HAVE MUCH TO BE THANKFUL FOR AT 65 YRS OLD…I HAVE A WONDERFUL HOME TO LIVE IN,CLOTHES ON MY BACK AND FOOD IN MY STOMACH..ALSO NA WONDERFUL AND MUCH BELOVED SISTER..PATRICIA MARIE, WHO IS A BREAST CANCER SURVIVOR…IT WAS CAUGHT EARLY..
WE ALSO HAVE 5 WONDERFUL PETS..ARABELLA THE COCKER SPANIEL AND 4 CATS WHO GIVE US MUCH JOY DAY AFTER DAY..THANKS AGAIN NATASHA FOR ALL YOUR INSIGHT AND I WILL PATIENTLY ANTICIPATE YOUR NEXT KNOWLEDGEABLE MESSAGE…LOVE AND HUGS PAUL J
Hi Paul,
Well, first off, as a favor to me, could you please not write in all caps? It suggests you’re shouting, which I’m sure you’re not :)
OK, next, it is true that Zyprexa can lead to diabetes, but it doesn’t for everyone and it’s important to know that. Now that you have been diagnosed with diabetes, I can’t say what caused it, but yes, it could have been the medication.
Second, it’s important to know that there are alternatives to Zyprexa. There are other antipsychotics that are similar and you can ask your doctor about switching onto one of them. Some others have less risk of diabetic side effects. That may help with your diabetes, but I can’t say for sure. Ask your doctor about it.
Regarding your VA request, I’m sorry, but I’m not sure what to suggest. The only thing I can think of is to contact a local mental health group (like NAMI) and see if they know of any resources you can tap into,
Also, I don’t know if you’re suffering from PTSD, but if you are, I recommend this book highly: http://www.mybacktothewall.com/index.html You can read the articles on their site for free and I think you’ll find the book a very worthwhile read if PTSD is an issue for you.
(Full disclosure, I have a business relationship with the author but make no money off of sales.)
I’m sorry I can’t be of more help. I’m thinking positive thoughts for you.
– Natasha Tracy
I have had some really good doctors in the past, but let’s face it. In today’s day and age medical insurance dictates quite a bit, since most of us are unable to pay out of pocket for monthly medication checks. So we are at the mercy of not only the insurance companies, but really the HR coordinator or the person who selects the benefits at our employer. My family was with Blue Cross, which paid claims correctly and had a large network of physicians. Then our insurance changed to Cigna, and consequently my doctor was no longer on the plan. My experience with Cigna is not a positive one, since I come from a healthcare management background. Their network is smaller and their claims processing is hit or miss. So I had to switch doctors because of the new plan change. I did my research and found another great doctor, then intermittent, he dropped Cigna patients. So then I found another, and the same thing happened after three years, dropped Cigna patients. Now I have found yet another, and he is really good, but it was again like picking a name using a dart. Of course you can choose to switch if you don’t feel comfortable, but it generally takes a month or two to get in as a new patient to make this evaluation. Even if I check on the internet and ask around about a particular doctor, the answers vary so much that it is quite difficult to make an educated guess in selection. To complicate matters even more, most patients find the whole process overwhelming. This is a really good problem you stumbled over. This is why there are so many medications out there for let’s say the common cold, because no one size fits all. People should still do their due diligence though in exhausting their efforts in the selection process. But it is exhausting.
Not many of us have any say in who we are referred to.I think we are just lucky to see anyone in this day and age.
We live in a rural area and it is extremely difficult to find a psych doc who treats children. There is one about 40 miles from us who has a very bad reputation and the next closest one is 130+ miles. Fortunately we are able to see him now thanks to telemedicine but that has its own issues. We did have one doctor who we really loved and trusted many years ago but the facility she worked for fired her for spending too much time with her patients…. and she is no longer in the area. So as much as we would like to pick and choose a doctor, we just don’t have that option and neither do many others that we know. Let’s hope that improves.
Hi Sue,
You’re in a special position as you need a specific type of doctor – that is most important on your list and so it sounds like you _have_ done your research. You know of a bad doctor and a good one and you’re making the good one work.
Just because there’s only 2 to pick from, doesn’t mean there isn’t a choice and just think about if you _didn’t_ know the bad one was bad!
– Natasha Tracy
Unfortunately, Dave is right-on. And you don’t have to be in a rural area – even smaller cities have the same limited opportunities for psychiatric patients. I have never, ever been given a choice of psychiatrist; I have been told I could change as long as I didn’t mind waiting another 6 months or more for another to come free to see me; but even that choice is only offered in extreme cases. A number of my medication changes have been purely due to the particular prejudices of the new psychiatrist. And I’ve had 7 different doctors over the past 12 years. When the number of psychiatrists in an area increases to the number of hairstylists, then, *maybe*, there will be options for psych patients.
Supurb! Did this come to you in a dream? Excellent way to get a serious matter accross with humor.
Hi DJ Maher,
No dreams involved, but hopefully some humor :)
– Natasha Tracy
You obviously live in a metro area. Here’s how we in the boonies choose a shrink:
1. Is he/she within a 100 miles?
and
2. Is he/she within a 100 miles?