county provided mental health care

with over 11 years of active depression bipolar and sever ptsd and anxiety i have been thru the system hospitals doctors and quacks.my original psychiatrist died about 3 years ago so i transfered to a private practice for med maintenence and talk therapy also recently i was let go after a sever kidney infection disabled me for longer than the 3 month guaranteed job back allowance here in California. SO i lost coverage cant afford private coverage and had to submit myself to the EER for medication refills and apply for free county care.

I have been appointed an intern who will be moving on in july of next year who i initially wanted as medicinal management since i was stabilitized on my current meds. she however says "most of her patients take....etc" and is jacking up dosages that leave me with migraines and severe anxiety with the fear that it may be too much or not enough or just stupid since i was doing fine before the dose tweekings.  i missed two appts due to the fact i am still unemployed dependant on parents at 30 and without transportation or walking distance to a bus or train route since i lost my job. and was chastised at the last appt. and in a seemingly ironic way punished by taking down more of my anti anxiety meds as she says "most of her patients dont take this much" upping my ocd bc "most her patients like me take...." and down my anti depressant and sleep aide "since my memory is obviosuly being affexted and that doesnt help remembering appts"  and is not comfortable with the amount i am currently and have been for over 6 yearsa with no problems of abuse unuse or decreased effectiveness. i dont want to sound like i dont appreciate her concern help or ideas but i think she is unqualified being so new to the psych doc/ patient relationship that she is ignoring cognitive therapy and playing with pharmeceuticals i believe to have been at the best theyd worked in my life at the time, with little if no insight on the actual consequences i must experince as the patient/ person taking the medication.  i have brought all of this to her attention gently and with just cause but since we are close in age i feel she thinks i am trying to dictate or am unwilling to try her method. i have also mentioned that i am not and if we could have a three way with the head of psych or another opinion which she defers. is this unreasonable? can i request a new doctor? wont i be treated with bias because they are collegues sharing file info based on my mental state and behavior? can i tell her of my concerns in any way that is less challenging or are my concerns even vaLID CONSIDERING I AM A PATIENT AND SHE IS A DOCTOR?

[gnarly_1]

HI AND I can feel your frustration im on the state of arizonza's mental health care and it can be frustrating at times both my wife and I are bipolar and recently had our meds changed do to budget cuts ....we went threw 3 weeks of hell coming off a non addictive med it can really be frustrating risperdal was the only med that worked on my wife now she is on something new and having problems ....problems the doctors dont care to discuss you may have to do what we did and go to the clinic supervisor to get something done
it took a few phone calls and several trips in but we are making progress on this just dont loose hope I hate when they mess with myy mesds to good luck and God bless......Gnarly  

[Luckytwice]

Your concerns are completely reasonable, She is the quack, not you.

There are some things you can do, like NOT taking the meds she increases, but sticking to the dose that YOU know worked. You can just save the extra pills for a rainy day, when you can't afford them if you happen to get cut off medicaid for some reason or other.

She should not be adjusting your meds for "punishment", that's just simply unethical practice, nor should she be tampering with your meds simply for the reason that" it's what other patients take".
Since she is a member of a "team" in the department, you can bet your @ss that you probably won't be treated fairly by her co-workers. They tend to cover for each other, not take your best interests first and foremost. It's the same as getting one teacher to say another is a bad teacher. it isn't going to happen.

She obviously has a superiority complex and because you are just a dumb unemployed person who couldn't possibly know anything she does,  and taking free government aid, that she can push you around and you should be grateful for whatever she gives you.

She needs to be put in her place. She is there to serve YOU, and while you were working and paying taxes, those programs are what YOU paid for- for your benefit and others so no one is without health care.

She MUST listen to what YOU say, and what has been working for you in the past and present. She has NO RIGHT to switch your meds, meds that were working for you and you had no problems with, for stupid reasons like that.

I hope you are documenting all of this. Document every single thing she says and does.

Then take this to an advocacy group which acts as a representative for the people getting screwed..er treated unfairly by the system, as they would be  familiar with the system and know how to better resolve your complaint in your best interest.  

Or maybe call a lawyer.

Make sure you keep a copy of everything as well. You may want to sue, and from what you are telling me you you just might have grounds.

This sort of stuff really ticks me off.

I don't live in California, or else I'd go give her a piece of my mind, LoL

[Luckytwice]

I'd also call and  demand she put your meds back the way they were, until you get another opinion from a Doc who doesn't put patients on meds because thats what another patient is on. Or change meds because they missed an appointment because they were unable to find transportation, which has nothing to do with memory.

[snakejones]

I'm so sorry to hear about your difficulties with your doctor. Why the hell do some doctors mess with success? Your psychiatrist obviously had you very comfortable on your drugs and dosages, right? I do know as an RN that health situations can change rapidly with bipolar patients--they can be very delicate physically as well as mentally and emotionally, and need careful, watchful, sympathetic, and nurturing care from their medical providers. Sometimes change may be needed, but the end result should always be homeostatic (stable) health as much as possible. Do you remember the meds and dosages that your previous, deceased doctor had you on? If not, you can get a copy of your medical records. You'll have to pay a little at most places for your copy, but they are YOUR property. This intern is way out of line forcing her idea of what you should be taking on you without you having at least some say-so. A good doctor is primarily a good listener and genuinely welcomes patient input. You are a TEAM, and she needs to be told that in no uncertain terms! This woman is obviously uncomfortable with give and take. She deserves an "F" in give and take, LOL! Perhaps it is because she is young and feels a little uncomfortable in her doctor skin. Hopefully she will get better at really listening and having a partnership with each future patient. If she's not careful, though, she just might have a special project in school before she graduates---her first lawsuit! There are some lawyers who do some pro bono (free) cases. You might call around. The next time you see the doctor, it would be a good idea to bring along a family member or friend to act as an advocate for you at your visit. Your intern is supposed to answer all your questions; start with each individual medicine you are on (make a list at home of each one, as well as if they worked for you or not and what the symptoms are if they aren't right for you. Get her reasons for prescribing each medicine, and have your advocate busy in the corner writing what she says in a notebook. Notebooks and people writing spook doctors like a horse seeing a rattlesnake! Well, you get the general idea. If she opens her trap again about "what MY patients take", tell her that we are all unique individuals, and your needs are not being met. Keep us posted and good luck!

[Luckytwice]

"Notebooks and people writing spook doctors like a horse seeing a rattlesnake!"

LoL! good one!

[snakejones]

Well Lucky, you certainly entertain the hell out of me all the time! Glad to make you smile.

[Luckytwice]

I just can't help myself sometimes :o)

[littlebit667]

The only thing I can add is just to second the idea of writing it all down while you are there.  Take a list of problems and go thru them one by one and why this worked and this did not.  Write Down everything she says as you "want" to appear compliant!  I will tell you that it really can make a difference in how you are treated.  It makes them really choose their words carefully if you are writing it all down.  

[vicki595]

Hi there!

What exactly is the background of this doctor?  New MD doing an internship/residency?  Also, what meds are you on, including vitamins and otc's?

Psych meds are very tricky! Is this the ONLY center you can go for your health care?  

Changing a dose of a med as punishment? No!  Which med was that? ARE you having memory troubles?