Has anyone had trouble finding a Psychiatrist?

[Beach-N-SnowGirl]

I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.

Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.

Any suggestions?

[Snell]

Yes, says the lawyer, but they depend on where you live. If you live
in the United States, depending on which state, there may be free-care
options. The trick in using these is NOT to advise the medical
practice beforehand that you're going to use the free-care. You know,
the whole "Payment is expected when services are rendered" thing.

Second: Don't tell them you don't have insurance, ever.

Third: E-mail me with your location (state only) and I can give you
some more personalized advice.

The Basic Maxim: Businesses are rational to do everything they can to
ensure that a customer is going to pay his/her bill. A red flag goes
up, for medical businesses, as soon as the prospective customer
(patient) declares that s/he doesn't have medical insurance. This is
manipulative and unethical. Like all manipulations, however, there are
counter-manipulations.

Snell, Esq.

[Snell]

Wait--you have Cigna POS? Then they're really being dodgy and nasty.
Cigna is reputed to have a low reimbursement rate, but that's sure not
the case from what I've seen, and I have Cigna POS myself.

My shrink "takes no insurance." That's not true--I pay him in cash (I
carry a running balance, of course) and then turn around and submit the
bills, marked "Paid," to Cigna. No problem. Kind of a problem if
you're low on cash, but the trick is to get in that door and in that
office, and worry about the payment issues at the *end* of the session,
when *you* have the advantage, without being screened out up front.

Snell

[Donna]

x-no-archive:yes

Have you tried your local city/county mental health department?
They should offer you free help in getting started in the right
direction. There are also psychiatrist nurses out there who
can write out the needed medicines and are cheaper then
the doctors.

There is another newsgroup that is for BP people. Check
it out as it offers great support. It's alt.support.depression.manic.

And yes, I had a hard time finding a psychiatrist to see me.
They all were not taking new patients. But I found this pnurse
and he's great.

Don't give up the fight! Help is out there so keep looking.

Donna

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

[liss]

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

go to ur primary care doc and ask for a referral. it usually works ok,
or at least for me. just stay strong and keep working hard to get help.
you'll find it soon. email me at ***@yahoo.com if you wanna
talk more.

liss

[Maggie]

Post by Beach-N-SnowGirl
Any suggestions?

Call your insurance co referral service. Tell them you have BiPolar
Affective Disorder....wich is specifically included in the Americans
with Disabilities ACT...ADA.

They are required to treat you like any onther person with a disability
and cannot limit the number of treatments and services even if mental
health visits are limited for normal persons with milder diagnosises.

Tell them that you want a referral now to a Psyhitrist/MD who
specializes in the diagnosis and treatment of Mood Disorders.

Tell them that THEY need to get you scheduled on an emergency basis
within the next 7 days or you will report the to the Department of
Insurance in the state where you live.

Cry.

Let me know what happens.

Maggie
Been there, done that.

[Beach-N-SnowGirl]

THANK YOU for all your wonderful advice!! I will let you know what
happens!

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

[Scott]

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

If conditions allow for it, shop for workplace with HMO coverage.

I went from HMO to private practice without much success. It took forever
just to find a doctor. I left with a list of referrals, but 75% of them
were "not taking new patients." The private doctor I did find wanted me on
a two week rotation of office appointments. I was tethered by small dose
two-week prescription refills. He was always running late by at least an
hour. He forced me into taking too much sick time. And his schedule didn't
allow for evening appointments.

Anyway, after about six months of this, being unstable more out of the
frustration and gaps in medication, I shopped for a JOB with Kaiser
coverage.

I see the doc once a year, do the lab work, and have a cheap steady supply
of prescription drugs.

[Beach-N-SnowGirl]

Kaiser is an option at my worksite, along with Cigna HMO, but I prefer
the freedom I get with a POS plan. And the options available to me on
POS are greater than that of the HMO. As far as Kaiser goes, no offense
to anyone, but I would NEVER choose it for my healthcare coverage.
Back in 1985, after a horrible snorkeling accident, we followed the
signs to the nearest "hospital" - a Kaiser facility. My father nearly
bled to death in the registration area because we were not members and
they refused to treat him. They wouldn't even give us bandages or
towels to stop the bleeding, and threatened to call the police to make
us leave when we pressed the issue. Fortunately, a patient waiting for
his appointment directed us to a nearby private physician who cancelled
appointments for the next two days in order to work on my father,
saving his life. I realize there are laws against this practice now
(primarily due to Kaiser's actions...or really, inactions), however my
anger towards them for being willing to let my father die rather than
even give us a single band-aid will never cease. Thus I will never
help that business succeed.

I am happy that you have gotten the help that you need and acknowledge
that many people have only had positive experiences with Kaiser. I'm
just not one of them.

Thank you for your advice, though.

**An Update on my situation: I was able to get an appointment, but it's
not until August. As I'm on the upswing right now, the only thing
pushing me to follow through is my own knowledge that the good times
won't last. After the holiday, I will get back on the hunt for a more
receptive doctor. Thanks again for all the support!***

Post by Scott

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

If conditions allow for it, shop for workplace with HMO coverage.
I went from HMO to private practice without much success. It took forever
just to find a doctor. I left with a list of referrals, but 75% of them
were "not taking new patients." The private doctor I did find wanted me on
a two week rotation of office appointments. I was tethered by small dose
two-week prescription refills. He was always running late by at least an
hour. He forced me into taking too much sick time. And his schedule didn't
allow for evening appointments.
Anyway, after about six months of this, being unstable more out of the
frustration and gaps in medication, I shopped for a JOB with Kaiser
coverage.
I see the doc once a year, do the lab work, and have a cheap steady supply
of prescription drugs.

[Beach-N-SnowGirl]

Kaiser is an option at my worksite, along with Cigna HMO, but I prefer
the freedom I get with a POS plan. And the options available to me on
POS are greater than that of the HMO. As far as Kaiser goes, no offense
to anyone, but I would NEVER choose it for my healthcare coverage.
Back in 1985, after a horrible snorkeling accident, we followed the
signs to the nearest "hospital" - a Kaiser facility. My father nearly
bled to death in the registration area because we were not members and
they refused to treat him. They wouldn't even give us bandages or
towels to stop the bleeding, and threatened to call the police to make
us leave when we pressed the issue. Fortunately, a patient waiting for
his appointment directed us to a nearby private physician who cancelled
appointments for the next two days in order to work on my father,
saving his life. I realize there are laws against this practice now
(primarily due to Kaiser's actions...or really, inactions), however my
anger towards them for being willing to let my father die rather than
even give us a single band-aid will never cease. Thus I will never
help that business succeed.

I am happy that you have gotten the help that you need and acknowledge
that many people have only had positive experiences with Kaiser. I'm
just not one of them.

Thank you for your advice, though.

**An Update on my situation: I was able to get an appointment, but it's
not until August. As I'm on the upswing right now, the only thing
pushing me to follow through is my own knowledge that the good times
won't last. After the holiday, I will get back on the hunt for a more
receptive doctor. Thanks again for all the support!***

Post by Scott

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

If conditions allow for it, shop for workplace with HMO coverage.
I went from HMO to private practice without much success. It took forever
just to find a doctor. I left with a list of referrals, but 75% of them
were "not taking new patients." The private doctor I did find wanted me on
a two week rotation of office appointments. I was tethered by small dose
two-week prescription refills. He was always running late by at least an
hour. He forced me into taking too much sick time. And his schedule didn't
allow for evening appointments.
Anyway, after about six months of this, being unstable more out of the
frustration and gaps in medication, I shopped for a JOB with Kaiser
coverage.
I see the doc once a year, do the lab work, and have a cheap steady supply
of prescription drugs.

[Beach-N-SnowGirl]

Thanks to everyone for his/her input!! While still hitting brick walls
with the psychs out there, I mentioned my dilemma to my former (or who
I thought would be my former b/c his office is so far from home)
primary care physician (whom I had to go to in order to refill a
prescription) and although he did not know of any good psychs he could
recommend, he did offer to get me started on meds in the meantime.
So yesterday, I began taking Zyprexa. My ex-boyfriend, who is bipolar,
just went off of it so he had a lot of insight to give me. (He'd still
be taking it if it weren't messing with his triglycerides.) So we'll
see what happens. If I don't like it or it's not working, the doc is
ready to try something else until we find what works. Even though I
struck out with the psychiatrists, at least I've been lucky enough to
get some awesome primary care docs over the years, all by random. Even
tho I have to drive 30 min (or over an hour if it's rush hour; damn 405
freeway through Orange County, CA!!!), it's worth it to have a good
doc, ya know? So, I guess he's still gonna be my PCP afterall!

Thanks again, everyone! I'll be checking in with ya and letting you
know how it goes!

Post by Beach-N-SnowGirl
I'm a self-diagnosed BPII (although my Masters in Counseling helped
with that diagnosis), but I cannot, for the life of me, get a
Psychiatrist to call me back! It seems like the minute I mention
insurance (Cigna, POS, not HMO), their secretaries say they're not
accepting new patients or they will run it by the doc and will call me
back. No one ever does. It's hard enough for me to take the steps
needed to get a proper diagnosis and medication (in addition to my own
fears, I had a boyfriend who is BPI and I know the drill all too well),
but when I have this huge roadblock with even making an appointment,
I'm starting to lose my resolve to get this shit straightened out.
Oh, I can't afford - and have no credit available, not suprisingly - to
pay for visits directly nor for the medication (which won't be covered
under insurance if a non-participating psych writes the prescription).
Would it be worth it to just go to my Primary Care Physician to get
started? I'm afraid, now that I'm sliding back up into hypomania which
generally feels pretty good, that I'm not going to go at all.
Any suggestions?

[Snell]

I think I might speak for everyone when I say how happy I am for you
that your PCP is being decent and *actually treating you* while you
look for a specialist.

The hyper-specialization of the professions (even of lawyers and
accountants--I don't know many general-practice lawyers) is a drag. I
know there are good reasons for it: Professionals get to know a small
area of the field really well; non-specialists don't have to worry
about making mistakes in their non-fields, etc. The problem is that
this inures to the benefit of the professionals and often prevents the
patients or clients from getting care or attention when needed.

It used to be that an Internal Medicine specialist was exactly that, a
SPECIALIST. My dad, a pediatric neurologist, used to joke that he was
a sub-sub-specialist.

I. general practitioner - physician - surgeon - pathologist
II. specialties: of physicians: internal medicine, family medicine,
pediatrics, OB-GYN (sort of a hybrid with surgeons), psychiatrists
III. specialties of internists: neurologists, pulmonologists,
cardiologists, yadda yadda
IV. specialties of neurologists: pediatric, adult, trauma

See? Eek!

But psychiatrists and internists are BOTH physicians! It's not as if
you're asking an orthopedic surgeon to prescribe medicine for the
central nervous system!

Psychiatry is one of the fields an internist must master in order to
become a psychiatrist, just as she/he must master emergency medicine,
treatment of infectious diseases, simple surgery, etc.

And I definitely agree about location. It is so damned difficult to
find a skilled doctor in a decent practice it's worth driving a long
way--for me, up to 90 minutes--to see her or him. I drive from remote
Massachusetts to New Haven, Connecticut to see my PCP. He has
expressed bemused confusion by this, and says I should "find someone
closer," but I ain't leaving his practice.

And then, once you've been in treatment for a couple of years, you'll
know better what you need in terms of psych meds, and can often resort
to that same PCP when you need a refill and your psychiatrist isn't
available. Physicians will often prescribe a medicine when they know a
specialist has already prescribed it for you when they won't initiate
treatment with a new medicine. A former romance was a pediatric
pulmonologist, and though we both knew it wasn't totally kosher, would
prescribe refills (of non-scheduled drugs) when my psychiatrist was on
one of his ten-week junkets to Venice. . . .

Anyway, I'm glad for you that you're discovering options!

Snell

[Snell]

I think I might speak for everyone when I say how happy I am for you
that your PCP is being decent and *actually treating you* while you
look for a specialist.

The hyper-specialization of the professions (even of lawyers and
accountants--I don't know many general-practice lawyers) is a drag. I
know there are good reasons for it: Professionals get to know a small
area of the field really well; non-specialists don't have to worry
about making mistakes in their non-fields, etc. The problem is that
this inures to the benefit of the professionals and often prevents the
patients or clients from getting care or attention when needed.

It used to be that an Internal Medicine specialist was exactly that, a
SPECIALIST. My dad, a pediatric neurologist, used to joke that he was
a sub-sub-specialist.

I. general practitioner - physician - surgeon - pathologist
II. specialties: of physicians: internal medicine, family medicine,
pediatrics, OB-GYN (sort of a hybrid with surgeons), psychiatrists
III. specialties of internists: neurologists, pulmonologists,
cardiologists, yadda yadda
IV. specialties of neurologists: pediatric, adult, trauma

See? Eek!

But psychiatrists and internists are BOTH physicians! It's not as if
you're asking an orthopedic surgeon to prescribe medicine for the
central nervous system!

Psychiatry is one of the fields an internist must master in order to
become a psychiatrist, just as she/he must master emergency medicine,
treatment of infectious diseases, simple surgery, etc.

And I definitely agree about location. It is so damned difficult to
find a skilled doctor in a decent practice it's worth driving a long
way--for me, up to 90 minutes--to see her or him. I drive from remote
Massachusetts to New Haven, Connecticut to see my PCP. He has
expressed bemused confusion by this, and says I should "find someone
closer," but I ain't leaving his practice.

And then, once you've been in treatment for a couple of years, you'll
know better what you need in terms of psych meds, and can often resort
to that same PCP when you need a refill and your psychiatrist isn't
available. Physicians will often prescribe a medicine when they know a
specialist has already prescribed it for you when they won't initiate
treatment with a new medicine. A former romance was a pediatric
pulmonologist, and though we both knew it wasn't totally kosher, would
prescribe refills (of non-scheduled drugs) when my psychiatrist was on
one of his ten-week junkets to Venice. . . .

Anyway, I'm glad for you that you're discovering options!

Snell