So I went to the therapist on Saturday and it felt SO GOOD to get everything out there. She told me I definitely had a lot on my plate---it would stress anyone out---but having all that in addition to some underlying generalized anxiety is a bad combination. We discussed how medication may/may not be useful. Either a long acting something (SSRI) or something to take short term when I feel overwhelmed/panicky/can't breathe (benzo) while I continue with therapy, mindfulness, exercise, journaling, etc... She gave me the number of the intake for the psychiatrist with the group, and if that wait was too long, too call my primary for an rx or referral. I felt good. I had a plan.
We had a pretty good, low-key weekend. The weather was nice. I went to the gym and barre class and took the dog on long walks. I took the kids swimming both days. I cooked a TON of CSA veggies (sitting in my lunch bag is a container with riced cauliflower, baked tofu, sweet potatoes, carrots, swiss chard, zucchini and onions in a red curry sauce as well as a side of cole slaw...G made the slaw).
I woke up early today and did my meditation app for 10 minutes. I drank coffee while I read more of "the Art of Happiness" and got some Dalai Lama wisdom. I showered, straightened my hair, got dressed and came down in great spirits to take over the kids' breakfast & getting ready. I walked B to camp---it was cool and breezy and sunny and he is so excited for another week of playing & swimming.
Then I got to work and decided to try to make that psych appointment. I called the # for the psychiatrist. "not accepting new patients at this time". I messaged my primary "out of the office for 10 days". I called to leave a message for the covering doctor and I'll hear back in 2-3 business days (this is just to see IF they prescribe anxiety meds and if so, I need to make an appointment). I called the behavioral health center of my university. they don't take my insurance. Only residents are taking new patients. I could self-pay and get an appointment with a resident in 8 weeks. The employee assistance program offers THERAPY but not medication management. I went to my insurance website. I went down the list for the psychiatrists in my city (it was a surprisingly short list) and called every number (there were a few groups that had 5-10 providers): "not taking new patients" "no longer take that insurance" "first available in December".
What the actual fuck? How hard does this have to be? And I'm actually doing well enough to have the motivation and organizational skills to make all these calls! And I have one of the two major insurances for this area---how does nobody take it? The freaking company headquarters are here! How can my university practice not take one of the insurance options they give to their own faculty? I am willing to self-pay and still have to wait several months just to see a resident (who probably started in last week)? And the people on the phone were just so matter-of-fact and RUDE. Obviously if you are calling a psychiatrist's office for an appointment, you are feeling pretty shitty. Maybe an "I'm sorry" could be worked into your rejection? I'm not going to get political, but there is definitely a supply/demand mismatch in mental health services.
I feel really discouraged. I have no plan. I have no idea what more I can possibly do. I don't know any psychiatrists personally. I can't prescribe myself psychoactive drugs, nor would I want to. Aaargh.
This is so frustrating and so wrong! I've given up on providers after much less frustrating experiences. It sounds like your best bet is waiting for your PCP to come back in 10 days. :( :(
ReplyDeleteWow, that really really sucks.
ReplyDeleteWhen we lived in an east coast city, we had similar problems with wait times for pretty much anything we wanted to do (this is part of the reason it took a year and a half of being bumped from provider to provider to get pregnant the first time-- every new provider meant a min 3 month wait for an appointment). All the arguments about long wait times if we switched to national health insurance seemed pretty ridiculous given how long it took with private insurance.
Also that is especially messed up that your uni won't take uni insurance. On the plus side... it won't be July anymore by the time you get in to see a resident. Man, what a mess. Lots of sympathy.
Maybe your therapist will have some ideas (or some pull) if your PCP's office doesn't work out?
Well, our university has multiple choices of health plans and I picked the HMO bc its cheaper. I think next year I'll look in more detail the option of the HSA and high-deductible plan and just planning to self-pay
DeleteMakes sense.
DeleteWe only have one plan now, and I actually prefer it that way. I can't ever regret the choice I made now.
Ugh. I'm so sorry. Do you see another provider who might be able to prescribe something short term? (Like, I got sleeping pills from my fertility specialist on the rec of my therapist...)
ReplyDeleteI'm seeing my PCP the day she gets back next Wednesday. I got a list of referrals from her colleague, but they are the same docs I called. They either don't take insurance or are not taking new patients or are booked until 2017!
ReplyDeleteThe above sounds incredibly frustrating! And yet oh so common.
DeleteGlad you at least got an appointment with your PCP next week - though a week can seem so long when you really need the appointment...
Maybe I'm missing something, but it seems like if you already have a therapist and you are being treated for anxiety and/or depression is there a particular reason you need a psychiatrist as opposed to having your PCP prescribe? I've only worked in the FQHC world but we would pretty much always manage these meds in primary care, coordinating with the therapist.
Hope maybe she can help you and you can avoid having the above battle again!
You may be completely right. I honestly have no idea about this area of medicine, especially in terms of the logistics. My therapist told me to see a psychiatrist so I figured I should?
DeleteFrom what you have described, having your PCP initially prescribe sounds like a fine idea. Your physical and mental history may be more complicated that what you have shared on this blog and in that case, a psychiatrist may be a better approach. Supposedly psychs are also better at tweaking combinations of multiple medications.
DeleteAnd just as a point of reference, everyone I know who uses a pysch goes off-plan and pays out of pocket and seeks the minimal reimbursement. I don't think this is an area where coverage is particularly better with a PPO/POS rather than HMO.
The person I talked to at the PMD office was super nice, said if I felt I couldn't wait until next Wed, to call back and they'd get me in ASAP with another doc. I so appreciate it when medical staff are pleasant and compassionate. Unfortunately I don't think our office staff are necessarily super amazing, and I feel for my patients...
ReplyDeleteUGH. I have heard this from other people, too ... this is why our mental health system is a complete mess. :( I hope that your PCP can help! If not, I would ask your therapist to help by advocating with someone she knows. <3
ReplyDeleteSo I literally have never commented on a blog, but I've been reading for a while and wanted to reach out about this. First, you mentioned your therapist recommend the practice psychiatrist. If he or she is willing to reach out for you, perhaps that would open the door (my mom has been able to make that work with full practices multiple times.) Second, so glad you are taking this step - as I've read in the past few months your journey is similar to my own. I finally took the meds my PCP recommended after being VERY resistant (Lexapro, with very occasional Xanax) and it was like I woke up inside of my own head. The sleep came back (although with very weird dreams) and now all of the therapy etc. is actually working. (Also, if it hasn't already been recommended The Upward Spiral by Alex Korb is amazing.)
ReplyDeleteGood point! I wish I had thought of it. I know that doctors who are "not taking new patients" will sometimes take someone who's specifically referred by another doctor. Can your therapist call the office and ask?
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