Update: I am seeing another provider at primary office tomorrow. I am going over & over in my head what I'm going to say to convince her to prescribe anxiety meds for someone she has never seen before!
Thank you: for the comments/advice on my last post. This is an area of medicine I know nothing about, in terms of logistics. You were right in that 1) primary care does the initial med prescribing for most run-of-the-mill anxiety/depression drugs with psych for ongoing management & complicated cases and 2) it is normal to wait a long time & pay out of pocket for psych. For those asking if my therapist could "Get me in"---the answer is no, I did ask. There is one psychiatrist who sees all the patients for 10+ therapists in the group. ALL the patients coming to him "have an in" with a therapist in the practice. There was a psych NP who helped him out who just left---they are hiring someone new, but until the new person is there, he literally cannot fit another patient in.
Mini-rants about work: I rarely talk about my clinical work but this morning! UGH!
- I had THREE no-shows. Do people not use calendars (I know the answer, but WHY NOT!?) I am a specialist with a long wait-time for new AND follow-up appointments. Ms No-show is likely the same one who will complain about wait-times or call and BEG me to fit them in. When I make an appointment I put it directly on my calendar (currently using Google calendar, but I used to have a physical one)
- Medicine would be so much more efficient if we could find a way to bill for phone consultations. I spent 25 minutes on the phone today, going over (abnormal but not life-threatening or urgent) labs, potential treatment options, risks/benefits of each, follow-up plan for each, send prescriptions and then documenting the whole thing. A follow up visit for me is 20 minutes. I could've billed a level 4-5 follow up in that time period if the patient was physically in my office. I know lots of docs make you come back in to discuss labs but I get that it is hard for people to miss work, etc... and I know they are worried, and our office has a policy that we address phone calls within 48 hours so I can't just NOT CALL and once they get me on the phone it is literally impossible to get off the phone. I wouldn't mind it so much if it "counted" for my productivity and clinical effort.
Goals: 1) No alcohol on weeknights. My wine/cocktail consumption crept up alarmingly again, and I need to reset. I'm on week 2 and its totally fine (of course it is! I don't NEED it, it just became habitual). Seltzer is refreshing in the heat!
2) Meditation. Oh man, I am tired of coming here month after month to tell you how I failed at sticking to it. I keep seeing books/articles/science about the benefits of it, and my new therapist is mindfulness as the best tool for managing anxiety. I need to treat it like medication and JFDI. I can't say "it doesn't work" if I don't try it consistently. I missed yesterday but I'm going to do it today. I AM!!!
3) Shopping ban. I don't need any more clothes so I'm not going to buy any. At least until 2017 but maybe a full year again.
4) Journal. Another habit I keep falling out of---writing down my "3 good things" at the end of each day. It ended the day on a high note, nothing except laziness keeping me from spending 60 seconds on this activity.