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Quix! Are Doctor recommended referrals unbiased?
As you may recall, my neuro is suggesting a possible conversion disorder diagnosis. He has referred me to a particular doctor that he knows from his recent neuro training. From your personal and professional experience, are there any tangible reason for not using a recommended physician or should I go find someone on my own? Some have told me that I shouldn't use anyone he recommends because of possible bias and now I'm just a little confused. Thank Much!!
Julie
Julie
Thank you for your feedback on my question regarding doctor referrals. It was a lot to think about and I have come to a conclusion about how to proceed with the psych eval that is somewhat inline with what you suggested. For now I am going to deal with the 2nd opinion on the MS question. I know I don't need a psych eval just yet and especially not for a dx of conversion. Like you said, CD is very rare and I agree that a doctor who comes to that conclusion after less than 3 months of seeing a patient is really trying to find an easy way out. I have also decided not to see this guy again as there is no point. As Dr. Quix would say "just move on..." and that is what I will do.
Thanks again for your insightful and very helpful information. I appreciate very much.
Julie
Thanks again for your insightful and very helpful information. I appreciate very much.
Julie
Hi Julie!
The choice to see a psychiatrist to identify if your neurological symptoms are due to a conversion disorder VS. if you have multiple sclerosis is ultimately up to you. I had the conversion disorder label suggested to me by many doctors and I've been to 13 doctors and now I've finally found a great neurologist who listens to me and who is commited to getting me diagnosed and who doen't dismiss me as some crazy neurotic women. Thank God! I would be VERY, VERY cautious about going to a psychiatrist right off the bat. You also have to choose your psychiatrist very, very wisely. From what I understand conversion disorder is a very rare condition and unfortunately when doctors are not finding objective evidence/explinations for your symptoms they all to frequently dismiss their patients as f**king crazy. I have been to 13 doctors, 6 of whom were psychiatrists. Only one of the six psychiatrists I went to were comptent and was able to give me good treatment recomendations. Unfortunately, there is absolutely ZERO science when it comes to the diagnosis of major psychiatric illnesses such as depression, bipolar disorder, and conversion disorders. You can go to 10 different psychotrists and get 10 different diagnosises depending on the "opinion" of the psychotrist you choose to go to. Then once you get the "label" they perscribe you multiple psychiatric drugs that unfortunately may not fix your health problems but may ultimately cause a host of new symptoms secondary to drug sideeffects that ultimately complication the diagnosic picture. Once you get a "psychiatric label"/psychiatric diagnosis it is all too often that all the subsequent doctors you visit will attribute ALL or most of your health problems to a psycosomatic mental illness. It is all to easy for a doctor who doesn't have the time or want to make the time to listen to their patients to dismiss them as crazy. Unfortunately, the dismissive doctors do not investigate long and hard to see what physical illesses could be causing/contributing to your health problems. My feeling is that doctors have an inherent obligation to look long and hard to find any physical health abnormalities that are causing your symptoms before they send you to a psychiatrist. I highly recommend that you find a good neurologist who is skilled in MS.
Good Luck to you!
The choice to see a psychiatrist to identify if your neurological symptoms are due to a conversion disorder VS. if you have multiple sclerosis is ultimately up to you. I had the conversion disorder label suggested to me by many doctors and I've been to 13 doctors and now I've finally found a great neurologist who listens to me and who is commited to getting me diagnosed and who doen't dismiss me as some crazy neurotic women. Thank God! I would be VERY, VERY cautious about going to a psychiatrist right off the bat. You also have to choose your psychiatrist very, very wisely. From what I understand conversion disorder is a very rare condition and unfortunately when doctors are not finding objective evidence/explinations for your symptoms they all to frequently dismiss their patients as f**king crazy. I have been to 13 doctors, 6 of whom were psychiatrists. Only one of the six psychiatrists I went to were comptent and was able to give me good treatment recomendations. Unfortunately, there is absolutely ZERO science when it comes to the diagnosis of major psychiatric illnesses such as depression, bipolar disorder, and conversion disorders. You can go to 10 different psychotrists and get 10 different diagnosises depending on the "opinion" of the psychotrist you choose to go to. Then once you get the "label" they perscribe you multiple psychiatric drugs that unfortunately may not fix your health problems but may ultimately cause a host of new symptoms secondary to drug sideeffects that ultimately complication the diagnosic picture. Once you get a "psychiatric label"/psychiatric diagnosis it is all too often that all the subsequent doctors you visit will attribute ALL or most of your health problems to a psycosomatic mental illness. It is all to easy for a doctor who doesn't have the time or want to make the time to listen to their patients to dismiss them as crazy. Unfortunately, the dismissive doctors do not investigate long and hard to see what physical illesses could be causing/contributing to your health problems. My feeling is that doctors have an inherent obligation to look long and hard to find any physical health abnormalities that are causing your symptoms before they send you to a psychiatrist. I highly recommend that you find a good neurologist who is skilled in MS.
Good Luck to you!
Back to the topic of seeing a doctor recommended by another.....we have a magazine called D magazine here in Dallas. They fax ballots to staff and physicians and they vote on who they like and/or play golf with etc. Once your name is chosen you then have to pay $20,000 for a whole page that is reserved for the really, really good doctors and they even bring you a plaque for your office as though it was an award. This magazine is in every store once per year telling how wonderful someones golf buddy was and they get to write it off for advertising. As for the psychiatrist, well that is your choice but go together. I took my hubby and we both left shaking our heads. I gave in and he saw that the process is really like talking to a very best friend with no unwelcome responses. He has been that person for me forever so for us it works to be there for each other. As for getting your own doctors I have started an interview sheet prior to seeing them. The first visit is an interview of their skills not my symptoms and whether I think he can help me. We save the treatment plans for visit 2 after he reviews my symptoms and decides if he likes my aggressive approach to managing my health. I can't stand to wait for results as I am sure you all have some idea of from my journal. Just do what you think is right and if your wrong then fix it and try over. In fact, that is my new motto!
Plus, you can point to him and say you already have the recommendation to see a psychiatrist as part of your record now and if you don't go for at least one meeting it will look like you do have problems with CD and want to avoid the discussion. You have to do this to clear your name!! :-)
I wouldn't dwell too much on any of this - just wait til he leaves again and go do it - you're a big girl and know what you need to do.
My best,
Laura
I wouldn't dwell too much on any of this - just wait til he leaves again and go do it - you're a big girl and know what you need to do.
My best,
Laura
Julie,
If you would like to learn more about this idea, read this book (available used on Amazon.com)- Dr Guarneri is a highly respected cardiologist and in this book she writes extensively about the heart driving so much of what we do. It is a very easy read and I would recommend it to everyone!
The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing by Mimi Guarneri (Paperback - Jan 2, 2007) - Bargain Price
Used & new from $4.40
If you would like to learn more about this idea, read this book (available used on Amazon.com)- Dr Guarneri is a highly respected cardiologist and in this book she writes extensively about the heart driving so much of what we do. It is a very easy read and I would recommend it to everyone!
The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing by Mimi Guarneri (Paperback - Jan 2, 2007) - Bargain Price
Used & new from $4.40
You are such a true and loyal friend. I think your suggestion is brilliant and it will work for him. He is an Engineer and he surrounds his world with logic. I think he can understand the min/body connection if presented at an appropriate time as you suggested. Thank you so much. It is so simple, yet this approach hadn't occurred to me.
I will let you know how it turns out.
Julie
I will let you know how it turns out.
Julie
Julie,
I would begin by giving him some time to be home and process what you told him. When you have quiet time again, you could approach this from the brain/body connection - I'm sure he understands your brain's connection to the possible MS in your body.
Then expand the conversation that your brain is also connected to your heart - and despite what we might think about our heart, it does so much more than just pump blood for us. Explain to him that the possibility exists that your heart is guiding your brain in other ways that are also detrimental to your body. By talking with a psychiatrist, you can eliminate the heart speaking in a bad way off the diagnosis table. BTW there is much research being done now on the way our heart governs us - we are much more heart centered than we have previously been led to believe.
What do you think? Will he accept a physical explanation?
Good luck and enjoy these precious days,
Laura
PS he should be livid about the CD suggestion - the rest of us here were !!
I would begin by giving him some time to be home and process what you told him. When you have quiet time again, you could approach this from the brain/body connection - I'm sure he understands your brain's connection to the possible MS in your body.
Then expand the conversation that your brain is also connected to your heart - and despite what we might think about our heart, it does so much more than just pump blood for us. Explain to him that the possibility exists that your heart is guiding your brain in other ways that are also detrimental to your body. By talking with a psychiatrist, you can eliminate the heart speaking in a bad way off the diagnosis table. BTW there is much research being done now on the way our heart governs us - we are much more heart centered than we have previously been led to believe.
What do you think? Will he accept a physical explanation?
Good luck and enjoy these precious days,
Laura
PS he should be livid about the CD suggestion - the rest of us here were !!
OK, so my husband just came in last night from a war zone last night and we talked about a lot of stuff. When I told him about the conversion disorder idea the neuro came up with he was appalled. He was absolutely livid when I told him that the neuro thought it might be a good idea to see a psychiatirist for an eval. He doesn't think it is a good idea at all. He said to just do the 2nd opinion and leave it at that, that doing a psych eval won't really do anything except be on my medical record. He said he doesn't see the logic in all this.
What do I do? I know this is my decision to make, but this is strange territory that both my husband and I have never come across. He just doesn't want me to be put through this, but then again he comes from a culture where mental illness is much more of a stigma than it is here in the states.
Again, any insight you all can pass on to help me help him understand what is going on here would be very appreciated. Thanks, thanks. and more thanks.
Julie
What do I do? I know this is my decision to make, but this is strange territory that both my husband and I have never come across. He just doesn't want me to be put through this, but then again he comes from a culture where mental illness is much more of a stigma than it is here in the states.
Again, any insight you all can pass on to help me help him understand what is going on here would be very appreciated. Thanks, thanks. and more thanks.
Julie
This guy is young - cuter, but young. He just got board certified 2 years ago and I just think he probably needs more real world experience. I'll get a different psychiatrist. Thanks for saving me a ton of money, time, and anguish over this decision.
Julie
Julie
Okay, I missed something BIG here! This neuro is sending you for a second opinion on the point of MS WHILE ALSO ENTERTAINING THE DIAGNOSIS OF CONVERSION DISORDER????
WTF??!!!!!
No, one excludes the other!
Is he an idiot?
Oh, my.........this made my brain hurt.
Uhhh....ummmm....breathe.....uhhhh....do not (read that NOT) see the psych he recommends. He learned his stuff about CD somewhere. As to the other neurologists at the medical centers. Check them out if you can, and they might be okay.
WTF??!!!!!!
huh?
WTF??!!!!!
No, one excludes the other!
Is he an idiot?
Oh, my.........this made my brain hurt.
Uhhh....ummmm....breathe.....uhhhh....do not (read that NOT) see the psych he recommends. He learned his stuff about CD somewhere. As to the other neurologists at the medical centers. Check them out if you can, and they might be okay.
WTF??!!!!!!
huh?
I'm sorry to belabor the point here as you guys have put me on a clear path now. I just didn't want to make a bunch of appointments only to cancel them and have to wait for another set of appointments. I don't have the time or money to mess around with not getting objective, truly objective evaluation of my psyche and/or medical status. Thanks. I know what I have to do now.
Julie
Julie
Julie,
Perhaps since you had such a positive experience today with your PCP you could ask her for a recommendation? I would hesitate going to the psychiatrist that the neuro studied under, because that's probably where he learned conversion disorder in the first place. That may be the psychiatrist's clinical interest area.
Good luck,
Laura
Perhaps since you had such a positive experience today with your PCP you could ask her for a recommendation? I would hesitate going to the psychiatrist that the neuro studied under, because that's probably where he learned conversion disorder in the first place. That may be the psychiatrist's clinical interest area.
Good luck,
Laura
I'm not going to assume anything that this neuro is thinking, but he did recommend two other physicians at local universities that he knows has MS experience.
As for the CD dx, it was the psychiatrist that he recommended because he "studied under" him. Does that make a difference?
Julie
As for the CD dx, it was the psychiatrist that he recommended because he "studied under" him. Does that make a difference?
Julie
I would be very leery of going to a second opinion to someone recommended by the doctor, especially on a topic as fraught with bias as Conversion Disorder.
If the doctors studied together, they likel;y have the same point of view on many things. It is human nature to refer to someone who is likely to agree with you. A specialist's income is made from getting referrals.
There are times when a doc just isn't sure and would like colleague to take a look. This is different. It is bringing another mind in to look at the situation. I frequently did this.
But, if the question is something like Conversion Disorder, whether surgery is needed, or if the working diagnosis just feels wrong, then I think a more disinterested second opinion is in order.
You can check out Drs. by googling "Rate your Dr." and checking out some of the bigger online doctor rating sites, like "ratemds[.]com".
quix
If the doctors studied together, they likel;y have the same point of view on many things. It is human nature to refer to someone who is likely to agree with you. A specialist's income is made from getting referrals.
There are times when a doc just isn't sure and would like colleague to take a look. This is different. It is bringing another mind in to look at the situation. I frequently did this.
But, if the question is something like Conversion Disorder, whether surgery is needed, or if the working diagnosis just feels wrong, then I think a more disinterested second opinion is in order.
You can check out Drs. by googling "Rate your Dr." and checking out some of the bigger online doctor rating sites, like "ratemds[.]com".
quix
Hy, I agree.... watch out for those school connections... they can be deadly, I ended up with my first neuro this way, and it was a mistake. I am going to NYU tomorrow, and praying my head off, wishing, hoping, having everyone cross their fingers.
Seriously, run. That whole buddy system is scary. They want, from the bottom of their heart to believe their buddy doc's. Not in a bad way, but as a friend, so run.
Find you're own doc through other patients, the phone book, anything that you can that will give you a decent doctor. Try to find a patient who goes there and LOVES him... that always at lives gives you a leg up.
((((hugs))))
~Sunnytoday~
PS sorry, I'm not Quix....
Seriously, run. That whole buddy system is scary. They want, from the bottom of their heart to believe their buddy doc's. Not in a bad way, but as a friend, so run.
Find you're own doc through other patients, the phone book, anything that you can that will give you a decent doctor. Try to find a patient who goes there and LOVES him... that always at lives gives you a leg up.
((((hugs))))
~Sunnytoday~
PS sorry, I'm not Quix....
I am not Quix but I do agree. It might be a waste of time to go to a recommended referral if you are looking for a second opinion.
I went looking for a second opinion and ended up going to a doctor who had go to the same school the first doctor went to and all I ended up with was high praise for my first doctor and a scolding because I was " a good parent and not taking enough time for myself." I went to that appointment with optic neuritis, two spots on my MRI, a family history of MS, and a few other things.
Five months later I was still having trouble, second bout of ON. I went to an MS specialist and was diagnosed on the spot. She said I should have been diagnosed much sooner and started on DMD's.
When I went for the second opinion I looked through my insurance manual to find someone who was covered. I had no idea the doctor I was going to see had any connection with the first neuro I went to.
So, I'd find someone on my own if I were you and hopefully it won't end up being someone who has connections with your current doctor.
I went looking for a second opinion and ended up going to a doctor who had go to the same school the first doctor went to and all I ended up with was high praise for my first doctor and a scolding because I was " a good parent and not taking enough time for myself." I went to that appointment with optic neuritis, two spots on my MRI, a family history of MS, and a few other things.
Five months later I was still having trouble, second bout of ON. I went to an MS specialist and was diagnosed on the spot. She said I should have been diagnosed much sooner and started on DMD's.
When I went for the second opinion I looked through my insurance manual to find someone who was covered. I had no idea the doctor I was going to see had any connection with the first neuro I went to.
So, I'd find someone on my own if I were you and hopefully it won't end up being someone who has connections with your current doctor.
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