<p>Son has been getting his ADD meds from his pediatrician but he turns 18 next week so we took him to a psychiatrist in December (needed to anyway - depression issues.) </p>
<p>We first asked the pediatrician’s office for a referral. They said they didn’t have anyone they typically referred to but said that if I told them who was covered by our insurance, they would see if they knew any of them. Turns out, my insurance has exactly one psychiatrist on the list in our county, and he’s too far of a drive to see on a regular basis. (Have to pick up the prescription in person every month.) I asked my doctor - he didn’t know anyone. I finally googled and found this guy who was in a good location. Both times we’ve been, we’ve had to wait a very long time, plus I’m not feeling like the guy listens or cares. </p>
<p>How in the world do I find someone better? I’m totally comfortable asking a friend “Who did your LASIK?” but I don’t know anyone who has talked openly about seeing a psychiatrist.</p>
<p>A few years ago my D needed to see a psychiatrist for depression. She was then 13 years old and we had a hard time finding a psychiatrist that would take children. We got a list of doctors from her school counselor and we also got several names from the pastor at our church. I also asked friends who I knew had gone through the same problems. There were very few psychiatrists for children listed on our insurance list but we ended up going to a doctor on the list. We had to beg them to accept us as they weren’t accepting new patients. The doctor she saw was at the UT Health Science Center and was actually a medical student. He had a supervising physician we also talked to regularly. It worked out well and after about 6 months my D was well enough to stop going. I hope you can find someone. I would probably try the one you mentioned with the long drive.</p>
<p>A pediatrician should be able to refer you to a psychiatrist. I don’t understand why your pediatrican isn’t able to do this. You can contact your local high school and speak with someone in the special ed. dept. They may be able to recommend someone. In addition, you can ask your own physician for a recommendation. Another option is to call your insurance company directly and ask them about your options.</p>
<p>He could see a regular doc or a neurologist for the meds. My son goes to a pediatric neurologist for ADHD meds and DH goes to family doc for anxiety meds. When they have needed counseling in addition to meds, they have gone to a psychologist. I understand that some states are starting to allow psychologists to prescribe some meds.</p>
<p>Another thought is to check if you have an employee assistance program at work that is different than your health insurance. Sometimes you get a certain number of visits to a psychiatrist or psychologist through them and their network can be different than your health insurance.</p>
<p>As a nurse for 20 years I would never ask a physician for a referral. I have found that they normally refer friends or colleagues and normally don’t know how they practice on a day to day basis. When I need to find a new physician I will call a hospital and ask to speak to a nurse on a unit where the speciality is that I’m looking for. I usually say "I’m a nurse and know you aren’t allow to refer physicians but if you had to take a family member to “this person” would you? Usually they’ll give you a thumbs up or down off the record. I normally do the same thing when someone calls me and asks if I’d go to a certain physician. We’re not supposed to give referrals but I’ll gladly say “yes,I go to this physican or my husband does”. That’s how I find my own… Good luck.</p>
<p>One suggestion -
Do you have a nearby Children’s hospital? or even Medical center?
Look for a psychiatrist who specializes in Adolescent Psychiatry.<br>
You also might want to contact a local mental health agency - they may be able to help you find an appropriate psychiatrist.</p>
<p>I am also surprised the pediatrician doesn’t have a few they recommend. Your son can not be the only patient who needs a psychiatrist. Maybe it is where I live but I know quite a few kids and adults who see a psychiatrist or therapist.
My oldest saw one who was also a psychologist, they did talk therapy along with med management. Since she left home she has had a hard time finding a psychiatrist who she likes. She has found a good therapist.
My younger D has been going to a neurologist for migraines. Since she started seeing him I have had several people tell me they use the same Dr for their kids ADD meds. This guy is supposed to be great medically but he has absolutely no personality and I can not imagine anyone talking to him about depression.
A possible solution is to find a neurologist and also a therapist. One person for meds and another for talk therapy. Also if you know any therapists they should have Dr’s they refer their patients for meds. I find my insurance company picks up more of the cost of the neurologist so it costs me less.
Is the pediatrician not willing to continue writing the meds? If you are switching him to a internist maybe that Dr would be willing to write the prescription if your son does not need a med change.
Once your son decides on a college you might call the Disabilities office and find out where most of their students get their prescriptions. Most student health centers do not carry stimulants. At one of the schools my son seriously considered the Disabilities office helped them set up a relationship with someone to get prescription. The school he is at did not and said most students get their prescriptions from home. With my son I get the prescription from the psychiatrist, refill it and put it in the mail.</p>
<p>Why can’t he continue seeing the pediatrician for ADD meds? Around here, pediatricians will see kids well into their 20’s, certainly through college.</p>
<p>missy - What I’d do is find a local ADD support group, and ask who they would recommend. But you might try a couple of other approaches also. After all, your main job here is to show your S several ways that he can find professionals. Good luck with this teaching opportunity!</p>
<p>If you are near a university with a Ph.D. program in psychology, you might try calling that program’s training clinic and asking for their referral list for when young adult patients need a prescribing psychiatrist for ADD meds. If they have a psychiatrist who comes in and lectures the psychologists in training about medication and covers ADD meds, this might be a good person to find. The university’s disabilities office might also have a list of psychiatrists to whom they refer when ADD students relocate to the area for college and need a new physician.</p>
<p>I must say, I’m shocked that your pediatrician can’t help you, too.</p>
<p>I ran a group home for juveniles who were declared delinquent or otherwise involved in the court system, and most of them saw the same psychiatrist who prescribed meds, but did not do any sort of therapy. We live in a medium sized college town and do not have a lot of options for psychiatrists. It seems that they generally do in-patient work in their practice. The boys that needed therapy saw psychologists for anger managment and behavioral issues as well as depression. They only saw the psychiatrist when they needed a refill, and then it was a very brief appointment. That might be why you’re getting the vibe that the psychiatrist doesn’t listen or care. This may not be other’s experience at all, but mine has been that if you want someone who listens and cares you see a psychologist, and if you want someone who will give you lithium and admit you to inpatient care you see a psychiatrist. </p>
<p>I would say to find your son a good general practitioner or family doctor. My younger two see a pediatrician but my 18 year old sees a gp. I had actually switched my 18 year old to this gp and liked him so much I intended to have everybody see him, but when I tried to make more appointments he had stopped taking new patients. Your son will need a regular doctor anyway because you can’t call your psychiatrist if you have strep throat. The gp can usually quite competently handle meds for adhd, and can also be a resource for other options if you need them. My husband is also on adhd meds and sees the family doc for them. The prescriptions do need to be picked up at the doctor’s office rather than having the order faxed or phoned in because they are narcotics. It’s a bit more complicated because of that.</p>
<p>So, I’d say if you were just looking for another doctor to continue prescribing the meds that he’s been getting, then just get him a gp. If you’re looking for someone to do more in depth evaluation of the issue and perhaps some therapy then look into psychologists. </p>
<p>I know there are some websites where people review doctors–kind of like tripadvisor.com but for doctors instead of hotels. I have only found the doctors I like by trial and error. Anyway, that might be another option for you.</p>
<p>This guy just does meds (not therapy) but I didn’t get the idea he was listening even with respect to that. It has been a long time since the brand of ADD meds and dosage had been adjusted and Son had become so much more hyper - but the doc just prescribed the same thing in the same amount. At the first appt. he said there were lots of different antidepressants to try and just pulled one out of a hat. When we said that one caused major insomnia, he wanted to just prescribe sleeping pills instead of trying a different antidepressant.</p>
<p>Also, if your insurance has only 1 in network provider in your area, you may be able to negotiate with them to cover an out of network provider (if you dont have OON benefits) but the Dr will not be expected to accept the in-network rate.</p>
<p>No suggestions, as I’m still trying to find one myself, but I counsel patience. Finding a psychiatrist with whom you are comfortable is extremely important and you’re just as allowed to shop around for a psychiatrist who makes you feel comfortable as you do a pediatrician or any other health-care provider.</p>
<p>I’ve had a psychiatrist who did nothing but meds and gave me a 15-minute write-off on how I was doing; definitely didn’t work for me. I had a psychologist who couldn’t/wouldn’t diagnose or provide meds, but did excellent talk therapy. I had a psychiatrist who did talk therapy, but she was much more keen on diagnosis and medication than the therapy. And so I am still looking.</p>
<p>Because I am at university, I have access (and insurance) for the health center attached to my school. I can visit Counseling and Psychological Services, speak with someone about my concerns, and get a referral to one or more pdocs in a 20 mile radius. I second Nester’s suggestion to contact your local university.</p>
<p>Best of luck! Though this side of medicine is reaching the light little by little, it’s still hard to have an open conversation about it, and I’ve found support – personally and professionally – to vary greatly from person to person.</p>
<p>Hi- I am a LCSW- here’s what I suggest- do you know any therapists to ask for a referral?
“Talk” therapists always have references for psychiatrists to refer to for their patients who need medication in addition to counseling. They know the quality of the psychiatrists well.</p>
<p>Cornmuffin, you just caused a light to go off in my head. I have a neighbor in the social work field and she talks quite openly about her own little boy’s ADD and meds…I bet she’d have some ideas for me.</p>
<p>As far as shopping for someone, the problem is that the initial consultation for these folks tends to be around $250 a shot, which is 100% out of pocket. Such a contrast with the law field, where I talk to folks on an introductory basis for free all the time.</p>
<p>This is exactly why I support Clinical Psychologists with extensive psychopharmacological training to be able to prescribe mental health medication</p>
<p>missypie- look on you plan for a neurologist. The insurance might pay more of the visit. My insurance once my son turned 18 paid very little of the psychiatrist bill. His Dr was out of network and was very expensive. Few of the psychiatrists in our town take any insurance. Plus many are not taking new patients. They paid almost all of my D’s neurologist bill.</p>
<p>Missy, I am in a medical family, and I am a medical administrator. It sounds like the resources are not overabundant where you live, but this is what I would do. If you are leaving the pediatric practice, try to find a GP, Family Practice doctor or Internist that your son likes. In today’s medicine, most give medications of the mental health variety. I would recommend a psychologist for counseling since they really are into the talk therapy, and this can be a big help. The GP etc can recommend one. I think the hospital or medical school ideas as sources of practitioners or referrals is also a great idea.</p>
<p>Contrary to what Nurseratchet says, we personally do not favor “friends”. Most of the doctors we know are really known to us professionally, and not personally. We are not in a large group, and there is no incentive for us to give other than sincere recommendations.</p>