STRUGGLING with DEPRESSION, ANXIETY, or BIPOLARITY? LEARNING can really HELP. Start with ARTICLES above or Topics below. Ty! Bill

“I’m mad as hell and I’m not gonna’ take it anymore!”

I have a major axe to grind. That’s right, “I’m mad as hell and I’m not gonna’ take it anymore!” Well, not to worry, I’m not gonna’ flip out. But somehow I aim to do something about it. Maybe you can help. Okay, okay…here’s what fried my bacon. And, no, that isn’t me in the pic.

I got paged late this morning to assess a patient who’s been having a tough time with anxiety and panic. So I get there and begin to work with this very nice 29-year-old woman who’d been an anxiety sufferer since she was 13. And, of course, depression had made an appearance, as well.

Not really part of my point here, but I always find meds interesting. She’d been treated over the years with a number of antidepressants and benzodiazepines. She’s currently prescribed alprazolam (Xanax), .25mg PRN TID (as needed, 3x/day). She told me she typically takes two tablets per day. And for the past month she’s been taking 20mg/day of paroxetine (Paxil). Her meds are prescribed by her primary care physician (PCP).

Okay, now for what really chaps my fanny. The woman had an appointment earlier this morning with her PCP in an effort to secure a paroxetine refill. See, the doc had only prescribed 30 days worth and she’d run out. And if you’ve experienced selective serotonin reuptake inhibitor (SSRI) withdrawal, especially from paroxetine, you’ll know why she wanted a refill. Not to mention her anxiety and panic had been nasty as of late.

So does the doc take care of his patient by giving her a refill? By the way, whether or not you or I think paroxetine is good medicine is irrelevant here. Nope…he tells her to report as a walk-in to the behavioral health intake department at the hospital just across the street (where I assessed her), telling her she could receive counseling and meds services there. Oh, and before I forget…God forbid the doc give her a prescription for maybe ten days worth of paroxetine while she finds another source.

Sadly, when I looked at the referral, the doc had written a department/program that hadn’t existed in years. Worse yet, though an assessment could certainly be provided free of charge, the facility doesn’t even provide the kind of care the doc promised. And that meant I was going to have to refer her elsewhere. Two places, in fact…one for counseling and one for meds. Just what an acutely anxious person needs, isn’t it?

And just for the record, the woman told me when she presented, acutely anxious, to the doc’s office a month or so ago, she had to wait three hours before seeing him. And she knew at one point he was in the back eating lunch.

Is this an outrage, or what? I guarantee this doc had no interest in retaining this woman as a patient. And I’ll double guarantee his disinterest was fueled by the fact that he couldn’t deal with the complexity of an anxiety case and the reality that the woman’s health care coverage was through Medicaid.

So he “streeted” her, even giving her a carelessly considered and written referral.

This kind of mistreatment happens time and time again, especially to anxiety sufferers who turn to their PCP for help. Here’s a link to a post detailing this exact issue. Absolutely, this kind of “care” is based in ignorance, stigma, and greed. And I’m so motivated to do something about it, beginning with sharing my outrage right here on the blog.

Would you help me with other ideas? Just click on the COMMENTS link just below the post title above, and you’re on your way.

  • Come on…we can defeat this kind of mistreatment if we don’t have ideas. Why not share with us?

  • klv

    All too common. It seems like he could have given her a sample for God’s sake, although he was probably saving them for his full price patients. There doesn’t seem to be much of a middle ground from the docs who just throw a bunch of scripts at the patient without giving them adequate time to work, and the ones who do what this guy did. When I was originally diagonsed 29 years ago, I was lucky enough to have excellent insurance and an excellent shrink who was willing to run the gamut of meds with me. and who saw me off and on for years when new meds came out even though she wasn’t in my insurance plan, so we could have an informed discussion about what might work and now long the half life was, etc, so i could go to my PCP with suggestions and dosages. I no longer live there and haven’t for 8 years, so have been on my own (she doesn’t feel comfortable doing it over the phone) and have been on my own since then. Thank god for the internet, and my ob/gyn who spends the time talking with me, staying current on a field outside of his speciality because with no insurance, the 4 other doctors i’ve tried have suggested HRT (even though I have no menopause issues) and going to the free clinics, although one doc did give me samples of zanax- 45 ,(.5) to be exact and no follow up appointment- told me to follow my instincts with taking it. Also, i am extremely lucky not to be a substance abuser. I guess this post doesn’t help because I have any suggestions on how to fix it. With no insurance, and really no reliable way to find a good doc except word of mouth (which is kind of hard to bring up unless you know someone really well) Maybe this will become my #9 on the recovery guide. sorry for going kind of off topic, but what you described is just SO typical, i got ticked off. thanks bill

  • Thanks so much, Karen, for your comments. You’ve helped by acknowledging and writing about the issue. Dang, I wanted to call this guy’s office so badly and tee him up, but that wouldn’t have been so good for job security. I’ll tell you, clinics and hospitals need to spread the word to providers as to the exact nature of their services. Another matter, so many of the E.R. physicians I work with ask for psych assessments mostly to cover their butts re liability. And that’s another part of the problem with our entire health care system…litigation.