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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Ricardo on December 24, 2002, at 8:27:12
Hi!
Has anybody here ever felt like you knew more than your doctor? Here, in Brazil, if you need to see a doctor, you have some kind of a directory that each health insurance company issues regularly with the names of the doctors they've accredited and who they will pay for. Those lists can be quite comprehensive. Usually, you try to locate a doctor whose practice is the most conveniently located for you, or for some other subjective reason (you kind of like the person's ethnicity, for example), since you have no resume attached. I did when decided to see a psychiatrist in the first place, I think location was what first came to my mind. I chose this doctor who has this very elegant practice located in very upscale neighborhood here in Sao Paulo. This led me to believe that she should to be good enough to be able to afford the rent in an area like that. Well, I had my first appointment with her. She listened to me in a cold way and agreed that I needed to take anti-depressants. She put me on a Brazilian brand of paroxetine (Paxil, in the US). When I mentioned that a friend of mine was doing well on Effexor, she said: well, if you want to try that, it's OK with me! I said: I want what YOU think is the best for me. I ended up taking Paxil for one month. Second time I went there, I told her about how badly I had felt all through that month, so she switched me into Wellbutrin, which was the name that I had already chosen for myself if she came up with a different one. I mean, is that the regular procedure you can expect from a psychiatrist?
Many thanks,
Ricardo
Posted by Geezer on December 24, 2002, at 10:35:12
In reply to How good is my doctor?, posted by Ricardo on December 24, 2002, at 8:27:12
> Hi!
>
> Has anybody here ever felt like you knew more than your doctor? Here, in Brazil, if you need to see a doctor, you have some kind of a directory that each health insurance company issues regularly with the names of the doctors they've accredited and who they will pay for. Those lists can be quite comprehensive. Usually, you try to locate a doctor whose practice is the most conveniently located for you, or for some other subjective reason (you kind of like the person's ethnicity, for example), since you have no resume attached. I did when decided to see a psychiatrist in the first place, I think location was what first came to my mind. I chose this doctor who has this very elegant practice located in very upscale neighborhood here in Sao Paulo. This led me to believe that she should to be good enough to be able to afford the rent in an area like that. Well, I had my first appointment with her. She listened to me in a cold way and agreed that I needed to take anti-depressants. She put me on a Brazilian brand of paroxetine (Paxil, in the US). When I mentioned that a friend of mine was doing well on Effexor, she said: well, if you want to try that, it's OK with me! I said: I want what YOU think is the best for me. I ended up taking Paxil for one month. Second time I went there, I told her about how badly I had felt all through that month, so she switched me into Wellbutrin, which was the name that I had already chosen for myself if she came up with a different one. I mean, is that the regular procedure you can expect from a psychiatrist?
>
> Many thanks,
> RicardoHi Ricardo,
Same process I have been undergoing here in the States for 30 years. We are now under a "managed care system" (the doctor gets paid less and IMHO services have diminished in recent years), as compared to our old "fee for service system". I routinely select which med. to use and the pdoc goes along with the decision (within reason). I have had limited success (Unipolar Major Depression/Depressed/Meloncolic) with many psyc. meds. for brief periods but I never blame the pdoc. They just haven't made the right AD for me yet.
I am TRD so this does not mean you will have the same problems....I have a bad history.Very best wishes,
Geezer
Posted by JonW on December 25, 2002, at 8:59:29
In reply to How good is my doctor?, posted by Ricardo on December 24, 2002, at 8:27:12
My advice to you is to find the best pdoc for your illness that you can afford, even if it requires travel, and trust their decisions and that they know how to treat you. Nothing wrong with doing research and asking question, but you'll fare best if an expert pdoc is steering the ship. This has saved my life.
Jon
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