Switching doctors question

[goldengirlz]

Quick backstory: I recently needed to change psychiatrists because my old one left the state. The new practice I switched to is HUGE; they literally have three dozen doctors across multiple locations.

I saw one a couple of times (over telemedicine), and it’s clear we’re not a fit. The most diplomatic way to say it is I don’t like her bedside matter (the less diplomatic answer is that I find her condescending AF — ironic since I chose her because I saw on her bio that we went to same university!)

Anyway, the practice won’t let me switch. You have to open a whole case with the central management office, which I’m not particularly inclined to do.

I’m just curious though. Does this sound typical? I’ve never encountered anything like this before. Sometimes two people just don’t click!

[Deleted]

I know nothing about this but feel like this is absurd given that this is a field where people connecting is critical to the success of treatment.

[wanderingback]

I guess what do you mean they won’t let you switch?
When you call the scheduling department to say I want an appointment with X, they tell you no?
I have never heard of that before. Sorry!

[goldengirlz]

Mar 9, 2023 17:20:25 GMT -5 wanderingback said:

I guess what do you mean they won’t let you switch?
When you call the scheduling department to say I want an appointment with X, they tell you no?
I have never heard of that before. Sorry!

Exactly. They emailed me about scheduling a follow-up, and I responded that I don’t think Dr. X is a fit and I’d like to transfer care to someone else in the group.

They wrote back saying I should be aware that it’s a “lengthy process” that requires an “internal review by management.” They want me to send “detailed” documentation on why I want to switch. The whole idea of a review process is making me very uncomfortable. Like do I need a whole management team reviewing my medical records??

[jenny1223]

I had a similar issue years ago with a GI doc. I didn't care for him after a couple appointments and asked to switch and was told that was next to impossible. And that all docs in that department would provide the same care and treatment recommendations. I ended up sticking with him (and actually grew to really like him and was so bummed when he retired!). I'd say a psychiatrist is a totally different thing though and finding a good fit is more critical.

[Pilsy]

Not the same, but I ran into this with my daughters' pediatrician. I was annoyed and switched to an entirely different practice.

[jennistarr1]

Definitely need to chime in. I went to an OB practice where you meet everyone at different appointments so that when you deliver it's always some one you met before . Then who delivers you becomes your doctor. Well I hated my delivery...hated the doc, hated some smug shit I heard him saying about another patient when I'm in triage..and hated follows ups where he wasn't understanding of how much my periods have worsened. They won't let me switch . So I'm looking for a new provider.

But that will be easier for me than you, I believe...finding new psychiatrists is hard. I would personally pursue the process they presented to you, at least as one way of voicing concern over the process...if that makes sense

[wanderingback]

Mar 9, 2023 17:23:08 GMT -5 goldengirlz said:

Mar 9, 2023 17:20:25 GMT -5 wanderingback said:

I guess what do you mean they won’t let you switch?
When you call the scheduling department to say I want an appointment with X, they tell you no?
I have never heard of that before. Sorry!

Exactly. They emailed me about scheduling a follow-up, and I wrote back that I don’t think Dr. X is a fit and I’d like to transfer care to someone else in the group.

They wrote back saying I should be aware that it’s a “lengthy process” that requires an “internal review by management.” Like what would that even entail?

Did you call the central scheduling number?
I know psychiatry is different than the medicine I practice so I do know they can have some different rules, but I think you should start over by calling again and asking for a specific doctor. You don’t have to mention anything about a good fit. I think most psych new appointments are 1 hour so it can take awhile to get in.

If they refuse you an appointment then I would ask for a patient advocate or office manager.

[Saudade]

Is this with Kaiser? Because I've heard similar issues with them and it's nearly impossible.

FTR, in my practice we want the patient to find the best provider for them. None of us is offended if the patient wants to switch and there are many times where I make the change for them in the room because it's a simple click of a button.

I'm so sorry you're dealing with this. It shouldn't be this hard and you deserve to find a provider you match well with.

[wanderingback]

Oh, Kaiser! Yeah I’ve heard crazy things about them :/ Sorry if that’s the case!

[goldengirlz]

Mar 9, 2023 17:33:35 GMT -5 Saudade said:

Is this with Kaiser? Because I've heard similar issues with them and it's nearly impossible.

FTR, in my practice we want the patient to find the best provider for them. None of us is offended if the patient wants to switch and there are many times where I make the change for them in the room because it's a simple click of a button.

I'm so sorry you're dealing with this. It shouldn't be this hard and you deserve to find a provider you match well with.

No, not even Kaiser! Just a private group.

[Saudade]

Mar 9, 2023 17:47:51 GMT -5 goldengirlz said:

Mar 9, 2023 17:33:35 GMT -5 Saudade said:

Is this with Kaiser? Because I've heard similar issues with them and it's nearly impossible.

FTR, in my practice we want the patient to find the best provider for them. None of us is offended if the patient wants to switch and there are many times where I make the change for them in the room because it's a simple click of a button.

I'm so sorry you're dealing with this. It shouldn't be this hard and you deserve to find a provider you match well with.

No, not yet even Kaiser! Just a private group.

How horrible is it that people in the midwest and east know how difficult it is with Kaiser? lol 

I'm not sure whether it's bad or good. I am sorry you're dealing with this. It would not be acceptable in my group. Obtaining psychiatric care is so difficult as it is.

[k3am]

In Kaiser’s specialty practices, you don’t “switch doctors” you “get a second opinion” and then just keep seeing that doctor.

[starburst604]

I would ask them where that policy is posted for you to have known that in advance. Their website, your intake paperwork etc.

[sent]

This is insane and I hate to say this, but the first thought I had when I read your post is that it smells like corporate medicine.

[tacokick]

If I had any choice at all, I’d find another practice. Even if you could get around their “policy” some way it doesn’t sound like a culture I’d want to depend on, be around or support.

Doctor shopping is the worst. We’ve had the best luck lately by flat out saying we want the doctors with the best bedside manner and sense of professionalism and the front desk people always know exactly who that is and hook us up. Sometimes they’ve referred us to another location but it’s worked.

[goldengirlz]

Mar 9, 2023 19:04:04 GMT -5 tacokick said:

If I had any choice at all, I’d find another practice. Even if you could get around their “policy” some way it doesn’t sound like a culture I’d want to depend on, be around or support.

Doctor shopping is the worst. We’ve had the best luck lately by flat out saying we want the doctors with the best bedside manner and sense of professionalism and the front desk people always know exactly who that is and hook us up. Sometimes they’ve referred us to another location but it’s worked.

I’m planning to start calling around tomorrow just to see who else might be available. I’ve had the toughest time finding a psych practice taking new patients but maybe I can get on a waiting list. (She did refill my prescriptions at our last visit so at least it’s not urgent. Or worst case, my PCP would probably call in a bridge Rx.)

Idle musings:

I do wonder if this has something to do with not wanting patients to “pill shop,” like if they’re looking for controlled substances. That’s the only benefit of the doubt I can give them.

[goldengirlz]

Mar 9, 2023 17:27:36 GMT -5 jennistarr1 said:

Definitely need to chime in. I went to an OB practice where you meet everyone at different appointments so that when you deliver it's always some one you met before . Then who delivers you becomes your doctor. Well I hated my delivery...hated the doc, hated some smug shit I heard him saying about another patient when I'm in triage..and hated follows ups where he wasn't understanding of how much my periods have worsened. They won't let me switch . So I'm looking for a new provider.

But that will be easier for me than you, I believe...finding new psychiatrists is hard. I would personally pursue the process they presented to you, at least as one way of voicing concern over the process...if that makes sense

Now this might be the worst policy I ever heard!

My OB practice made you meet everyone just in case but you still had a “main” doctor. And it didn’t change based on whatever random day you happened to go into labor. What happens when you have more kids? You need to switch again!?!

[tacokick]

Mar 9, 2023 19:29:57 GMT -5 goldengirlz said:

I’m planning to start calling around tomorrow just to see who else might be available. I’ve had the toughest time finding a psych practice taking new patients but maybe I can get on a waiting list. (She did refill my prescriptions at our last visit so at least it’s not urgent. Or worst case, my PCP would probably call in a bridge Rx.)

Idle musings:

I do wonder if this has something to do with not wanting patients to “pill shop,” like if they’re looking for controlled substances. That’s the only benefit of the doubt I can give them.

Hmmm, that’s possible but surely they’d have some way to track that internally that wouldn’t involve these hoops.

Good luck, it shouldn’t be this difficult to get basic care.

[wesleycrusher]

Mar 9, 2023 19:29:57 GMT -5 goldengirlz said:

Mar 9, 2023 19:04:04 GMT -5 tacokick said:

If I had any choice at all, I’d find another practice. Even if you could get around their “policy” some way it doesn’t sound like a culture I’d want to depend on, be around or support.

Doctor shopping is the worst. We’ve had the best luck lately by flat out saying we want the doctors with the best bedside manner and sense of professionalism and the front desk people always know exactly who that is and hook us up. Sometimes they’ve referred us to another location but it’s worked.

I’m planning to start calling around tomorrow just to see who else might be available. I’ve had the toughest time finding a psych practice taking new patients but maybe I can get on a waiting list. (She did refill my prescriptions at our last visit so at least it’s not urgent. Or worst case, my PCP would probably call in a bridge Rx.)

Idle musings:

I do wonder if this has something to do with not wanting patients to “pill shop,” like if they’re looking for controlled substances. That’s the only benefit of the doubt I can give them.

I work in a large psychiatry practice. Our procedure is that you can switch doctors once.  If after that switch the patient is still not happy then they are welcome to seek care elsewhere.

[wanderingback]

Mar 9, 2023 19:29:57 GMT -5 goldengirlz said:

Mar 9, 2023 19:04:04 GMT -5 tacokick said:

If I had any choice at all, I’d find another practice. Even if you could get around their “policy” some way it doesn’t sound like a culture I’d want to depend on, be around or support.

Doctor shopping is the worst. We’ve had the best luck lately by flat out saying we want the doctors with the best bedside manner and sense of professionalism and the front desk people always know exactly who that is and hook us up. Sometimes they’ve referred us to another location but it’s worked.

I’m planning to start calling around tomorrow just to see who else might be available. I’ve had the toughest time finding a psych practice taking new patients but maybe I can get on a waiting list. (She did refill my prescriptions at our last visit so at least it’s not urgent. Or worst case, my PCP would probably call in a bridge Rx.)

Idle musings:

I do wonder if this has something to do with not wanting patients to “pill shop,” like if they’re looking for controlled substances. That’s the only benefit of the doubt I can give them.

I don’t think it has to do with controlled substances but more that people with mental illness it could be part of their illness to switch doctors, whether that’s cause they’re paranoid or have borderline personality disorder, etc. I think most places let you switch once or twice though, so that’s why it sounds odd.

[gummy]

Yes I've had this at UCSD in a different specialty. You could request a 2nd opinion from a different doctor in their office but if that doctor suggests the same treatment then you have to go back to the original doc. It's insane to me because the original provider I saw was a complete twat waffle and THAT was my problem, not her plan of care. When I complained to the clinic admin about it she just flat out told me the twat was one of their most highly requested providers. AYFKM. I switched everything out of UCSD over it. All providers.

[gardengal]

That policy seems ridiculous for psychiatrists.

My PCP unbeknownst to me had that policy. My initial appt I just booked first available female. She was nice but was impossible to get a sick appt with & would somehow tie strep to me needing to lose weight. Anyways, I’ve completely changed practices.

[livinitup]

Can you just tell the psychiatrist at the next appointment that you want a referral to another provider? Discuss it directly?

[ssmjlm]

I would be honest at the next appointment that you don’t find her a good fit and ask to switch providers.

I’m assuming that your file shows you’re not a doctor shopper as pp alluded to above.



FWIW, we switched within our pedi practice and the office manager did call and ask why. I said that the previous pedi would change milestones from appointment to appointment which resulted in an unnecessary speech consult. So I felt I could no longer have confidence in her care. The manager thanked me for the feedback and scheduled us with the new provider.

[jobae1234]

Psychiatrists are notorious for their bad bedside manner. It’s not that hard to find a competent one, but finding a personable one is not easy. Psychiatric NP’s are generally much, much nicer to work with.

[jg183]

When I wanted to switch therapists apparently I had to have my current therapist sign off on it- how awkward is that- I dont want to schedule an appointment with her to be like hey I dont like you and want someone else. I ended up having my psychiatrist do it for me telling her that it was literally giving me anxiety thinking about this appointment- AND THIS IS WHY IM GOING TO THEM.

So I recommend you call the central scheduling people, tell them and remind them they are messing with your mental health- the same mental health they are supposed to be supporting. WYF

[bittybomb]

Same deal with my daughter’s endocrinologist. We requested an appt with a specific doctor but were assigned to the doctor who was on call the week she was diagnosed with type 1 diabetes. I actually like the doctor we had no choice over, but even still I felt some kind of way about our lack of choice. I could not even imagine how frustrated I would be in your shoes.

[msmerymac]

Mar 9, 2023 17:23:08 GMT -5 goldengirlz said:

Mar 9, 2023 17:20:25 GMT -5 wanderingback said:

I guess what do you mean they won’t let you switch?
When you call the scheduling department to say I want an appointment with X, they tell you no?
I have never heard of that before. Sorry!

Exactly. They emailed me about scheduling a follow-up, and I responded that I don’t think Dr. X is a fit and I’d like to transfer care to someone else in the group.

They wrote back saying I should be aware that it’s a “lengthy process” that requires an “internal review by management.” They want me to send “detailed” documentation on why I want to switch. The whole idea of a review process is making me very uncomfortable. Like do I need a whole management team reviewing my medical records??

As someone who sees a therapist due to anxiety, this is the last thing I would want to spend my time doing.

[wildrice]

Mar 9, 2023 17:23:08 GMT -5 goldengirlz said:

Mar 9, 2023 17:20:25 GMT -5 wanderingback said:

I guess what do you mean they won’t let you switch?
When you call the scheduling department to say I want an appointment with X, they tell you no?
I have never heard of that before. Sorry!

Exactly. They emailed me about scheduling a follow-up, and I responded that I don’t think Dr. X is a fit and I’d like to transfer care to someone else in the group.

They wrote back saying I should be aware that it’s a “lengthy process” that requires an “internal review by management.” They want me to send “detailed” documentation on why I want to switch. The whole idea of a review process is making me very uncomfortable. Like do I need a whole management team reviewing my medical records??

I had this happen with a psychiatrist a few years ago. She was awful - she basically told me ADHD was not a real thing for adults and when I got super teary about it (because I was really struggling and had hoped so much that this appointment would change things), she acted like she didn't even notice I was crying and didn't ask me what was going on. I felt so dismissed. Good thing I wasn't in a dangerous place mentally - it felt so neglegent. Anyway, since the practice had been recommended I wanted to just switch to another doctor within the practice. I was told I'd have to have one more appointment and then my request would be reviewed by someone in a high level role there - and it turned out that person was going to be the doctor I had seen! There was no chance I was going to do that, so I just never went back.

If I were you I'd just go to a new practice unless there is some reason you can't. This sounds so uncomfortable and laborious for no reason.