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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by honeybee on May 31, 2006, at 18:14:34
I'm just curious. It's annoying when your pdoc looks at you from his comfy chair and says, "Have you talked to your primary about that?" or then says, "Maybe you should see a [insert specialist here]." Seriously, I want a pdoc who actually orders the tests himself and can interpret it instead of playing chemistry set with me as his beaker.
Anyway, seriously though, anyone? anyone?
Posted by willyee on May 31, 2006, at 18:36:51
In reply to Does anyone's pdoc actually order blood tests?, posted by honeybee on May 31, 2006, at 18:14:34
Im comming to ten years now in treatment,and i havent hadent a single doc use any scieance,blood work,health questions etc,not a single one,and ive seen quite a few.
They all seem to simply address medication,not taking the blame off myself,but i think due to this they hold partial blame for me being so obsessed with "finding" that magic drug.
Posted by Ocracoker16 on May 31, 2006, at 18:47:30
In reply to Does anyone's pdoc actually order blood tests?, posted by honeybee on May 31, 2006, at 18:14:34
Yes, my doctor orders blood tests for me. Your doctor should be able to write the tests you need on a prescription sheet. The doctor should tell you what lab to go to. Thyroid function tests and liver function tests are just a few that you should get.
Katie
Posted by deuce224 on May 31, 2006, at 18:58:53
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by Ocracoker16 on May 31, 2006, at 18:47:30
I agree, my psych doc has ordered thyroid,kidney, and liver tests. IF they can't or don't then you might wanna switch doc's.
Posted by yxibow on May 31, 2006, at 19:11:59
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by deuce224 on May 31, 2006, at 18:58:53
Yes -- my psychiatrist has ordered an eye exam (overcautious) for Seroquel (high doses have been observed in beagles to cause corneal deposits though this is super rare).
I believe if I recall correctly, he has also ordered a CBC panel when I was on Remeron, as agranulocytosis is again a rare but possible issue.
And collaboratively with my primary care doctor he ordered (finally after a while in treatment to make me more at ease) an MRI to fully put the tumor ideation to rest and that it was a psychiatric case.
If your psychiatrist cannot order CBC panels for medications, there is something wrong -- because agranulocytosis is a common issue with many psychiatric medicines, rare, though existing, and should not be just shuffled aside as "a cold" even if it is. It is required by law, of course, for clozapine (Clozaril).
Other conditions too, related to medication can be ordered by a psychatrist, such as diabetes screening and the like.
A psychiatrist is a mental health practitioner first but also an MD.
The best situations of course are where the psychaitrist is associated with a public or private hospital rather than a sole public practice, which would create problems of getting results back to the psychiatrist. But its not impossible -- they're just prescriptions.
Posted by Phillipa on May 31, 2006, at 22:13:21
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by yxibow on May 31, 2006, at 19:11:59
My old one did an executive profile every three months. Now I have to go my primary doc for med tests. Love Phillipa
Posted by RetiredYoung on June 1, 2006, at 6:19:10
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by yxibow on May 31, 2006, at 19:11:59
Yes. My pdoc ordered blood tests for glucose and lipids for my Zyprexa, and we've begun the game of blood tests for each add'l dose of Lithium to get me into the theraputic range.
Posted by fca on June 1, 2006, at 8:38:00
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by RetiredYoung on June 1, 2006, at 6:19:10
yes, pdoc routinely norders liver, lipids and thyroid (on initiation)--very willing to order any and all necessary lab work fca
Posted by Larry Hoover on June 1, 2006, at 8:50:58
In reply to Does anyone's pdoc actually order blood tests?, posted by honeybee on May 31, 2006, at 18:14:34
> I'm just curious. It's annoying when your pdoc looks at you from his comfy chair and says, "Have you talked to your primary about that?" or then says, "Maybe you should see a [insert specialist here]." Seriously, I want a pdoc who actually orders the tests himself and can interpret it instead of playing chemistry set with me as his beaker.
>
> Anyway, seriously though, anyone? anyone?Not nearly as many, nor as often, as would suit me. Geez, does he think he can imagine those assessments? Or, wouldn't some numbers give a little extra insight?
Lar
Posted by honeybee on June 1, 2006, at 9:53:31
In reply to Re: Does anyone's pdoc actually order blood tests? » honeybee, posted by Larry Hoover on June 1, 2006, at 8:50:58
Hm. Maybe it's time to switch pdocs. He *must* be able to order them. Maybe he's just lazy.
Posted by Larry Hoover on June 1, 2006, at 11:12:45
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by honeybee on June 1, 2006, at 9:53:31
> Hm. Maybe it's time to switch pdocs. He *must* be able to order them. Maybe he's just lazy.
No, it's about money, unfortunately. *Demonstrated* need is the criterion. Canadian medical treatment, combined with parsimonious nature?
I'll give you an example of the former. If I want a prostate antigen test, I have to pay for it myself. If I show positive, I no longer do, for follow-up tests.
The latter, I ticked off one extra box on the thyroid panel he ordered, once, on the way down to the lab. He got quite ticked with *me*.
Lar
Posted by honeybee on June 1, 2006, at 13:05:27
In reply to Re: Does anyone's pdoc actually order blood tests? » honeybee, posted by Larry Hoover on June 1, 2006, at 11:12:45
Very savvy of you, Larry. Didn't you just grin and shrug and say, Huh, it's funny that those results came back. Lab mix-up, I guess. So what were they????
In the meantime, if I could get my pdoc to show enough initiative to even *order* a test.
Posted by Emme on June 1, 2006, at 14:21:08
In reply to Does anyone's pdoc actually order blood tests?, posted by honeybee on May 31, 2006, at 18:14:34
> I'm just curious. It's annoying when your pdoc looks at you from his comfy chair and says, "Have you talked to your primary about that?" or then says, "Maybe you should see a [insert specialist here]." Seriously, I want a pdoc who actually orders the tests himself and can interpret it instead of playing chemistry set with me as his beaker.
>
> Anyway, seriously though, anyone? anyone?
>
>Yes, lots of them. If it's been a while and I haven't had a reason to see my GP, then she'll order CBC, B12, folate, and CMP just to keep up to date.
She's also ordered thyroid panel (several times), ferritin, Lyme disease (twice), lipids (just for good measure), dhea, testosterone, 24 hour urine cortisol, 24 hour urine corticosteroids and ketosteroids, and probably a few other things I've forgotten.
emme
Posted by cecilia on June 2, 2006, at 6:40:25
In reply to Re: Does anyone's pdoc actually order blood tests? » honeybee, posted by Emme on June 1, 2006, at 14:21:08
My pdoc has never ordered any blood tests. Well, a couple of times he did, for drugs that required blood levels. My GP keeps track of my thyroid meds, well, she does when I remind her and point out what the new normal levels are-the lab's levels are years out of date. Not that treating my hypothyroidism had the slightest effect on my depression. Emme, I'm curious about the various cortisol tests, what does your doctor plan to do if they come back abnormal-I know there are potential new AD's in trial that work on this system, but nothing now that I know about. I can't see my HMO ordering a test if there's isn't any current way to fix what it
tests for. Cecilia
Posted by Emme on June 2, 2006, at 16:58:34
In reply to Re: Does anyone's pdoc actually order blood tests?, posted by cecilia on June 2, 2006, at 6:40:25
> Emme, I'm curious about the various cortisol tests, what does your doctor plan to do if they come back abnormal-
I believe she would send them to an endocrinologist for further exploration of any potential endocrine problems. I know she was talking to an endocrinologist at one point.
Posted by bimini on June 5, 2006, at 8:50:25
In reply to Does anyone's pdoc actually order blood tests?, posted by honeybee on May 31, 2006, at 18:14:34
Yes, my pdoc ordered blood tests on my request. I requested the tests from my PCP because I had been on medications for over 2 years without blood tests. His response was that the doc who prescribes the meds should order the tests.
As usual I requested a copy of the results. Next exam with PCP I find he has no knowledge of bloodtest results and asks ME for a copy. All I could could do is stare at him incredulously and ask "tell me why I am here." I asked his secretary to access the network, the test results printed within a minute.
Now comes the interesting part. Blood tests ordered by PCP were covered under health insurance, the tests ordered by the pdoc were bounced around, landed with the seperate mental health insurance. If there is a difference in reimbursement, affiliation with the lab could influence reason.
bimini
This is the end of the thread.
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