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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by PaulB on June 29, 2001, at 17:33:26
I wanted to understand how people in the US go about finding a private psychiatrist to treat them. I live in the UK and it seems a more complex business to just make a consultation appointment to see a pdoc. My research led me to the belief that the best and normal route was to contact a private hospital and to locate a psychiatrist there. In the UK's telephone/service directory there is only listings of psychologists. In the US is the situation different. If you want to see a private psychiatrist can you just pick up the phone and schedule a consultation appointment? My understanding is that a psychiatrist can provide drug-therapy and talk-therapy and a psychologist only the latter which is why I am interested.
Posted by kazoo on June 30, 2001, at 17:01:26
In reply to Locating Psychiatrists, posted by PaulB on June 29, 2001, at 17:33:26
> I wanted to understand how people in the US go about finding a private psychiatrist to treat them. I live in the UK and it seems a more complex business to just make a consultation appointment to see a pdoc. My research led me to the belief that the best and normal route was to contact a private hospital and to locate a psychiatrist there. In the UK's telephone/service directory there is only listings of psychologists. In the US is the situation different. If you want to see a private psychiatrist can you just pick up the phone and schedule a consultation appointment? My understanding is that a psychiatrist can provide drug-therapy and talk-therapy and a psychologist only the latter which is why I am interested.
^^^^^^^^
One of the best ways in finding a psychiatrist (in any country) is to do something "socially inappropriate," like putting on a pink tutu with army boots and proceed with a pas de deux with an imaginary partner in the middle of the Interstate during rush hour. This will surely get you into an ER where a psych-consult will be indicated.
I want to clarify something you're misperceiving about state-side medicine: sure, you can pick up the phone and pick a name out of the Yellow Pages and make an appointment with anybody, but will that "anybody" be qualified, competent, compassionate? Anybody can find a "doctor" but finding a "good doctor" is more of a challenge. So finding the right doctor the first time around is a miracle, at best.
Also, when you make an appointment here in the Colonies, the first thing they want to know is how you plan to pay them. You can be hopping on one foot along the outside edge of 87th floor of the Empire State building, calling from a cell phone, but before they make any sort of an arrangement for therapy, you gotta come across with the dough, or insurance ... and if insurance, that which they will accept. With the influx of HMOs, most doctors have been refusing people because HMOs don't accept all doctors, or have their own, or are slow paying, if they pay at all. And if you don't have any insurance or money, then social services kicks in, but let me tell you: psychiatrists and psychopharmacologists usually don't take this form of government assistance because the gov't sets a limit as to how much these professionals should get. Needless to say, the professionals don't think it's enough.
My last visit to a therapist cost me $140 bucks for 30 minutes. I paid this out of my own pocket because I can, but the well isn't bottomless so there may come a time when they will find me hopping on one foot on the outside edge of the 87th floor of the Empire State Building, only without a cell phone. I managed to save my pink, silk ballet slippers from the last time.
AMERICA: the land of dime-a-dozen Doctors and Lawyers, the latter group you can put on a garbage barge and sink.
kazoo
Posted by AKC on June 30, 2001, at 17:43:51
In reply to Re: Locating Psychiatrists...rabbits and hats » PaulB, posted by kazoo on June 30, 2001, at 17:01:26
My approach to finding a pdoc here in the good ole u.s. was the same as finding any provider of anything in a capatilistic society - recommendation.
Now I happen to be able to afford to pay out of pocket - so I can go outside of my hmo network or to pay the ppo copay, depending what insurance flavor of the year I have. I got lucky in so many ways when I moved to my current city - a therapist (not mine, out of town at the time of a major crisis) recommended a doctor, that office was downright unhelpful, the therapist suggested my current pdoc, that doc couldn't get me in but went out of her way to find someone to help me. I knew right then she was the one - to help me so much when I wasn't even her patient spoke volumns. She frustrates me a lot at times, but I trust her - and I don't trust many people at all.
However, I do believe that even within most HMOs that if you are in larger cities, there is enough of a selection, you can do some shopping around - if you can find the energy to do so - horrible thing about depression is it tends to make so many of us remain still. There is still that piece of flexibility in the U.S. system. Those who must rely on medicaid and who live in small towns, unfortunately get what is there - and that I am certain can be very good at times (I believe most doctors do want to help people), but at times can be really bad.
kazoo - be kind with the lawyer comments. We are not all slime. In fact, some of us are very caring people who don't deserve to be drowned on a garbage barge.
Posted by Marie1 on July 1, 2001, at 10:55:02
In reply to Locating Psychiatrists, posted by PaulB on June 29, 2001, at 17:33:26
Interesting you should ask - I was curious about the UK system because some people who have posted here make it seem relatively hopeless and there is no "shopping around" as we do here. The thing about finding a competent pdoc here in the states (in my experience) is you have more chances if you can afford to pay out of pocket. As Kazoo stated, most HMOs will only pay for the docs who agree to accept payment which is about 60% of the going fee (about $130.00 - $150.00/hr. in my area). I tried going the HMO route originally but became extremely frustrated when their doctors either didn't return my call or weren't taking new patients. Being suicidal at the time, I finally just called a local pdoc (I live in a small town outside of D.C., but there seem to be plenty of shrinks - go figure!! < g > and apparently I lucked out. I think my pdoc is enormously talented and he is helping me. I pay out of pocket and occasionally my HMO chips in - after much begging, groveling, etc. So basically, if you can afford it, good care is relatively easy to find here, especially if you live in a major urban sprawl or suburb.
Marie
Posted by kazoo on July 2, 2001, at 0:59:49
In reply to Re: Locating Psychiatrists, posted by AKC on June 30, 2001, at 17:43:51
> kazoo - be kind with the lawyer comments. We are not all slime. In fact, some of us are very caring people who don't deserve to be drowned on a garbage barge.
^^^^^^^^
Yeah, sure, fine, Uh-huh, yup ... but you're right about one thing: a garbage barge is too good for lawyers.Let me tell you something: I've yet to meet ONE that I've trusted, not ONE out of hundreds. This includes judges as well.
I'm confident that you feel you might be the exception to the rule, but the best of the worst still isn't very good.
And while I'm at it: http://www.perkel.com/pbl/
kazoo
Posted by Dr. Bob on July 2, 2001, at 7:51:55
In reply to Re: Locating a slimeless lawyer... » AKC, posted by kazoo on July 2, 2001, at 0:59:49
> > kazoo - be kind with the lawyer comments. We are not all slime. In fact, some of us are very caring people who don't deserve to be drowned on a garbage barge.
>
> ^^^^^^^^
> Yeah, sure, fine, Uh-huh, yup ... but you're right about one thing: a garbage barge is too good for lawyers.I understand you may have your own issues with lawyers, but please don't overgeneralize. Besides, you wouldn't want others talking about you that way, would you?
> Let me tell you something: I've yet to meet ONE that I've trusted, not ONE out of hundreds.
And how would you know if you met the first?
Bob
Posted by kazoo on July 3, 2001, at 0:09:48
In reply to Re: please be civil » kazoo, posted by Dr. Bob on July 2, 2001, at 7:51:55
This space was intentionally left blank.
Posted by PaulB on July 4, 2001, at 15:42:04
In reply to Re: Locating Psychiatrists, posted by Marie1 on July 1, 2001, at 10:55:02
> Interesting you should ask - I was curious about the UK system because some people who have posted here make it seem relatively hopeless and there is no "shopping around" as we do here. The thing about finding a competent pdoc here in the states (in my experience) is you have more chances if you can afford to pay out of pocket. As Kazoo stated, most HMOs will only pay for the docs who agree to accept payment which is about 60% of the going fee (about $130.00 - $150.00/hr. in my area). I tried going the HMO route originally but became extremely frustrated when their doctors either didn't return my call or weren't taking new patients. Being suicidal at the time, I finally just called a local pdoc (I live in a small town outside of D.C., but there seem to be plenty of shrinks - go figure!! < g > and apparently I lucked out. I think my pdoc is enormously talented and he is helping me. I pay out of pocket and occasionally my HMO chips in - after much begging, groveling, etc. So basically, if you can afford it, good care is relatively easy to find here, especially if you live in a major urban sprawl or suburb.
>
> MarieThanks for the information. I think the system is quite quite different in the US to the UK. I had to look up to find out what HMO meant and I guess its the equivalent of what we have in the UK called the NHS. On the NHS your entitled to see the local psychiatrist for your area but if he/she isnt any good then there are no alternatives on the NHS unless you move to a different county(state in US). Private psychiatrist certainly do not seem to be as abundant in the UK as they are in the US and the best route is via private hospitals and I think its easier if you are in the capital. Moving on though to continue this discussion you mentioned that if youve got the money it can be easy although finding the right psychiatrist may well be a trial and error process.
Anyone I would like to know peoples views on the general prices ranges for pdoc sessions(lowest, average, high rates). I contacted one myself and he charged $500 for consultation and $400 for all appointments therafter. What do you think of that?
Posted by Waterlily on July 5, 2001, at 16:30:41
In reply to Re: Locating Psychiatrists, posted by PaulB on July 4, 2001, at 15:42:04
HMO means "Health Maintenance Organization" - in order to see a psychiatrist you must first be referred to one by your primary care doctor (family or internal medicine). That's if you expect the HMO to pay at all for your treatment. You can pick which psychiatrist you see, provided he/she is on the list of doctors that the HMO deals with. If you have a good HMO you should have several to pick from. If you have a lousy one, then the doctors don't want to mess with the HMO, so your choices will be limited to the few who are either desparate for business or who aren't really concerned with how much money they make. (You can pick from HMOs when your employer has open enrollment for health insurance. Your employer decides which HMOs to offer to you). Not all people who have health insurance have an HMO - some have PPO, which is a bit more liberal with the choice of doctors but usually cost you more out of pocket.
Now, you can bypass this whole thing, pick up the phone book, and make an appointment with a psychiatrist if you like without a referral at all. The downside (a big one) to this is that you will have to foot the entire bill yourself.
My psychiatrist charges $75 for a 15 minute medication check. I pay a $25 copay for this (I have an HMO). My psychologist (a PhD) charges about $135 for 50 minute therapy sessons. I pay $25 each time I see her - the HMO pays the rest.
This is the end of the thread.
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