Team Work?!…

I never had a Psychiatrist I loved.  Heck, I never had one I liked.  Honestly, my relationships with my Psychiatrists these last 20+ years don’t even measure up to an “acquaintance” standard.  They are short, sometimes snippy, and barely lift their eyes off their laptop to make eye contact.  These doctors that control what medications I take… and I am only in their office for a whopping ten minutes… at most.

It bugged me yesterday as I sat in the waiting room for my appointment.  I wasn’t even meeting with my normal Psychiatrist.  I had a sub-psychiatrist for this visit as my normal doc was out on maternity leave.  No big deal, it wasn’t as if I were close with her even after seeing her for over a year.  I entered my sub’s office where he asked me the typical psychiatrist questions:

“How are you feeling?”
“How are the medications working?”

Yada, yada, yada.

I thought maybe he at least read my file before meeting with him, but nope, he didn’t.  I had to tell my story of the last year to him as quick as possible as I only had about 2 minutes left on the clock of my appointment.  And like that, my ten minutes were up.  I am not sure what was accomplished as this man knows nothing about me and just handed me prescriptions for controlled substances.  Upon leaving, I made my next appointment.  I asked the receptionist who I should make it with and she responded, “It doesn’t matter.  Your regular doctor will be back then if you would like to see her.”  Then was three months away.  Then was almost at the end of summer.  Then was August.

On my drive home, I really thought about the Mental Healthcare system in the United States.  I even crowdsourced to see if my revelations about the system had merit and wasn’t shocked with the answers, but I should have been.  Most of the people that responded to me agreed that they had appointments with their Psychiatrists that lasted up to 30 minutes at most, but it was more like 10 minutes where only drugs were discussed.  These people then revealed that like myself, they saw a Therapist weekly or biweekly for an hour or more at a time.  And the kicker, these 2 team members never conversed with each other about care!

This is what angers me.  I’ve signed waivers to no end that enables my Psychiatrist to contact my Therapist (and vice-versa) concerning my care and they never have.  There are waivers signed for them to contact my Primary Care Physician… never have.  This situation was even more complicated when I was hospitalized.  I had additional doctors, several hospital Psychiatrists, along with my Therapist and regular Psychiatrist and there was still no contact.  Amazingly, the hospital Psychiatrists didn’t even converse with each other.

I thought some more.  How can I receive the best care possible when my “Team” chose to be independent workers?!  I became the go-between, the third party mediator.  This was all fine and dandy for now because I am doing well but a couple of months ago when I had a breakdown… wouldn’t it have made sense for this “Team” to talk?  It’s bad enough as the patient your medications are a trial and error affair taking weeks sometimes months to get correct, now you, mentally impaired with Depression and Anxiety, need to be able to handle the negotiating between your “Team”?!  I understand from a work perspective, as I hold a full-time job myself, that it is hard to fit things in.  Asking these Psychiatrists to talk with their patients Therapists is another step to make in a busy job they already do.  Think about it… if they work 8 hour days and see 4 patients an hour (although 15 minute appointments are a stretch), that’s 32 patients a day.

32 patients a day… that’s 160 patients a week!  I’d be shocked if they knew my name without looking at their laptop when I came in!  But they should.  They are dispensing medications that can be harmful.  These medications carry some serious side effects, some even include suicidal thinking. With this knowledge, wouldn’t it be a wise decision to discuss the patient’s condition with both their PCP and their Therapist?  Get an idea of who their patient really is aside from there in depth 15 minutes?! (note sarcasm)  See if they have any medicinal allergies they are lying about?  See if they are known to hide their suffering to an extreme?

How do we accomplish this?  Among my crowdsourcing was a Therapist and she even agreed she would rather be doing the Team method but that it was hard to enforce.  By not having our Teams discuss our care we are really at a disadvantage here in the United States with Mental Healthcare.  We need this system to be audited, to be dissected, and to be resurrected in a way that really has the patient’s care at the core of the system.  After all, this is May, it is Mental Health Awareness Month!

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