How do I shop for a psychiatrist?

January 23, 2008 3:11 AM

Is it appropriate to shop around for a psychiatrist?

I am not sure I am as comfortable with my new psychiatrist as I was with my old (in my city of last residence), but unsure how to approach this with a putative new psychiatrist. Do I outright say that I'm not sure whether I'm compatible with my new choice of doctor? My main source of hesitation in shopping around is that I am looking for psychiatric care as opposed to, say, podiatric.

In case it helps, I am prescribed a couple of medications but nothing out of the ordinary for someone with anxiety/depression. My prescriptions are written monthly, which makes it awkward to shop around.

posted by anonymous to health & fitness (19 comments total)

Absolutely yes. You need to make sure that you're getting the most out of it that you can (they are, after all, paid). A psychiatrist you don't connect to will be at most a waste and at worst actively damaging. As for "breaking up" with your current psychiatrist, you can do it over the phone- just tell them you don't think it's helpful and you're trying to find someone else.

They shouldn't pressure you.
posted by ®@ at 3:38 AM on January 23, 2008

absolutely you need to find one whose approach fits your needs, otherwise it will be a waste of your time and money if you are not getting the help you need, in the manner that will be the most effective. you can communicate this to your present psychiatrist by saying that their approach is different to your last therapist and that you are looking for someone with a more similar approach as that has been really effective for you. they should understand this as it's part and parcel with the profession.
posted by violetk at 3:43 AM on January 23, 2008

Oh Yes - Many Psychiatrists are bad, and half are below average, so definitely shop around. However, from what I understand, the good ones can be very difficult to make appointments with (4-6 months and up in "midcity" USA).
posted by brandnew at 3:50 AM on January 23, 2008

Yes, and you can tell your doc you're getting a second opinion. If they act like a jerk about it, it's a clear sign to find someone new.
posted by sondrialiac at 3:53 AM on January 23, 2008

First of all, sorry you're having to go through this when it's probably the last thing you need. There is security in a good doctor and when it's in limbo, it can make you feel uneasy. I also understand the unease about "shopping" for a psychiatrist, but I agree with everyone above - it's important to find someone you can feel comfortable with. As far as what to tell doctors as you "shop", simply be honest and tell them you are looking for someone you feel comfortable with and leave it at that - no need for details as they hear it all the time.

One thought you might consider, as you call around and make appointments, is that your question makes it sound as if you're mostly looking for a psychopharmacologist to manage your medications. Many psychiatrists specialize in that direction (medication management) while others are "classically trained," and do extensive therapy work (psychoanalysis ). With this in mind, I would make sure you ask this question on the phone as you seek a new doctor. This will save you wasted visits with psychiatrists that want to work with you "classically."

You have my best wishes - good luck in the search!
posted by Gerard Sorme at 5:13 AM on January 23, 2008

I don't see anything wrong with it.

When I was younger, I went through 6 or 7 diffferent ones.
They, being psychiatrists, understand that patients have preferences when it comes to hears about their personal life and who handles their medication.

If you are looking just for medication management, I would just have that handled through your Primary Care doctor. It took me a while to realize that psychiatrists are just for dispensing and changing medications and that's about it.

I always try to check out the doctors through internet searches.
Example: when I was younger, I only wanted a female and under 45 (now, I don't have a preference with age/sex). So I would see if there was any more information about the doctors in my area through my health insurance website or see if the doctor/healthcare facility has a website.

good luck!
posted by KogeLiz at 5:44 AM on January 23, 2008

It is appropriate to shop around for ANY kind of doctor. Keep looking until you find someone you feel comfortable with.
posted by Silvertree at 5:49 AM on January 23, 2008

Bring up your discomfort with this psychiatrist. In talking about it, you may solve the problem.
posted by Carol Anne at 6:14 AM on January 23, 2008

By the way, it's cheaper to have prescriptions written tri-monthly; this is the standard mail-order amount, and most health plans have an option for ordering that way. Even if you don't have a health plan, there are good, cheap mail-order services for prescriptions. I told my psychiatrist that I needed to save the money, and he was happy to write me a prescription three months out; I'm sure they hear this all the time.

That would probably make it a little easier for you with the shopping around.
posted by koeselitz at 7:23 AM on January 23, 2008

Sorry if I'm not being clear, I mean to say that it's standard for mail-order prescriptions to be written for a three-month supply of the drug, since mail-order takes about two weeks and would be a hassle to do over and over again. Psychiatrists write prescriptions like this all the time.
posted by koeselitz at 7:24 AM on January 23, 2008

they see you because you pay them, not because they're your friends. you're free to dump them, sue them, etc, if their work is not satisfactory to you.

they'd sure as hell stop seeing you if you stopped paying them for their time.
posted by matteo at 7:38 AM on January 23, 2008

Echoing matteo that they're not your friends. I've stopped seeing a psychiatrist just by cancelling an appointment and never calling back to reschedule. You wouldn't keep going to someone who gave you a terrible haircut, and your psychological health is more important than your hair.
posted by desjardins at 8:48 AM on January 23, 2008

I just recently did a doctor switch. You can give whatever reason you like for the switch, the new doctor just likes to know that you already have a diagnosis and medication plan in place. Don't be worried about looking shady, your mental health is important and you need to have a good relationship with your doctor to get the best care. As for breaking up with the old doctor, just call up and say you're discontinuing treatment and thank them for their time. A professional won't hassle you or ask for a reason. Just be sure that you have an appointment with the new doctor lined up before you drop the old one, they don't like renewing prescriptions after you've stopped seeing them.
posted by blueskiesinside at 8:57 AM on January 23, 2008

Yes, yes, shop around. Also -- if your meds are stable, I don't know why they would be written monthly (as opposed to three months, six months, etc.).
posted by ClaudiaCenter at 9:15 AM on January 23, 2008

Try to think about yourself as a health care consumer. It might be different if you were doing intensive work with the psychiatrist and you were coming up on some kind of resistance. But even so, you don't need to have any more anxiety about wanting a different psychiatrist than you would have about wanting to go to a different restaurant or car repair shop.

It happens all the time and I'm sure the psychiatrist is familiar with people coming into and leaving his practice. Just mention to him that you're not feeling as comfortable with the fit between he and you and that you're going to switch. You can even ask him for recommendations, if you like. By all means, shop around.
posted by jasper411 at 9:24 AM on January 23, 2008

100% yes. Even put it that way- suggest that you get together for an initial session and interview each other to see if you're compatible. It runs both ways. IANAP, but a bunch of my family are, and there are certain people they'd prefer to see over other people (just quirks-wise. one, for example, has a lot of experience with treating anorexic patients, another specializes in childhood issues).

After the first session, thank him/her for his time, and say you need a little time to think.
posted by arnicae at 9:53 AM on January 23, 2008

nthing everyone. Mental health care professionals are just like any other health care professional - and you deserve to have one you are comfortable with.

If your current psychiatrists feelings are hurt, they can talk with their own shrink.
posted by never used baby shoes at 11:56 AM on January 23, 2008

Absolutely! I've pondered this matter before and I also wondered why there isn't some kind of standard interview process or at least a brief questionnaire so you can find what you need.
What do they value what are their beliefs or even prejudices?
The last thing I need is some person with strange ideas thinking that is what's wrong with me, missing the point entirely and putting their spin on my slanty shanty. I'm not paying for that crap. That crap is free.
posted by mu~ha~ha~ha~har at 2:01 PM on January 23, 2008

Shop around. Research shows that it is therapist empathy/connection with client that makes treatment effective. If you are doing anything at all beyond drugs, you want this in your favor.
If you don't connect, a relationship can't heal.
posted by Maias at 3:37 PM on January 23, 2008