Picking a doctor when doctor information in my area is scarce?
December 27, 2011 6:54 AM   Subscribe

How do I pick a psychiatrist when I can find absolutely no information (besides the basics like contact info and education history) on any of the doctors in my area?

Basics- I'm a biological female who is severely questioning her gender identity, and whose sexuality is in a whirlwind. I recently took a job as a copywriter and have been finding that I am having extreme trouble concentrating and focusing. It is like my mind is in a whirlwind as well, with millions of individual thoughts all pestering me to pay attention to them, not my job. I have always had problems focusing (drifting into daydreams nearly constantly, distracted by everything, and occasionally bouts of extreme focus where I absolutely MUST do something, and while I do it the entire world fades around me, as though only I and my task exist). I breezed through high school because my history as being an honor student followed me until graduation, so teachers generally let my mishaps slide, and I graduated valedictorian despite not being able to focus on most work and focusing on some work so much that the end product was basically indecipherable. This pattern (if you can call it that) of focus/unfocus has really been affecting my performance in my writing job. Change requests pour in. It sometimes takes me hours to write what should be a 20-minute piece. My sister has ADHD, and I'm starting to suspect that I may have ADD (I've never been hyperactive in any way).

I was diagnosed with Asperger's Syndrome and social anxiety with agoraphobia in August by my child/adolescent psychiatrist. She prescribed me medication (BuSpar) and it helps a little bit with the anxiety, or at least enough for me to be fine with taking it.

I live in a small town (pop. ~50,000) and recently turned 18. My former psychiatrist, whom I saw every other week and who prescribed me my anxiety medication, was specifically a child psychiatrist, so she will no longer be seeing me for sessions. She said that she will continue to authorize my prescriptions for my anxiety meds, but due to reasons that I don't understand (insurance? clinic policy?) she won't perform therapy on me any longer.

I need to find a new psychiatrist. The problem is that because my town is so small, I can find virtually no reviews of any of the psychiatrists practicing in it. I can find their names, addresses, phone numbers, and sometimes educational history, but that's it. No patient reviews or ratings, nothing but the basics. There are around 12 practicing psychiatrists in the area, and there is hardly any information on any of them.

So how do I pick one? Googling their names gives me doctor review sites (no information) and nothing else. I've got nothing to go on at all and I don't know what to do. Should I simply call some of them at random, ask to speak to the doctor, and go from there? This is the first time I've ever had to handle a medical situation on my own. I'm lost. Any advice? How do you pick a doctor when there is no information available on any of the doctors in your area?

If you want to email me about this I've set up a throwaway account at this_isnt_real_at_all@yahoo.com.
posted by anonymous to Health & Fitness (7 answers total)
If there's that small of a community, your current psychiatrist should be familiar with at least some of them. Cab you ask them for a recommendation?
posted by griphus at 7:00 AM on December 27, 2011 [4 favorites]

Can your old psychiatrist give you recommendations?
posted by quodlibet at 7:01 AM on December 27, 2011

Best practices for graduating a pediatric client into adult care is to provide a recommendation and forward the record to the new practitioner. You may need to make an appointment with your pediatric psychologist to get this going, and may get a better response than a call into the office. This way, you can talk a little about what you're looking for in your new psychologist--for example, if you'd like to talk to one that has experience with gender identity issues. If your previous psychologist is unwilling to do this, ask to be referred to a pediatric psychologist or psychiatrist who will, or make an appointment with your pediatrician or doctor for just this issue. Graduating you into appropriate adult care is part of our job in pediatrics.
posted by rumposinc at 7:07 AM on December 27, 2011 [3 favorites]

There's a ton of overlap between Asperger's and ADHD (it always has the H nowadays, hyper or not; it's dumb like that), so it's worth getting checked out for both.

Adult ADHD is a fairly new field that's attracting a lot of specialists. Ask your GP if s/he knows of any.
posted by Sys Rq at 10:30 AM on December 27, 2011

Are you in the US? Check out the CHADD professional directory for the ADHD stuff. You may have to go to a nearby city if you want formal testing done.

And yeah, get a referral from your current psychiatrist. Or your pediatrician/GP, for that matter.
posted by SMPA at 2:56 PM on December 27, 2011

Agree that a referral is helpful. After that, though, I'd recommend asking for a "meet & greet" appointment, where you can basically just meet the psychiatrist and see if they're a good fit for you. Ideally, you'd have that sort of appointment with three or so, so that you could get a sense for the differences between them and what suits you best.
posted by Margalo Epps at 6:00 PM on December 27, 2011

Couple of days late, so you may have worked this out already, but here's what I've done when in a similar situation. Including too much detail, because I remember being a newly independent teenager, and wondering where other people found the manual for getting a good doctor:
1. I compiled a list of doctors/therapists/whatnots who were in my insurance network (according to a wonderfully terse list obtained from my insurance company) and whose offices were geographically convenient.
2. Compiled a prioritized bullet list of the things that I wanted to address first in treatment. Not all the things, just the most important.
3. Wrote out a short introductory spiel to reference when I made my calls, so that I wouldn't forget anything due to repetition or anxiety or whatever. Basically, "Hello, my name is [firstname]. I found your information through [source] and was wondering if you were currently taking on new clients. I am hoping to see someone on a [weekly/biweekly/etc] basis primarily to work on [bullet list]. I have [XYX/no insurance]." I more or less deliver this to whomever is taking info on behalf of the doctor, whether it's an answering machine, secretary, or the doctor themselves. Either then, or after a call back, a brief sort of interview follows. YMMV of course, but I've had the most success in person with those doctors who were willing to give me a few focused minutes to respond in terms of whether or not they fit what I had said I needed, and answer a few follow-up questions, such as what types of issues they felt they had most experience treating. And in your case I would specifically ask into their feelings about and experience with questions of gender/sexual identity, so that you don't waste your time seeing someone whose attitudes won't help you.
4. During the conversations, I take notes. If some obvious incompatibility pops up while we're talking, I thank them for their time and say I'm going to think things over, and do not call them again. Otherwise, I make an appointment. After I've spoken with everyone I want to speak with, I look over the list of appointments, and note which people seemed to be the best fit from our conversations. If there are more than a few appointments, I keep those with the best fits and as quickly as possible call the others back to say I need to cancel that date, but may reschedule in the future. No one I have seen so far has said this is anything other than okay, and ultimately time-saving for all parties involved (provided cancellations weren't last minute; 48 hours before is courteous for anything short of an emergency).
5. I go on my appointments, taking along an expanded bullet list. I answer all their background questions and ask all of my questions and try to get a feel for them as a therapist and person. I make future appointments with the best best fit, and then- hurray- therapy begins.
Thanks to out-of-area moves, people retiring, etc., I've had to do this every few years, but it turns out to be a useful investment of time and money. I've almost never had to meet with more than two or three new people in person before finding one who is a good match. One more thing that may or may not be relevant, but if you're concerned about privacy, it's perfectly okay not to give out your full name during the initial phone call. If you intend to keep (and definitely if you're going to have insurance pay for) an appointment, then you will need to give your information.
Good luck with things.
posted by notquitemaryann at 9:39 PM on December 30, 2011 [1 favorite]

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