Can I see multiple doctors? CAN I?!
February 22, 2012 4:59 PM   Subscribe

Is it acceptable -- in a legal sense, I suppose -- to see multiple doctors and have them prescribe different medications?

I'm thinking about contacting another doctor in my area to look in to ADHD prescriptions.

I have a doctor in internal medicine that I've been seeing for about a year now. He has me on alprazolam for anxiety. I don't take it all the time, but only when needed. I've mentioned to my doctor that I'm interested in ADHD medication, but said he'd rather not prescribe a stimulant and a benzo at the same time. Filling my alprazolam prescription at the time was a priority, so I just left it at that.

So, with all that in mind, is it legal for me to see another doctor to attain ADHD medications? Am I obligated to disclose any other doctors that I go to? I mean, if they ask me if I'm on any medications, I'll tell them.

For background, I have insurance and I've gone through a (painfully long) psychiatric evaluation where ADHD symptoms were noted, but not diagnosed, and was officially diagnosed with moderate depression and anxiety.

Thanks, internet!
posted by apip to Health & Fitness (22 answers total) 1 user marked this as a favorite
you are not obligated to disclose the names of the other doctors attending you but you need to disclose all medications you are taking.
posted by violetk at 5:02 PM on February 22, 2012 [1 favorite]

I don't know if it's legal, but it's really, really stupid. Some drugs interact with other drugs, and if you keep secrets from your doctors you could end up dead.
posted by craichead at 5:03 PM on February 22, 2012 [18 favorites]

ADHD medications can increase anxiety, just so you know. Also, taking daily doses of stimulants (ADHD meds) and depressants (benzos) at the same time is generally really, really bad for you. Good way to put yourself in a position to have a really decent psychotic break.
posted by erst at 5:07 PM on February 22, 2012 [2 favorites]

Well, your new doctor is most certainly going to ask you what medications you are on. Every doctor I've ever seen has made it very clear that I am expected to tell them what medicine I'm on, and that my care will be compromised if I don't tell them the truth. It might not be illegal not to tell, but, if the second doctor prescribes you a medicine that badly interacts with the first medicine, and you didn't tell them, one legal consequence is going to be that you won't have a very good medical malpractice suit.

I know you say you'll tell them if they ask; I've never ever had a doctor not ask what medicine I'm on. Please don't lie about this; there's probably a good reason your doctor didn't want to combine these drugs. Maybe he can explain it better if you go back and ask again. Maybe another doctor would prescribe two drugs together. You're certainly entitled to that type of a second opinion. But please tell all your doctors about all the drugs you're on and issues you have.
posted by dpx.mfx at 5:07 PM on February 22, 2012 [1 favorite]

If you are not satisfied with the treatment your doctor is giving you, the best course of action is to find a new doctor that you are satisfied with, not a doctor for each condition. You need to have a mature conversation with your current physician.
posted by Nightman at 5:07 PM on February 22, 2012 [5 favorites]

As long as you disclose all of your symptoms, treatments, and all of the medications that you are prescribed and/or taking, there's nothing wrong with seeking a second opinion. I don't know if you are obligated to tell them the identity of the other doctor you saw, but why wouldn't you?
posted by jabberjaw at 5:08 PM on February 22, 2012 [1 favorite]

Whoops, meant to add that it's perfectly legal to see different doctors; you just won't be able to sue any of them for the results of taking contraindicated medications if you don't disclose your other medications.
posted by erst at 5:08 PM on February 22, 2012 [1 favorite]

It's very common to have different doctors who each care for different aspects of your health and prescribe different medications. That's why your appointments usually always start with a medication review - why would they be asking if anything changed, if your doc was the only one prescribing meds? I.e. what violetk says, tell every doctor about all drugs you take.
posted by cabingirl at 5:09 PM on February 22, 2012

Note that your doctor said he was uncomfortable with prescribing you stimulants and alprazolam. This is *his* judgement call.
A few options here:
1. It is not uncommon for docs who don't use them much to not have a great handle on psychopharmacology. You may be able to find a psychiatrist or other doc who feels comfortable prescribing drugs to treat anxiety and ADHD together. I am a medical librarian and so not qualified to give advice, but not every benzo and every stimulant interact.
2. There are drugs besides stimulants that treat ADHD (for example, some antidepressants are used for this). There are drugs besides Xanax that treat anxiety.

I don't advocate getting two scripts from different docs for the safety reasons mentioned above (and FYI, if you do this, you'll get a lecture from your pharmacist as you fill the scripts), but there's no reason not to get a second opinion and perhaps find a doctor with a more liberal opinion (if you must have xanax and a stimulant ADHD medication) or more facility with treatment options for ADHD and anxiety (if you want to explore ways to fix these problems and are willing to change drugs).

Just to show you how this might work-- my prior doc was internal medicine and would give out Xanax scripts all day, but wouldn't prescribe antidepressants because she didn't feel comfortable managing patients on them. My current doc is a family practitioner and she feels uncomfortable prescribing benzos, but will gladly prescribe and follow patients on antidepressants when warranted.
posted by holyrood at 5:16 PM on February 22, 2012 [2 favorites]

It is perfectly reasonable for you to see a specialist (in this case, a psychiatrist with experience in psychopharmacology and specifically the treatment of ADHD) if you feel your general practice/primary care doctor isn't giving you the level of care you want for a specific condition.

It is beyond irresponsible and foolhardy not to disclose all medications (including supplements, vitamins, over-the-counter medications, and recreational drugs) you're taking to anyone prescribing you a medication.
posted by Sidhedevil at 5:24 PM on February 22, 2012 [1 favorite]

if you don't tell the new doctor about your current prescriptions, be aware that this is how addicts behave and if either doctor finds out, they'll probably treat you like an addict.

Bingo. It probably won't even have to go as far as them "finding out" you're taking other drugs, doctors are developing a sharp-eye for the sort of behavior you're contemplating. Walking into a new doctor's office, not disclosing that you've been seeing other doctors but pushing to get a certain kind of medication that you're sure you need for a condition you're sure you have (how?) - many doctors aren't necessarily going to be interested in playing along with that, and from what I've seen, you don't want to be under the care of the ones that will.
posted by ThePinkSuperhero at 5:44 PM on February 22, 2012 [3 favorites]

I agree with Sidhedevil - it would be a great idea to see a psychiatrist to discuss an ADHD medication. You should tell the psychiatrist about the benzo, and the psychiatrist can prescribe you either that specific benzo, or something else for your anxiety/ depression if appropriate.

I see a GP, gynecologist, and a psychiatrist. I am prescribed several medications by the psychiatrist, and occasional medications by the other two. At the start of every appointment with all three, we go over a list of all the medications I am currently taking, to ensure that they have accurate information. I also always fill all meds at the same pharmacy as another layer to check for possible interactions (the pharmacy has actually caught an interaction before, which turned out to not be a problem, but I was glad to know they were checking!).
posted by insectosaurus at 6:04 PM on February 22, 2012

Go see a psychiatrist for everything - this stuff is complicated, and if you're in a situation where you've actually had a workup done and gotten multiple diagnoses, that's sufficient grounds to move beyond internal medicine. One of the psychiatrists at the clinic I go to specializes in the intersection of anxiety, mood disorders and ADHD - she's so well known for this, other doctors in the community will mention her name at random when they find out you have any two (or like me, all three) of them.

Oh, and yeah - my regular doctors have been totally OK with prescribing antidepressants, anti-anxiety medications, or both, but have never been cool with even giving me a 30-day "my psychiatrist cancelled the appointment and now I'm screwed" script for my various (controlled) stimulants.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 6:05 PM on February 22, 2012

It's legal but not advised. Doctor's view this as drug seeking behavior and usually will get really pissed off at the patient if they find out it is going on. You could end up with no prescribed meds from either of them. Go to a specialist and get a proper diagnosis and let them decide what kind of meds you should be taking.
posted by cairnoflore at 6:08 PM on February 22, 2012

but said he'd rather not prescribe a stimulant and a benzo at the same time.

in other words, he doesn't want to be on the hook if you have a bad reaction. like, if you accidentally take a lot of both at the same time. he could face a lot of risks if you did that, and also he doesn't get much benefit form prescribing the new drug.

if you're describing what he said accurately, you'll notice he didn't say "oh, no, that's really bad, you could die, go blind, etc."
posted by cupcake1337 at 6:10 PM on February 22, 2012

you are not obligated to disclose the names of the other doctors attending you but you need to disclose all medications you are taking.

The latter is true. The former actually isn't in some circumstances, particularly when we're talking about controlled substances like narcotics. A doc prescribing you narcotics is going to want to know both what you're getting and who's giving it to you. And the DEA, if I remember correctly, requires him to know who the other guy is, so the two of them can talk if one of them thinks there's something fishy going on.

Other than that though, the quoted answer seems to be correct.
posted by valkyryn at 6:32 PM on February 22, 2012

[Few comments axed, please consider reading the entire question and OP, don't snark at free advice. MetaTalk is always your option. thanks.]
posted by jessamyn (staff) at 6:45 PM on February 22, 2012 [1 favorite]

I don't think it's ever illegal to see multiple docs, period. However some provinces in Canada - not sure where you are - have province-wide databases of prescriptions filled so that if you get multiple prescriptions from different physicians it will show up in the database at the pharmacy where you are filling your prescriptions (ie any pharmacy).

Partly this is to prevent abuse (multiple oxycontin prescriptions eg) but also to protect patients in the event of contra-indicated medications being unwittingly cross-prescribed by different docs.
posted by lulu68 at 6:52 PM on February 22, 2012

There's nothing wrong with getting a second opinion, so long as you are honest and upfront about all symptoms, medications, complications, etc. But, you should also be aware that other doctors may share the first one's opinion; doctors generally want to treat what you've been diagnosed with (thus the alprazolam), not what you show symptoms of. Many people with depression and anxiety have symptoms that overlap with other disorders, including ADHD. He may think that the "as needed" is enough for your symptoms.

If it's something that you feel strongly about, by all means seek a second opinion (perhaps from a doctor more informed about such than internists usually are) but don't EXPECT that your desire for ADHD medication will result in your getting it, particularly since you've already gone through an evaluation that suggests you may not need it.
posted by sm1tten at 7:17 PM on February 22, 2012

A psychiatrist will be in a better position than your GP to deal with interactions between multiple psychiatric medications, so I just would make sure to tell anyone you're dealing with everything you're on, and seriously consider just having the psychiatrist prescribe all the psychiatric stuff if you end up on a stimulant.
posted by gracedissolved at 11:59 PM on February 22, 2012

I agree with the above posts. You must let both doctors know what medications you are taking. I worked in an independent pharmacy where the pharmacists were very careful and were able to spot when one doctor prescribed a med that was dangerous with what another doctor prescribed. You may not be lucky enough to get that kind of pharmacists. If you go to a chain pharmacy, it is very likely that it would be overlooked. You can't google the information you need to make these decisions on your own.
posted by myselfasme at 6:18 AM on February 23, 2012

Google medication reconciliation.
posted by YukonQuirm at 7:44 AM on February 23, 2012

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