and if you have an actual psych diagnosis forget ever being able to qualify for private insurance.

With my history, before I got Medicare I applied to various insurance companies....the only one that offered me coverage was Blue Cross Blue Shield at $1800 a month...what a fucking joke!

It's not just psych meds that will do it though...it's just about any maintenance med....like cholesterol drugs/statins etc.

Universal Health Care cannot come too soon---on the other hand western medicine which is controlled by Big Pharma is not something I'm interested in utilizing unless I've been in a car wreck....yeah, it's good for something...

I pay for all my health care now...out of pocket because medicare doesn't cover my alternative doctors.

It is paying for the drugs I'm withdrawing from....at least some of them...I reached the donut hole after 6 months last year and had to dish out a few thousand bucks for meds the rest of the year. This year I'm on so few meds finally I might actually be off drugs before I reach the donut hole...

sorry for the ramble!

One of many reasons I do not accept third party payments. Assigning a DSM IV diagnosis makes it harder to get insurance also. Privacy? What privacy?

You are still sunk even if you are perfectly fine off of meds, possibly even worse off, since then you look "non-compliant." Once diagnosed. Always diagnosed. I have given up on finding private life insurance to protect my wife and daughter. For a while it looked like I could get it if I agreed that I was bipolar and paid through the nose. I'm unwilling to do that. I'm waiting until I can purchase insurance through an employer. Accessing "mental health care" was the worst decision I made in my entire life. I don't think doctors have any idea the true costs. This is one of my biggest worries about kids entering the system. You'd better believe they will be kicked out of private insurance for the rest of their lives, no matter how insignificant the original complaint.

Interesting he is the doctor that charges boatloads of money for SPECT scans that supposedly "determine" mental illness in the brain of which is not covered by insurance!

2 comments to this posting:

1. It is not just psych issues that cause trouble with insurance coverage. Preexisting conditions are the fraud of the insurance industry I just salivate to hopefully read of the savy lawyer who can nail these fuckers for this alleged right the industry has to do this to customers. If you didn't notice, I hate a lot of insurance companies. Managed care is the true ruin of psychiatry!!!

2. Dr Fuller's comment is on the money, but it is hard to pay out of pocket for mental health care, so what do you do? Here's the irony to what I dealt with first hand a few years ago when I had a part time private practice that did not take insurance: patients wanted to see me quick because I was available without much of a delay (because one of the tricks that private practitioners play to avoid seeing a patient with crappy insurance reimbursement is to tell them it will take 2 to 3 months to be seen), and yet when I told them on the phone I did not take insurance to ensure no intrusions to the health care process, I actually had people swearing at me how insensitive I was that I would not accomodate them. The entitlement was so obnoxious, it reinforced my decision. And yet, these are the same people who complain when they are told they can't get certain meds, can only have so many visits each year, and what diagnoses will be reimbursed to the provider.

Actually, there is a third comment:
Stephany, isn't it interesting this guy Amen, who Carlat tackled head on, is quoted here when he is trying to define people's diagnoses with his novel techniques. Again, to me the irony is dripping with stool:
"let me tell you what your problem is so no one can help you and get paid for it hereon."

I sometimes really wonder if people ever stop to think before they open their traps.

And last point, remember that about 70% of antidepressant prescriptions are written by NON psychiatrists. So your primary care/family doc can really screw you over without thinking.

Hence why the adage "the road to hell is paved with good intentions" should be above every health care professional's door.

Just one opinion.

My family doc is the one who started me on this little Prozac Caravan. I was better off depressed.

I have been wondering about this HIPPA crap. I haven't been in a nuthouse or taken a psych drug in almost ten years. I'm no longer in therapy.

Isn't there some sort of statute of limitations about discharge summaries? Can I not have them expunged after seven years? I've been thinking of consulting an attorney about this.

The last two discharge summaries are a worry to me, especially the one from the local hospital. I won't bore everyone with the details, but there was a HUGE lapse (actually several lapses by several people) in medical judgment which nearly killed me and caused me to end up with a really nasty and untrue discharge summary. One guy ended up being fired, as a direct result of the mess. I met with the heads of the ER, the mental health center and some other high mucky mucks who were totally appalled at what happened. One of them even pointed out that a test the ER doc had ordered was never done.

Unfortunately, the meeting was chaired by the hospital's "Risk Management" person. I didn't understand that the risk she was managing was the hospital's, not mine. I'd asked to meet with the Quality Control person and was told they "didn't have any one in that position right now". Turns out they NEVER have "any one in that position" because they don't HAVE that position.

At the end of the meeting the only thing I asked was that the discharge summary being altered to reflect what actually happened. I left an amended copy with the woman and was assured it would be done.

Well (surprise, surprise), it never happened. I've had to go to the ER since and all was well until they read this (by now almost ancient) discharge summary, at which point I'm treated like crap. The last time my husband and I ended up sneaking out when their backs were turned because it felt very unsafe to be there. You cannot provide good medical care to someone if you are contemptuous of them.

I just turned 60, an age when one begins to contemplate ones mortality (trust me on this). I live in a rural area. This is my community hospital. It is 20 miles from my home. The nearest other place is 35 miles from my home.

I'm seriously afraid to be taken to this place in an emergency. It is notorious for treating anyone with a psych diagnosis badly, no matter what the presenting complaint. (My friend went in with fainting spells and skyrocketing blood pressure brought on by a reaction to newly prescribed blodd pressue meds and ended up in handcuffs in the back of a police cruiser on her way to the state hospital where--I'm happy to report--they immediately released her.)

I not only have a psych label, I have this troublesome (and by now ancient, did I mention that???) discharge summary. I actually fear for my life and never feel comfortable going to any doctor because the hospital owns all the local practices and all the records are computerized.

So I'm wondering, with all the so-called rights of HIPPA (privacy not being one of them, thanks to computerized records), isn't there a statute of limitations as to how long docs/medical facilities can keep your records?

I'd be most grateful if anyone has an answer to this question.
Sherry

Bravo to the honest doc who put this in writing...Something that concerns me is the amount of child abuse neglect, maltreatment, ADHD, Bipolar, etc. we are seeing now. What does that hold for the future of these children who will need to become insured when they turn 18? You can be a victim of a serious crime, in need of psychological services possibly for the rest of your life only to be re victimized by the insurance industry. It’s nothing short of criminal. Where the hell is the government on these issues? And they think we have a healthcare crisis now? Wait another 10-15 years...

The hardest insurance to obtain while taking psych meds is disability insurance. Most folks taking these meds will be declined for coverage.

Life insurance can be a bit easier, but one may not qualify for the best level of discount, but the same would be true for high blood pressure or diabetes.

re: PCP's and psych meds. Oh yes, that's where I've been given Zyprexa,Prozac, Seroquel, Trazodone, Xanax all for ANXIETY!!

Not to mention the PCP did not ever monitor those meds, ever do blood work or EVER tell me of any side effects, NONE. Not even the diabetes alert with Seroquel which has a black box warning.

Sherry-
You bring up an issue that I am sure many of us on this site can tell you numerous stories of discrimination from not only mainstream society but from the medical field as a result of a psych dx. Unfortunately, this is why there is a problem with a psych dx in the first place. People are starting to realize these things and choosing not to get the help they need. Maybe then some crafty lawyer can start holding insurers liable.

I very much liked your comment TherapyFirst.

fwiw, I myself have had only bad memories of my own Pdoc.

She was incompetent, uncaring, egotistical, condescending and the most important of all, she wrong on all counts of her opinions and predictions.

Her decisions caused me a lot of problems for a long time.

At that time in my life, I did not forget, and I did not forgive.

I did some personal work on my issues with professional mental health workers over the years. Suffice it to say, I know pdocs are just people too and people, are far from perfect being only human.

It pleases me to see a psychiatrist contributing to these posts and I do hope you will stick around for a bit regardless of others.

I am not clear which comment you liked, Jane, but thank you for the appreciation.

As I said in an earlier posting, I am considered a heretic by many in my field these days, as I do not support this "better living through chemistry" attitude everyone seems to embrace like oxygen in the past 15 years. It is about a biopsychosocial model, so that is what I preach in my office, and more than not seem to agree who practice it as the patient.

Too many psychiatrists, which goes along with being an MD in general, take the paternalistic approach to new lows. Doctors work WITH patients, not for them or on them. Another model that just blows chunks with me is calling the patient the "consumer" or "customer". Hey, I work in a doctor's office, not a shop or store. The business model only demeans and diminishes what a physician does. It is a different relationship than what is applicable in a health care model.

Just my opinion.

Hope all had a nice extended July 4th weekend.