Is there a medical board of ethics?

[klb444]

What is the name of your state?Pennsylvania
My 27 year old son has been suffering from mental illness for 3 years. The psychiatrist we have been seeing for the past year and a half has prescribed three different types of anticonvulsive medications plus lithium for what he diagnosed as bipolar. We have watched as our son's mental functioning, memory, and ability to concentrate declined while the doctor continued to increase his medications up to 24 pills a day. At our last appointment when we questioned the psychiatrist about removing some of the meds on the advice of other medical professionals who have seen our son and believe he is over medicated, he became angry and told us the appointment was over without asking our son one question about how he was feeling--but he charged us $195.
We set up another appointment to ask him for help in weining off the meds (this is our son's request), but canceled due to an emergency prior to 24 hours--and he charged us $195.
We are now asking for his help again in getting off the meds because without proper supervision our son will likely take a seizure. The psychiatrist at first told us "no" but then agreed only if we paid another $195!
Please advise.

 

[BelizeBreeze]

Get your son evaluated by another psychologist.

Commonwealth of Pennsylvania
Department of State
Complaints Office
P.O. Box 2649
Harrisburg, PA 17105-2649
Toll free Complaints Hotline: 1-800-822-2113 (Pa. only)
717-783-4849 (outside Pa.)

Or you can file a complaint online at http://www.dos.state.pa.us/bpoa/cwp/view.asp?a=1104&Q=432617&bpoaNav=|

 

[rmet4nzkx]

Your son is the patient, there is no we.
Your son needs to make his requests to the doctor, not you.
If your son fails to cancel the appointment, there may be a charge.
Once the session starts the psychiatrist may charge for the entire session.
You or your son may file a complaint with the medical board and they will investigate.
Your son may seek therapy with another provider or admit himself to the hospital for assessment or supervised withdrawl.
It is very common for bipolar patients to complain when their medication is working.
It is also common for persons with other disorders such as OCD or Asperger's to be diagnosed/treated as Bipolar and lithium/ASD's help on some level, that may explain the high dose required to get results or there is an issue of non compliance. Is your son's blood tested for therapeutic levels? Even if you attend these appoints, you may not be getting an accurate account from your son.

 

[klb444]

Pennsylvania
This psychiatrist only treats patients in the presence of the family--so in this case "we" is appropriate, and all appropriate paperwork has been signed. My husband and I and our two other sons have been in attendance for every appointment. My bipolar son is not capable of scheduling or canceling appointments because of his decreased mental functioning, so "we" have had to it.
Yes, his blood levels are in the theraputic range but that does not preclude him from having side effects from the meds.
We have already had a psychologist's evaluation and verification that he felt our son is overmedicated, and with our son's permission, spoke to our family about getting his meds reduced. However, since he is a psychologist and not a psychiatrist he is not qualified to do it.

 

[ellencee]

M e d i c a l d o c t o r...n e u r o l o g i s t: one who provides medical management of seizures. P s y c h o l o g i s t: one who does not.

$195...my fee.

Please submit immediately.

EC

 

[klb444]

Pennsylvania
EC,
If you read my question properly you'd see that my son DOES NOT have a seizure disorder--A NEUROLOGIST IS NOT A PSYCHOLOGIST I agree.
I'm not sure whether doctors or lawyers are more unprofessional.

 

[BelizeBreeze]

Pennsylvania
EC,
If you read my question properly you'd see that my son DOES NOT have a seizure disorder--A NEUROLOGIST IS NOT A PSYCHOLOGIST I agree.
I'm not sure whether doctors or lawyers are more unprofessional.

Neither, it's people asking for free advice then not liking what they hear.

 

[rmet4nzkx]

Pennsylvania
This psychiatrist only treats patients in the presence of the family--so in this case "we" is appropriate, and all appropriate paperwork has been signed. My husband and I and our two other sons have been in attendance for every appointment. My bipolar son is not capable of scheduling or canceling appointments because of his decreased mental functioning, so "we" have had to it.
Yes, his blood levels are in the theraputic range but that does not preclude him from having side effects from the meds.
We have already had a psychologist's evaluation and verification that he felt our son is overmedicated, and with our son's permission, spoke to our family about getting his meds reduced. However, since he is a psychologist and not a psychiatrist he is not qualified to do it.

Is this psychiatrist treating your whole family? I see you have had substance abuse problems with your 17/18 yo son and underage DUI and review of your posts reveals a history of making complaints.

If his meds are in the therapeutic range then he is not being overmedicated, that doesn't mean he doesn't have side effects or lacks the energy he has when unmedicated, that excess energy or inappropriate behaviors can be truly destructive. As I said it is common for bipolar and other disorders to complain when they are appropriately medicated, they are not the best judge, but a psychologist as you know, is not the one to make that determination. The psychologist, can with your son's permission consult with your son's psychiatrist and discuss their clinical observations.

If you truly feel that your son requires futher evaluation please take him to another psychiatrist and or to a psychiatric hospital for evaluation and supervised withdrawl.

 

[panzertanker]

What is the name of your state?Pennsylvania
My 27 year old son has been suffering from mental illness for 3 years. The psychiatrist we have been seeing for the past year and a half has prescribed three different types of anticonvulsive medications plus lithium for what he diagnosed as bipolar. We have watched as our son's mental functioning, memory, and ability to concentrate declined while the doctor continued to increase his medications up to 24 pills a day. At our last appointment when we questioned the psychiatrist about removing some of the meds on the advice of other medical professionals who have seen our son and believe he is over medicated, he became angry and told us the appointment was over without asking our son one question about how he was feeling--but he charged us $195.
We set up another appointment to ask him for help in weining off the meds (this is our son's request), but canceled due to an emergency prior to 24 hours--and he charged us $195.
We are now asking for his help again in getting off the meds because without proper supervision our son will likely take a seizure. The psychiatrist at first told us "no" but then agreed only if we paid another $195!
Please advise.

Psychiatrist can charge whatever amount he wants to for services, you can just choose not to pay it and retain the services of someone in your price range.
BelizeBreeze gave you good contact info, use it.

A neurologist would be effective for managing seizure disorders.
A psychiatrist would be effective at medically/pharmacologically managing mental health disorders.
A psychologist would be effective at managing mental health disorders in a counseling atmosphere.

I understand your post to state you are concerned about your son having a seizure while going through a decrease in his medications, NOT that he has a seizure D/O and is being treated for it....

Go to a mental health facility and get your son the help that he needs....

 

[tbob69]

KLB444 -

Some seizure medication is also used for treating Mental disorders. Does the doctor you were originally seeing have it posted about cancelling appointments and a fee. If not, he may not be able to charge you for the visit you cancelled. As for the appointment that you asked the questions in and he stopped the session immediately afterwards, he may be able to charge for that one. I have friends who are drug reps (legalized drug pushers). The doctor you are seeing may be receiving incentives from these companies to prescribe their drugs.

you never said earlier whether you have a Power of Attorney for your sons healthcare. If so, you have every right to make requests. If not, you may not. I noticed that you said that you were in all his sessions. I don't think that it is unreasonable to ask to reduce his medication. 24 pills a day is alot of medication.

No matter what you do, change doctors from this one.

 

[klb444]

tbob69
Thank you for a sensible and reasonable answer. No, the doctor in question never gave us any indication that 48 hours is needed to cancel an appointment, not does he have it posted. I will definitely try to see if he legally can charge us. Thank you.

To the "flip" lawyer,who asked if our whole family is being treated the answer is NO. It is this psychiatrist's policy to have input from all family members, so that is why we all attend. My 17 year old son did have an underage alcohol conviction, but he was NOT DUI nor is any substance abuse involved!! Jumping to conclusions, aren't you???

Yes, this is a difficult time in our lives. We are a very loving family who spent much time raising our three sons. One was blessed with an illness and one made a stupid 17 year old mistake. In asking for advice I guess I expected more than sarcastic answers--I really needed help during those times.

Signing off.

 

[rmet4nzkx]

KLB444 -

Some seizure medication is also used for treating Mental disorders. Does the doctor you were originally seeing have it posted about cancelling appointments and a fee. If not, he may not be able to charge you for the visit you cancelled. As for the appointment that you asked the questions in and he stopped the session immediately afterwards, he may be able to charge for that one. I have friends who are drug reps (legalized drug pushers). The doctor you are seeing may be receiving incentives from these companies to prescribe their drugs.

you never said earlier whether you have a Power of Attorney for your sons healthcare. If so, you have every right to make requests. If not, you may not. I noticed that you said that you were in all his sessions. I don't think that it is unreasonable to ask to reduce his medication. 24 pills a day is alot of medication.

No matter what you do, change doctors from this one.

It is true that antiseizure Rx are used to treat other disorders, in the case of bipolar, when patient isn't compliant or can't tolerate lithium, this was previously stated. Other Rx such as atypical antipsychotics.

We don't know the facts around what happened and why they were charged or how often emergencies caused patients to cancel or forget appointments, it may have been a habitual problem. There is significant pathology in this family, this is not the only family member with mental health issues, nor can we be assured of the accuracy of OP's account. I specifically explained how the psychologist might relate their clinical observations to the prescribing psychiatrist if they were concerned of overmedication. The psychologist knows they can do this with the patient's permission.

OP leaves out significant facts in relating their story. Without knowing the specific Rx, no determinaiton can be made re the amount of pills being too much especially when OP confirms that son is tested regularly and within the therapeutic range. I have had clients take huge amounts of Lithium yet their body was a rapid metaboizer and they were within the therapeutic range.

OP was already refered to another psychiatrist or better yet a psychiatric hospital for further assessment and supervised medication withdrawl.

 

[Heather2]

Anticonvulsants suck and will make him very slow and sedated. Go see another psychiatrist because there is no need for him to be on that many meds and there are many alternatives to anti-convulsants. A doctor who gives you an attitude because you/he want to decrease his meds doesn't sound like a good doctor anyways.