Re-entry into the US Mental Healthcare System

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Remember that last post I published?  The one from September 2013 that said I would be off for two months?  Well, that didn’t pan out, did it.

What has panned out is being hired back to my old job and moving back to the US, which means having to once again enter the US healthcare system.

For my foreign friends – finding docs in the US is a tricky business at best.  In The Netherlands, it’s required that your huisarts (GP) is located within a certain distance from your home in case of emergencies so there really aren’t all that many to choose from.  Here in the US, you simply ask a colleague if they like their doc and no matter where they are located, go try them on for size.

So in the US, trying to find a psychiatrist presents a whole different challenge.  Everyone needs a GP at some point, but not everyone is bipolar. You can’t just walk up to someone and ask if they like their psychiatrist.  Even if one out of four people in their lifetime suffers from some form of mental illness, which means statistically those you know have at least one family member that’s seen a psychiatrist, it’s better to keep that question to yourself.  Because of that little thing called stigma.

I decided the best route to take would be through a referral service that categorizes docs by their areas of expertise.  Heart docs, osteo guys, psychiatrists with specializations in bipolar.  As it turns out, my new/former employer offers just such a service.  They will even help people hook up with the right attorney, the right smoking cessation program and the right weight loss group.  Here’s the catch.  One of my colleagues informed me that if someone takes advantage of this service, their manager is informed.  The manager is not told what the employee has inquired about, only that the employee has requested assistance.

Non-starter.

I work in an industry and for a manager that would severely penalize me for having the condition I do.  Damn straight it isn’t fair.  Or legal.  But it is what it is.

So I’ve resorted to one of those lists from a mental health magazine that is sorted by specialty.  Sure, the doc has paid beau·coup dol-ores to be on that list, but it’s the only confidential starting point I have.

No matter who I wind up seeing, I have made a promise to myself.  Whatever doc I decide to try on for size isn’t touching the med cocktail I’ve been stable on for almost one year.  No one is messing with the concoction that has me in the most stable phase I’ve been in for my entire life.  And one mention of putting me on some antipsychotic as a prophylactic?  I’m out the door.  “Just bill me!” I’ll shout as I tear out the secret squirrel exit, and I’ll never turn back.

Ah, I’d forgotten how much fun the US healthcare system can be when it comes to finding psychiatrists.

Woo hoo.

The game is afoot.

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10 thoughts on “Re-entry into the US Mental Healthcare System

    Ruby Tuesday said:
    January 12, 2014 at 8:45 PM

    Ugh. I hate breaking in new doctors, especially psychiatrists. But hello, and welcome back to WP Land! I’ve missed you!

      ManicMuses responded:
      January 15, 2014 at 1:38 AM

      Hi there! Good to be back! I’m not thrilled about having to train a new doc, but at least I have a few months of med in the reserves so I can take my time ;)

        Ruby Tuesday said:
        January 15, 2014 at 1:55 AM

        Very smart lady. ;)

    Laura P. Schulman, MD, MA said:
    January 12, 2014 at 11:48 PM

    Good luck in your hunt! My MO has been to look for a University, and if there is one, try to muscle my way in to the chief doc there by looking in the University Directory. When I was working in a sensitive position I went so far as to pay out-of-pocket so it wouldn’t show up on my employer-paid insurance records, even though it is illegal for one’s employer to look at those records. But if you’re working in the type of position where you’re subject to surveillance and/or need a security clearance, all bets are off and paying out-of-pocket is the only way to go. I even paid for meds–expensive, but no bread-crumb trail, if you know what I mean.

      ManicMuses responded:
      January 15, 2014 at 2:05 AM

      I hear you loud and clear. I am so petrified of someone finding out about my condition. If I take advantage of the prescription benefit I should be OK – no antipsychotics or antidepressants, only anti-seizure meds. The doc is the tricky part. I don’t dare try to search for a doc at work since it is a sensitive environment and all activity is monitored. I make lists at night and make calls from the work parking lot all day. Hah! We both sound paranoid – but the fact is that if we weren’t we’d be in real jeopardy of losing our livelihoods and potentially a lot of friends as well. Doubt it will change in our lifetime. Just have to go with the flow.

        Laura P. Schulman, MD, MA said:
        January 15, 2014 at 3:08 AM

        It’s a sick world where we have to hide the fact that we’re taking good care of our health. One of my physician colleagues didn’t make it because he was too afraid of losing his job to seek help. I wrote a post about him: “The Hero Who Lost The War.”

        ManicMuses responded:
        January 19, 2014 at 4:19 PM

        I’ll read your post tonight. And yes, it’s sick. My employer is always preaching ‘wellness, take advantage of the twice-yearly physical checkups, and, most of all, manage stress!’ (Yeah, we live under a lot of pressure in my world.) But if I ever divulged that I am probably one of the few who does just that…it’s the door for me.

        Laura P. Schulman, MD, MA said:
        January 27, 2014 at 3:23 AM

        Jeez….I’d love to know what profession you work in, that could legally show you the door because of a psych diagnosis. Airline pilot? Spooks? I almost married a big chief spook and had to keep my dx under wraps. I couldn’t get a civil pilot’s license because of the benzos, but he had no problem despite an arrhythmia. Go figure. He did teach me to fly and land the plane though, in case he died while we were flying :-D

    Sandy Sue said:
    January 13, 2014 at 12:23 PM

    Yaay! She’s back! You’ve already done the most important part–finding that cocktail and making up your mind to fight for it. No matter what doc you find, when you go in with that attitude, you’ll be fine. Do you have your records from the Netherlands? That might help to have documentation of the meds you tried. Much luck.

      ManicMuses responded:
      January 15, 2014 at 2:09 AM

      Sandy Sue! How goes it? Yeah, my doc in NL is writing me the necessary intro letter since my records are in a language even Dutch people can barely understand :) I do have a ‘tide, too. I figured finding a doc is such a royal pain in the @ss I’m entitled to a bit of whining. :)

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