How Would You Handle This psychiatrist Mess?

[jal]

Hi,

I haven't been around in a bit, but I need some advice regarding this situation. (I apologize as this may be long). difficult child has been doing well on his current medications (see below). We have had a great psychiatrist for over a year. I lost my job in Oct, but had insurance thru March of this year. We ordered difficult child's medication thru mail order. On the last order the psychiatrist ordered Depakote in it's generic form delayed release. difficult child always takes Depakote Extended release 24 hr. When I opened the medication last week I noted the difference and immediatley called the psychiatrist. He told me it was fine and difficult child could take it. By Friday difficult child was a mess. Constant raging and tantruming. Bad day at school and daycare. A mess when we got home. Coffee table flipped over, dining table chairs being tossed. We could barely calm him. By Saturday a.m. he was just as bad if not worse. I called psychiatrist who told me to call the mail order and check the script. They said they filled it correctly. psychiatrist said he tried to call, but could not get through to mail order. He said he e-mailed me a copy of the original script and the ordering history for difficult child. He said if he made a mistake "he would pay for the refill". Well, I looked at it and saw that the last order was for generic depakote delayed release when my son takes extended release. Got a hold of a pharmacist at the mail order co who explained the difference between delayed and extended release and that they are not interchangable. I e-mailed the psychiatrist the info and waited. By 4:30 I called and left a message. He called back and became very defensive and told me if I thought he was incompetent that maybe we should look for another doctor. All the while I never was upset, I just wanted my son to get better and be on the right medication. I have never seen him take a tone like this with us ever. Then he was swearing he ordered the right thing (delayed) but he would pay for it (because now my insurance was up and 120 pills was $233.95 when I now had 360 for $50 that I cannot use). Then he says "well this leaves a bad taste in both our mouths". WHAT? So he called in the script and left his cc number and we got that filled. Now it took a few days for difficult child to get back on track but he is (thankfully). But, it cost us also a $75 seat at Cirque du Soleil that's in town (husband stayed home with difficult child - we were to go with-my parents as a b-day gift) and a day off of work for husband on Monday so we could make sure difficult child was ok (because this week is vacation and I don't want him messing up his daycare). So on Monday I e-mailed the psychiatrist to thank him for taking care of the script, let him know that difficult child was better and that I hoped we could continue our relationship. NO RESPONSE from him so far. I also came across a warning from the FDA from June 2007 that spells out the difference between Depakote delayed release versus extended release that warned that they are not the same. Biochemically they are different and they cannot be interchanged, but a lot of practicioners use the 2 terms interchangeably. I am on the verge of sending him a letter with this warning. I don't want to lose psychiatrist, but I feel that he is upset because he thinks he was right, and unfortunately he was not and I feel he is bitter because he paid for the script. He offered, I didn't even ask or demand that he do it. He has always been very good to us and always reachable. I don't want to lose him, but after this mess maybe it is best?

 

[gcvmom]

Well, he did offer, and you did thank him. I don't think he's obligated to reply to your email. He may be very busy (I know ours always is) or dealing with some other issue that came out in his attitude towards you. He's human -- we tend to forget that about our docs. I think I'd let it go. And if he starts interchanging his terms for extended and delayed, whip out a copy of the FDA report for him and tell him you're feeling confused.

That's my 2 cents.

 

[susiestar]

I think that future prescriptions should be checked before you leave the office with it, or if you call it in be very specific with the person on the phone.

For now, to make peace (sounds like he is feeling defensive) maybe sending a nice note (maybe with some cookies or homemade muffins?) thanking him for helping you navigate through this.

Normally I would just let it go, but it sounds like this was very hard for him as well. We ALL know insurance companies can make everyone in healthcare go nuts. I would blame the mix-up on the insurance co, just to make sure future dealings with this doctor are as positive as the ones in the past.

the reason for hte cookies or muffins is to show that you appreciate him taking care of this. You want future appointments and prescriptions to be usefull. finding a new psychiatrist is a rough and hairy process, no one likes it. So, if a small token on your part can keep this positive, I say go the extra and do it.

Hugs, and I am really sorry you had to deal with this medication mix up. It is so hard on the kids, and probably harder on the moms who have to live with the kids and straighten out the mess.

by the way, have you contacted ppa.org - they do medications for those with no medication coverage.

Susie

 

[totoro]

If he is great and has been good besides this "mess up" Considering how hard it is to find a good, decent psychiatrist! I would give him another chance.
Who knows maybe he has other stressors going on in his world? Not that that should affect you, but we are all human.
I am sorry difficult child had to go through this, but at least someone was willing to help!
Susies idea is nice... if he is close by.

 

[Hound dog]

I like Susie's suggestion of making some muffins or cookies as a thank you to go along with the email. This would show him you appreciate his generousity in correcting the mistake and that there are no hard feelings.

In this day and age it doesn't take much for a doctor to find himself facing a lawsuit. This probably accounts for the defensiveness, or he could've been having a bad day. Odds are he probably doesn't even realize the 2 aren't interchangable. An honest mistake, and even docs are only human.

I'd hate to give up a psychiatrist this good over a mistake.

Nichole's psychiatrist did it twice. Nurse didn't catch it, and that's her job. I called psychiatrist to have it fixed and there was no problem. Just double check the scripts before you leave.

Hugs

 

[jal]

Thank you for your suggestions. I just really don't want to lose this doctor. I haven't checked into that info regarding help with-the cost of medications as my new insurance for my new job kicks in May 1. We had figured using the mail order would cover us for 3 months, while I waiting the month for my new insurance to kick in.

Thank you.