Incoming Psych Intern - Need to find (personal) Psychiatrist in New City...

[ID Obscura]

I am about to move to a different area of the country to begin my Psychiatry Residency. Meanwhile, I need a Psychiatrist myself. (Please, no debates about whether or not people with Psych diagnoses should go into Psych themselves. Trust me when I say that I am VERY STABLE. I’d rather not give more details because I don’t want anyone to think I’m asking for MEDICAL advice.)

The only part of this whole move that is concerning me is getting hooked up with a new psychiatrist. I’m only arriving a couple days before residency starts and I know my schedule will be unpredictable and chaotic (ie, scheduling new appointments will be difficult). I should have 3 months worth of refills with me when I arrive (from my current psychiatrist), but at some point I’m going to need to see someone in the new city…

I talked this over with my current psychiatrist & also stated maybe I’d try the “other” psychiatry residency in that city as (1)I want to make sure I get hooked up with a GOOD psychiatrist. Like “several” others on this forum, I have at times seen patients come in on really bizarre and inappropriate treatments, and I don’t want this to happen to me. (2)I don’t want to see a psychiatrist at my OWN program because that would just be weird. (My current psychiatrist is affiliated with my school & although it really hasn’t been a problem as my Dr. doesn’t teach med students, I have run into my Dr. at lectures, etc. on occasion & it’s been somewhat uncomfortable for me. I was also really terrified of ending up at my own school’s residency program as my Dr. DOES teach residents. We’d already discussed that my Dr. would help me find a DIFFERENT doctor [not affiliated with the program] should this happen, but I still was going to feel VERY weird about the whole situation…)

Anyway, my Dr. also thought it was a good idea to try to find someone at the other program in my new city. My Dr.’s good advice (which I hadn’t thought of) was “why not go ahead & call the other group NOW, get an intake appointment set up for one of the days right before your program starts, that way you will be “established” with the person, they will know you, and if your schedule gets so chaotic that you can’t fit in a follow-up appointment 3 months from them, they would be more comfortable re-filling your Rx at that time without necessarily seeing you. Also, my Dr. said it was very common when there were 2 programs in a city like this that they sort of have an “agreement” worked out where they would see each other’s residents, for exactly the reasons I’ve already mentioned.

So, this sounded like a good idea.

Before I continue, let me say that I haven’t received my CONTRACT or any other official paperwork (like details about the health plan) from my residency. Although the GME people were able to tell me the name of the company my health insurance will be through. (But I don’t know whether I’ll even HAVE mental health coverage…) I don’t even know if the coverage will kick in immediately or if there might be a 30-90 “probationary period” or how any of this is going to work.

So, I called the other school’s psychiatry practice. (1)They have no formal “understanding” with my program, but told me they DO have patients who are employees [including residents] of the new school where I am going. (2)When I mentioned what my insurance would be, they told me that only a very limited number of their doctors accept that insurance. (Great. So to top everything off, I’ve got a loser health plan that nobody wants to take…) (3)They couldn’t go ahead & schedule an appointment for me yet because they need all of my insurance info (my insurance #, etc.) first.

So much for being proactive and trying to set this up ahead of time so it will be the least disruptive upon my schedule & clinical responsibilities. (And it’s SO HARD to schedule appointments anyway, when you don’t know what the hours/schedule of your rotation [3 months from now] are going to be like.)

I just wondered if any of you had any advice:
(1)First of all – I know there are doctors out there who would be considered “a psychiatrist’s psychiatrist” – ie, they see others in the field as patients. Probably people at my new program (like the program director!) would know who the people are in town with that reputation. But I really don’t see a way to ask around for this info without “outing” myself, and I’m not really sure I want to do that. Is there any sort of “informal” way to find out this info via the web or something?
(2)If my insurance is so crappy that nobody is going to take it, I’m sure that will make scheduling appointments all the more difficult. Maybe I should just call the other program & ask to pay out of pocket so that I have more options & possibly could get in sooner? (I know some people pay out-of-pocket [including for meds] to avoid an insurance “paper trail”, but I’ve already got a paper trail so might as well make use of my insurance if I can. But if it’s not really practical to get the care I need going through my insurance I guess I’ll pay out-of-pocket if I have to.)
(3)Isn’t there some kind of informal “professional courtesy” type thing between doctors that I should be able to tap into? (ie – there must be a “back door” somewhere; how do I find it?) (Sort of along the lines of “ok, so the only appointment I have for a new patient in the next 4 months is at 8am on a Tuesday 3 ½ months from now. And you have no idea if that will fit your schedule or not, because you won’t be finding out your schedule for that rotation until about 3 months from now. But you’re afraid it probably WON’T work because you’re going to be on your medicine rotation and will probably be rounding with your team at that hour. OK, well then, why don’t I just “squeeze you in” 1 afternoon next week…”)

(Does that sort of thing exist?)

Any advice on how to handle all of this would be appreciated.

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[BobA]

That post was way too long to actually read without 150mg of concerta IV, but from what I could skim you're moving to a new city and need a good psychiatrist who is not affiliated with your program. I'm in a similar situation.

I'm going to talk to my PD. I just plan on telling him that I heard it's a good idea for psychiatrists with an interest in doing therapy to try being in therapy themselves with a psychiatrist while they are residents and ask if he could recommend anyone. In fact, my own dept chair (who knows nothing of my psych history) suggested I do just that, saying it was one of the best things he did while he was a resident.

Your PD can probably recommend someone who works well with residents and who might even offer a discount.

EDIT: Another idea would be to contact the current chief resident and ask for a recommendation. Since they will be leaving, you'd never work with the current chiefs anyway and they've probably been around enough to know who's good.

 

[Doc Samson]

That post was way too long to actually read without 150mg of concerta IV, but from what I could skim you're moving to a new city and need a good psychiatrist who is not affiliated with your program. I'm in a similar situation.

I'm going to talk to my PD. I just plan on telling him that I heard it's a good idea for psychiatrists with an interest in doing therapy to try being in therapy themselves with a psychiatrist while they are residents and ask if he could recommend anyone. In fact, my own dept chair (who knows nothing of my psych history) suggested I do just that, saying it was one of the best things he did while he was a resident.

Your PD can probably recommend someone who works well with residents and who might even offer a discount.

EDIT: Another idea would be to contact the current chief resident and ask for a recommendation. Since they will be leaving, you'd never work with the current chiefs anyway and they've probably been around enough to know who's good.

All good advice, except chief residents often stick around as junior faculty.