tons of people on Adderall...

[WisNeuro]

I can't speak to this particular poster's anecdotes, but I (a PCP) see stuff like that at least once/month. A local psychiatrist retired last year and all of his patients are filtering through to everyone else trying to get refills. No takers so far.

Agreed, I get people on goddawful med regimens from a variety of providers. The ****ty prescribing bug does not seem to discriminate by degree type. I'd love to see some studies about prescribing trends by provider type. But, anyway, people in glass houses and all that.

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[SeniorWrangler]

I used to practice in an area where there were only two regional psychiatric inpatient facilities, a county hospital and a nationally famous psychiatric training hospital. Guess which one discharged patients with severe polypharmacy?

 

[Igor4sugry]

There are psychiatrist with terrible prescribing practices, worse than NPs. High dose benzos+high dose stimulants, or worse yet opiates.
Dr. Alen Salerian comes to mind.
The Spectacular Unraveling of Washington’s Favorite Shrink | Washingtonian

 

[chocomorsel]

The theme I am seeing here is "older psychiatrists" and midlevels overprescribig.

Maybe the older guys on the way out just don't care much anymore and just want to be done? I know I see it in my field. Poor medicine with a few of the older guys. They are tired!!!

 

[Jules A]

Maybe the older guys on the way out just don't care much anymore and just want to be done? I know I see it in my field. Poor medicine with a few of the older guys. They are tired!!!

Totally agree that seems to be part of the issue, although I don't find that acceptable, especially in psych where it becomes a ClusterB and SUD free for all. The other thing to consider is the handful of benzos strategy was perfectly reasonable back on the day and unfortunately many are either ignorant of current recommendations or holding on to the path of least resistance, again unacceptable in my opinion.

 

[WingedOx]

There's bad prescribing, and then there's prescribing amphetamines (with benzos) to elderly patients as a discharge Rx when you're an inpatient psychiatrist.

He wasn't elderly (though they all become elderly eventually with the same regimens), but I've been cleaning up a patient who left a VA SARRTP (residential substance tx) program on xanax 2 TID, Dexadrine, Quetiapine, Latuda... This was from a facility that DID make the news, however.

His first trip to my facility he immediately demanded to speak to the supervisor or the psychiatrist who said he wasn't going to fill the stimulant.

 

[Shikima]

Remember, press ganey scores matter because it counts towards MOC! hahahahahahhaa