When's It Time to Change Doctors?
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Q:  When's It Time to Change Doctors?

Dear Dr. Phelps;
     My 24 year old son was just diagnosed with bipolar a year ago, after suffering with many problems for the last eight years or so.  He has seen probably six or so psychiatrists during that time.  He has been with the same psychiatrist since he was diagnosed, but he and I agree that he is doing very poorly.  My husband and I scheduled a meeting with the Doctor, and we are still unhappy.  We feel that our son is not being adequately treated, but we are unsure about changing doctors again.  How do you know when it's time to move on?

Dear Ms. C' -- 
Ooh, tough question. I could go on about this one.  But to start with a simple answer (low on time this week): how about getting a second opinion (or in this case, perhaps a 7th) without deciding in advance to "move on"; then, if you like what you hear and see -- a reasonable explanation for what's happened thus far; a recommended course of action that makes sense to you; and a good sense of "connection" for you parents and for your son; and maybe you get lucky and get "a sense of humor" too -- then you ask if you can continue with the new doc'. 

How much should you shop? At some point obviously the need to get treatment underway in a stable context is going to outweigh the possible "better" situation you might hope to find; that's perhaps what has happened to you thus far. Many people can't shop much: too few options, for a variety of reasons. By the time you've seen six, one would hope you've seen at least one good connection, unless you were very unlucky -- but perhaps that connection was not available for continued care (e.g. a hospital doc'). At some point you'd also have to wonder if you were being too selective, I suppose, but there are lots of psychiatrists out there who would make you want to move on; fortunately there are also a lot of really good ones. I'm sorry I don't have anything more systematic for you regarding how long to look. You may have already come across my guidelines on finding a therapist/psychiatrist? If not, there might be another thought or two (skim to sections that apply to you; it's long).  Good luck with your search. 

Dr. Phelps

Published April, 2006


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