Does a patient have a right to participate in their medication routine

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   schoolgirlforrealposted 12 years ago

   In my 20+ years of experience with psychiatrists, I've had doctors who have been very willing to take the patient's input and some who have been reluctant.
   
   Sometimes we become aware of a medication that has worked well for someone we know and we may suggest our doctor try us on it as well, particularly is that mecication is in the same family of medications. This works well and the patient has the right to suggest. 
   
   Well, I have a friend who has a very stubborn psychiatrist and cannot seem to get another one.  She has asked me to help intervene if I can and I'm just wondering if you have any advice.
   
   Thanks

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      Diane Insideposted 12 years agoin reply to this

      She may need to ask the doctor why he does not want to change or add a new medication. There are many reasons not to change. Sometimes it takes weeks for medications to get into you system and a doctor may feel it is not worth the time yet until he is possitve that the current medication isn't working.  He also may know of side effects that he does not like or may be risky. I could go on and on about reasons but ultimately she just needs to find out why he is opposed to this medication first, then decide whether she still wants to pursue it.

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      MelissaBarrettposted 12 years agoin reply to this

      My first advice would be to ask why the doctor won't prescribe it.  Generally, there really is a reason why one medication is chosen over another.  Even meds in the same "family" can interact differently with other medications or with a whole other myriad of considerations.  Doctors don't always do a good job of explaining and patients don't always do a good job of listening. 
      
      If the doctor feels that the medicine is less effective or has a higher chance of complications in a particular patient, he is not going to risk malpractice just to appease a patient.  He can't afford to.  Your support is unlikely to get him to change his mind.
      
      If that is the case, then finding another practitioner is your friends only choice.  Difficult though it may be.

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         HattieMattieMaeposted 12 years agoin reply to this

         Well most psychiatrists don't like you telling them how to dispense meds! I suppose it is there ego's. Not sure why you couldn't find a 2nd opinion unless are a person that goes doctor to doctor trying to get meds. From my experience working with Mentally impaired adults, they don't always tell you the whole story. Sometimes lieing to get more meds. I've experienced this many times, and it is hard to decipher to believe them or not. I've also found them complaining about Doctors, Payees, Caseworkers etc, and they just don't like following the rules, regulations, or good advice. They really believe these people aren't doing there job, and are making appropriate choices. I would go with an open mind, and ask why she is on the meds she's on, and hear him out. I'd be cautious and learn all the facts about her story she may not be telling you. You may go with her and find out he's not being stubborn, just doing the right thing, and she doesn't agree.

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      Dave Mathewsposted 12 years agoin reply to this

      I see nothing wrong with discussing the possibility of some other drug being beneficial, but ultimately 'doctor knows best' It takes years and years for doctors to study and learn even just the basics, and new and better meds keep hitting the market all the time. This is why a doctor's business is referred to as a practice, they never stop learning and having things change.

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      Brenda Durhamposted 12 years agoin reply to this

      I think it's cool that your friend asked you to help.  Patients really do need a support group or person who can be a part of their therapy.  Psychiatrists are often put on a pedestal as being all-knowledgeable when in fact there's no way they can ever get to know a client as well as friends or family do.  Plus, they often treat patient coldly.

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   hollisterukoutletposted 12 years ago

   Have an idea...

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   schoolgirlforrealposted 12 years ago

   Thanks for the input.
   She is close to 400 lbs and needs meds that don't cause weight gain

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   wim99posted 12 years ago

   Coming from the darkness to the light of truth over the last 2000 years of mental illness, judging from the experience one must master the condition set forth by the doctor. The only person that can request a med change other then the psychiatrist is the client or more correctly the consumer. Seeing that said individual is overweight, health concerns are probably dictating the thinking of reluctent doctor. Any change in psychotropic medication must be handled with upmost sensitivity to protect the health and well being of your friend. Kindly bring up to your friend that she must deal with the doctor on an individual basis and ask for the medication reviewed, as to find a more appropiate cure. Many doctors have a handful of other type medications that might suit your friend. Just remember that nearly all pychotropic meds have side effects, and from a doctors standpoint sometimes no change is a good thing. After all, consider the mental heath industry as an example, while much has changed, much has also stayed the same. Bottom line is that your friend must make her own decision about her meds, either way she will ultimately have to pay the price. Look for overall health benefits derived from a med change, not weight gain issues, then compare results that best can help your friend. A med change might sound great, but what if something goes wrong, then you are right back where you started.Your friend should simply state to the doctor that the weight issue is bothering her, and ask if not plead for the doctors help. Usually the doctors are intelligent enough to see the light, and will do anything possible to remedy the situation.Remember that it must be your friends decision, not yours_Good Luck!

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   HattieMattieMaeposted 12 years ago

   Yes, fortunately alot of them are in it for the money. lol You don't want to get me started! lol

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      schoolgirlforrealposted 12 years agoin reply to this

      

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         gsidleyposted 12 years agoin reply to this

         Although I don't think it is reasonable for a person to dictate what the psychiatrist prescribes, if your friend is suggesting a particular medication the least she can expect is for the doc to give her a clear explanation of why he is not willing to prescribe it.
         
         If, on the other hand, a person doesn't want to be on a particular medication (due to side effects, for example) the doc. should offer an alternative. After all, the person imbibing the chemical is the only one who knows exactly what it feels like - in other words, the patient is the expert under these circumstances.

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   psycheskinnerposted 12 years ago

   I am not sure how you could not have that right unless committed. If you don't like how your psychiatrist is treating you, the option is always there to walk out the door and retain a new one.
   
   The doctor-patient relationship goes both ways--for the treatment to proceed both must be fully committed to it.

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      schoolgirlforrealposted 12 years agoin reply to this

      Makes you think thou, doesn't it? What you say is true, but some people are just overmedicated and not able to contribute to their health, or like I was saying, stuck w/ a doctor in a state w/ not good health benefits.etc.

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         schoolgirlforrealposted 12 years agoin reply to this

         this is where self advocacy comes in, OR what my dad used to call "being a good haggler"

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         Nouveau Skepticposted 12 years agoin reply to this

         If a person is not fully ready to be assertive and on top of everything, yes--a family or friend advocate should go with them. People will sometimes stay with a terrible doctor because they think leaving might be "rude". But really, there is nothing wring with shopping around to the extent your health coverage allows....

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   Marcy Goodfleischposted 12 years ago

   If you mean their medication therapies (what they're prescribed), yes, patients have a right to give input. Doctors depend on patients to tell them about other meds they're taking, allergies or preferences. By preferences, I mean choices they want to request or avoid. I can't sleep when I take anything with codeine in it, so if I have surgery or dental work, I always request pain relievers that don't have that in the compound.
   
   Other forms of participation can include weaning off of a medication, monitoring your physical reactions (side effects, etc.) to see what dosage works the best and requesting alternate formulations when you aren't happy with what you're taking.
   
   However, this 'right' does not extend to demanding drugs you don't need or are at risk of abusing. A doctor's license can be at stake if he/she over-prescribes. As a clinic manager, I have seen 'drug seekers' try to get narcotics, pain meds, tranquilizers and other prescriptions so they could sell them, or to feed an addiction.
   
   Aside from abuses such as those mentioned above, patients are in partnership with their providers when decisions are made. If you're not included in these decisions, consider finding another provider.

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      schoolgirlforrealposted 12 years agoin reply to this

      "Other forms of participation can include weaning off of a medication, monitoring your physical reactions (side effects, etc.) to see what dosage works the best and requesting alternate formulations when you aren't happy with what you're taking."
      
      that's what I'm talking about

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   mega1posted 12 years ago

   adults who are not in a treatment facility are free to choose their doctors and their treatments - if she looks for a wholistic doctor she'll have an excellent chance of participating fully.  I strongly believe that participation helps your recovery from anything - leaving it up to the doctor to give you a pill - especially with psych issues - just doesn't usually work.   You end us treating just the symptoms usually.  What you want to do is be proactive in all your medical care and if your doctor doesn't like that, find another.  Wholistic medicine does not necessarily mean no pharmaceuticals - but instead it is treatment of the whole person - looking at all the many factors that may be causing the ailment - depression is usually caused by several things, not just one. I even think that making your own medicinal tea will help a lot more than just taking a capsule of the same herbs.  It's a whole mind, whole body approach.

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      schoolgirlforrealposted 12 years agoin reply to this

      she says she's having trouble in her state where she lives, the health care is not as good as MA, and it's hard to find other doctors who take her insurance. I am writing a letter to her doctor- some people are just not good at advocating for themselves- when (as you could imagine) one is feeling so depressed, down, overwhelmed, and sort of hopeless and they try to ask their doctor for something like a change in mood stabilizer and they flat out refuse- this is not good.

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         psycheskinnerposted 12 years agoin reply to this

         Could you find someone local who could go along as a support person?

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            schoolgirlforrealposted 12 years agoin reply to this

            I may go w/ her if my letter I"m writing isn't effective

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         mega1posted 12 years agoin reply to this

         I see what you mean - it is too bad that there is definitely a difference in care quality depending on where you live - and it is hard to find these great therapists and doctors anywhere.  Sometimes the help needed comes from an unlikely place - like finding a good GP (more available) who is also a good listener.  So, here's what I have done when I've had this same problem - educated myself as much as possible about everything I think is wrong with me - make a list of all the ailments I have been diagnosed with then make a list of all their symptoms, make a list of all the remedies I know of (not just meds, but also diet, exercise etc.)  Now rate  which ailments are the most crucially in need of treatment  and finally make the connections - rule out the meds and remedies for less important ailments that won't work with the crucial ones.  Does this make sense to you?  You end up with likely treatments for your conditions and you take this info to your doctor if it involves prescriptions for meds or treatments or tests. Being so involved in your treatment really helps you heal faster and better. And always ask about things you are considering doing. Any doctor who doesn't want you to be this involved with your own treatment for your own body and mind is not an adequate physician and you need to keep looking for another.  But I think most doctors will be impressed with your efforts and willing to help you - maybe find you more interesting and therefore give you better treatment.  What I'm saying is that if you think just finding a pill that will relieve your anxiety or depression or whatever is the best way to go - fine - it may work for you for awhile, but you'll probably find that learning and doing several things to treat your illness will have better long-term results.  Psych meds are notorious for losing effectiveness and must constantly be monitored - needing more or less or changing the scrip often.  You always need a Doctor who is willing to help you do this - and you must tell them everything that's going on with you.

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            schoolgirlforrealposted 12 years agoin reply to this

            very good advice mega, thanks! this is for my sister, you know, right? she just wants to be put on a med that does not cause weight gain! thankyou! great idea!

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               mega1posted 12 years agoin reply to this

               I understand and I just use "you" meaning "anyone" when I write about these things- if she finds an antidepressant that doesn't cause weight-gain, I hope you'll send me a message and tell me what it is.  I have had some good luck fighting off depression with a mixture of diet, exercise, regular routines and regular sleep schedule, valerian root tea, and positive thinking (meditation) exercises.   Now, I am also exploring the use of hypnotism.  I wasn't always this interested in my own health, but the depression is really tough to battle and I had to do something more than meds.  This is why I am passionate about letting other people know there are real remedies that work and not to give up.  I gained a bunch of weight too, and now, although I don't use the meds anymore, I still have the weight - so am hoping that hypnotism will be useful for the weight loss too.

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                  schoolgirlforrealposted 12 years agoin reply to this

                  weight watcher worked for me, i lost 25 lbs in 5 months. antidepressents that don't cause weight gain? hmm have to google that.

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   psycheskinnerposted 12 years ago

   Another option would be to get a full list of approved practitioners from the insurance company.  There must at least one or two you could look into.

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      Marcy Goodfleischposted 12 years agoin reply to this

      +1 on this suggestion.  You can also 'interview' providers to see if you click; just make an appointment and see how you feel about them.

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      schoolgirlforrealposted 12 years agoin reply to this

      good point!

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    Hendrikaposted 12 years ago

    I once had a doctor that was very clued up on his medication and he often described medication that is a little unorthodox and it always worked in the way he wanted it to; Now I know that many other doctors would not be willing to take the risk and that may be the reason why your doctor do not want to give you a specific medication.

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       kelleywardposted 12 years agoin reply to this

       as a nurse I think the patient should always have a right to be part of their medication program.

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