Psychiatric Evaluation Problems: Update

My previous post I shared my misgivings over the psychiatrist who is conducting my psych eval. The surgical group requires 5 sessions with psychiatrist. Last week I was informed I was 'in therapy' (no warning or explanation) for an unspecified amount of time, even tho I've been assured I'm an excellent candidate for WLS. Today was my next appointment, and I have mixed feeling about what I learned. In the months leading up to surgery, the Psych. & dietician work together to change the diet to a high protein, low carb one. If issues arise, they are dealt with B4 surgery. Dr. admitted no one 'gets by with' only 5 appointments. I'm still not comfortable with the coercive nature (if you try to change therapists once you've started, you're DROPPED from consideration! But it's either THEIR way or the HIGHWAY. The nearest 2nd choice for WLS clearly states you will see THEIR psychiatrist too! At this point, I guess I 'comply' to get the life-saving surgery I need. They have me 'over a barrel' so to speak. Thanks for listening!

I'd be uncomfortable, too.  Yet, after getting this far, I can understand why you might choose to just comply in order to get the surgery you need.

Are they able to tell you how many appointments they want you to do with this psychiatrist?  Or is it just open ended and you don't have any idea when you'll be done?

What did she say when you expressed your concerns?

Thanks for updating us.

The doctor was a bit taken aback by my polite but concise questioning. But she addressed each issue, and was willing to work with me on adapting the appointment schedule to help me. She did betray a little resentment (doctors rarely like to be questioned on their decisions/procedures, in my experience). I feel MUCH better knowing WHY it's taking so many appointments (no set number-'if it takes until Dec, that's what it takes', she said) Or until my insurance runs out? (sorry, I had to throw that one in) LOL I'm willing to 'go along to get along' for now. Thank you Kelly.

How bizarre.  I'm really sorry you are sort of stuck with this situation.  I think the surgeon and psychiatrist are both acting unethically, but that is just my opinion

Lora

Yes-I think the relationship between surgeon/psychologist/dietician is rather incestuous. What other medical procedure affords this much potential for 'abuse of power'? Even plastic surgery doesn't allow for this much intrusion into a person's life and choices! But it is what it is, and for now I must 'comply". She told me surgeons will immediately DROP ME if I try to change therapists! I understand them not wanting 'therapist shopper' just looking for a rubber stamp approval to surgery, but this crosses the line into autocracy, IMO. Thank you for your advice and support.

That is really strange.  I am a therapist and work with pre ops and post ops from time to time.  It is also very very strange that you are seeing a psychiatrist.  Are you sure it is a psychiatrist or is it a psychologist or clinical social worker?  Psychiatrists rarely do therapy anymore, they generally focus on medication management and often have limited therapy training.  It doesn't sound like you can fight this particular system though.  On the other hand, I often see post ops who are doing terribly, largely because they had really poor emotional preparation before surgery.  You are getting way more than most which could benefit you in the long run, though I agree with Lora, the way they are doing it does not sound ethical to me. 

Boy, is my face red! You're absolutely correct-this doctor is a PSYCHOLOGIST, not a psychiatrist! I assumed that's what she was because of the requirement listed in the informational packet given out during the seminar. And you're also right about the potential benefits of the system they have created. I'm going to avail myself of all they can offer to help me, that's for sure! I just wish there was more HONESTY and communication up front about what their view of 'psychological evaluation' means! Thank you Louise.

I am not surprised at all. The first surgeon that I went to also had similar requirements. The surgeon required that you see the WLS team for an unspecified number of visits, whi*****luded a psychologist, nutritionist and nuse practicing before surgery. What alarmed me was I would be required to block two hours for each appointment. After meeting with them all the first time, I thought it was great. The second time it just felt like a "revolving door". The psychologist literally came in and "chatted with me" for fifteen minutes about how crazy his day was. The nurse practitioner walked him typed a few things in the computer asked me if I had any questions and left. 

Once I received my EOB from my insurance company and saw how much each of them charged my insurance company, I was pretty much done with that clinic.

my honest opinion is that this is just a way to drive dollars into the clinic. If you want me to meet with a psychologist fine but tell me what the goals and objectives of those visits are!

I suspected the same thing-milk my insurance, then say bye-bye! But I'm determined to learn all I can, and utilize this time to (hopefully) work out any emotional issues BEFORE surgery. Yes! A clear presentation of the goals and objectives would have saved me a lot of worry and angst. Thank you!

An evaluation is that, an evaluation. It is not forced therapy. An evaluation should not be more than one or two sessions. I saw someone for the doctor's office for an evaluation just so they could send it to insurance. It was one visit. Had a nice chat and moved on. Don't get me wrong there were many hoops to jump through to get to surgery... but nothing was drawn out for the sake of drawing it out. Good Luck.