Question:
My psychiatrist is freaking me out!! Is this normal for a psych eval???

The doc I chose for my psych eval told me she has just started working with MO patients--and she wants to be put on the PCP/surgeon's referral list for Springfield(Missouri). She told me she could not give anyone a referral without meeting with them at least 4 times (at $150 a session), and a written eval letter is an additional $135 (not covered by insurance). It made me a little suspicious, but I'm willing to do whatever is necessary. It just seems a little odd to me that within the first 20 minutes I was in her office, she had told me I was codependent (because I said my mom had anger and depression problems), and my weight problem was obviously from lack of nurturing as a child, and I would benefit more from intensive therapy than surgery. Then, when she asked if I'd even been in therapy before, and I said yes, because I was raped, she would not let it go at that, even though I said I didn't want to go into it. She asked me to describe my rape, implying that she wouldn't approve me unless I told her all about it--which was something that I was totally unprepared for, and not ready to do. After making some horribly misinformed statements about date rape not being as truamatic as a regular rape, she told me that my comorbidities (depression, fibromyalgia, and asthma) were all just results of repressed emotions, and not obesity. She also told me that the lap RNY is a bad choice, because the doctors can't see what they're doing, and I was obviously choosing the surgery for cosmetic reasons if I was concerned about the scar. When I said I wanted lap because of the shorter recovery time and lower infection rate, she just raised an eyebrow at me. I have to go back for two more visits. How do I get through this step without letting her sweeping generalizations get to me???    — Stephanie M. (posted on July 17, 2003)


July 17, 2003
FIND ANOTHER PSYCH!!!!!!!!!!!!!!!! I would NOT put up with that from her. Talk to your doctor or your insurance company and find another one that has treated WLS patients before and is familiar with the procedure. This doctor sounds like she's not fully educated on the benefits and procedural methods used for a Lap RNY. Perhaps she needs to visit HER psychiatrist soon! :) Good luck
   — Cheryl M.

July 17, 2003
What an outrage. I would talk to the folks at your surgeons office and find out if they have a psychiatrist they could recommend that has specifically dealt with previous pre-ops. Good luck to you. -Kim open RNY 7/17/01 -145ish
   — KimBo36

July 17, 2003
I agree with the other poster find another therapist and quick! she sounds like an uneducated crackpot out to make money. There are therapists out there that suppport the surgery and are helpful who don't railroad you emotionally in the first 20 minutes. Talk to your physician or the insurance company to see if they can refer you to someone that has experience working with MO patients.
   — Tammy N.

July 17, 2003
Stephanie: Please find another Psychologist. Your psych. doesn't know what she's talking about and should not be put on a list of referrals for those looking into surgery. I saw my psychologist, and he and I talked about my past molestation as a child, my issues with my mom and dad, and other things. I completely explained things to him and explained that I had counseling in the past, and am being treated with Zoloft which has helped my situation tremendously. I told him that frankly, the counseling sessions didn't help; I found that I got more help from writing out what had happened and had learned quite a bit about myself from that. He was very impressed and I got a great review from him. As for the doctors not being able to see what they're doing with lap, the scopes that they use actually magnify everything so they see BETTER than with open. Please try to find another Psychologist who is better informed about this. Your comorbidities are NOT the result of repressed emotions; Personally, I think this person is a quack and has no business doing psych evals for surgical candidates. Good luck!
   — Moysa B.

July 17, 2003
sounds like she needs to be evaluated! dump her, get someone else she sounds like a greedy nutcase, you do not have to go to her, cut your losses and move on, of course she wants to be on a referal look at the oppertunity for her, move on!!!!!
   — janetc00

July 17, 2003
A agree with the others - find another psych. Unfortunately WLS has created "greed" in some support areas including with psychiatrists. The fact that she wants to be on your PCP referral list says alot. WLS reviews should not be used as a money machine.
   — M B.

July 17, 2003
RUN, don't walk, away from this quack. There's absolutely no reason to have to have 4 costly sessions. Ridiculous. I would ask your surgeon's office to recommend someone. My doc's office uses the same one for everybody, and it was great. In and out in a half-hour, and we just talked about normal MO-related stuff, my dieting history, why I want WLS. I answered one sheet of questions which she reviewed with me, and that was it. The cost was included with my surgeon's costs (I assume) since I haven't received a bill, and probably won't since it was done on March 19. This person doesn't sound very WLS-friendly either. I hope she doesn't get on the referral list you mentioned. Good luck.
   — Carlita

July 17, 2003
Get out while you can!! This woman is nuts herself. The only reason that the evaluation is required is that you are able to provide "informed consent", and what that means is that you see the psych. so that they can make sure that you have a realistic view of what is going to happen to you after surgery. That your expectations are real (that you know that you will not look like a supermodel or have a life like one after surgery) and that it's a life long committment, not just "another diet". I agree with everyone else, find another doctor, she's trying to make money, and also sounds like she jumps to conclusions...Denise 316/153
   — lily1968

July 17, 2003
Find someone else, no need to subject yourself to that type of treatment.
   — Kriola

July 17, 2003
Stephanie, I don't know much about MO, but here is the list of psychologists in MO that are listed here on this site. All of these should be WLS friendly. I noticed that there is one in Springfield and it is a man, not a woman, so obviously not the one you went to. Try calling him or one of the others. Mine eval was just a co-pay to my insurance (BCBS HMO) too, as it is a requirement of the surgeon and insurance company. Cape Girardeau(MO) Ken Callis, PhD Chesterfield(MO) Warren Kass, PhD Columbia(MO) Nancy Bumby, PhD Jefferson City(MO) Tom Becker Jefferson City(MO) Linda Schultz, mba Kansas City(MO) Bill Geis, PhD Kansas City(MO) Janice McKeehan, Ph.D Kirksville(MO) Chris Maglio, Ph.D. Lake St. Louis(MO) Rick Cavens Lee's Summit(MO) Judith Steffen, Ph.D. Springfield(MO) Leon Bradshaw, D. Ed St. Charles(MO) Greg Mattingly, Ph.D St. Louis(MO) Dianne Joyce St. Louis(MO) Rodney Robinson, PH.D Wentzville(MO) Kimberly Sloane, PhD
   — Christy L.

July 17, 2003
I agree with the other posters - this is not the right psych doctor! Speak to your surgeon's office and see who they recommend. They psych evaluation for WLS is a specific thing, and doesn't require extended therapy. Someone in my suppot group had a similar horrible long drawn out experience. The program that I am with (with a local university) only requires a screening. My appointment was one hour and focused on making sure I wasn't totally off the deep and and making sure I understood what the surgery involved and diet restrictions, etc. Others have had slightly more detailed evaluations, including a MMPI (did I get that right??) test and a discussion with the therapist/doctor. It really sounds like this woman does not understand WLS and also sounds like she's just out to make a buck. She also sounds very insensitivie and rude. HUGS! I'm sorry about your bad experience! It shouldn't be that way.
   — w8free

July 17, 2003
WHO says you have to go back? This woman sounds 'strange'. I would call your surgeons office to recommend a 'few' that others have used; or ask around in your support group. Psy visits are NOT mandatory for surgery. They can be 'required' by your surgeon (if so, they normally have someone they use) or if its REQUIRED by your insurance company - I would question the "not covered" part!
   — star .

July 17, 2003
Stephanie, Do yourself a favor and don't go back. I work in an out-patient Psychiatric clinic and one of our psychologists does these evaluations regularly. Lucky me, I can ask all the questions I want. Because WLS is an 'elective procedure', many insurance companies require an evaluation. Most do not require it be done by an MD level. It is very basic and they ask you a lot of questions regarding your procedure and your expectations. Almost like a little test to see how much you really know. You can't imagine how many people do NOT do the research and know very little. What you experienced was unique (I hope) and out of line. Perhaps you can find a psychologist to work with. I find they aren't quite as 'stuffy' as some doc's (no offense to any MD's). In addition, I have seen our psychologist give the MMPI (it's a personality inventory test) on occasion. Sometimes she also recommends a few therapy sessions (either with herself or an LCSW) prior to surgery. From what I have seen it's usually required only of the people that have no clue what they are getting into or they have given the impression it's all about cosmetics and not their health. Keep your chin up and look elsewhere, I can't imagine your next experience could be that bad!
   — Angela T.

July 17, 2003
It just reaffirms my beliefs about phychiatrists. They are just money hungry grubs. I would turn this person in to whatever board that they answer too. This is'nt right.
   — Danmark

July 17, 2003
Gosh, and I thought I had the all time bad experience with my initial psych evaluation. Run, don't walk to another psych reccommended by your WLS doctor, and tell this crazy lady that she is absolutely not permitted to share your files with anyone...there are plenty of WLS supportive psychciatrists out there - get thee to one now, and forget about this woman! How demeaning and awful. Sometimes I am shocked by the judgemental statements psychicatrists can make...
   — rebeccamayhew

July 17, 2003
GET AWAY FROM HER NOW! Average cost for a pre-op psych eval is around $300.00. That shuld cover a 1 hour session talking with the doc and they should also administer a Minnesota Multiphasic Psyciatric Test/Eval - it's about 535 questions long. It actually takes longer than the chat with the doc. Really all they are evaluating is whether or not you are able to make this decision, understand the gravity (i.e. you could die from surgery or post op) and the dedication it is going to take after surgery to lifetime follow up w/dietition, nutritionist, wise food choices. They may also recommend some follow up sessions after surgery for support or if you have any food specific issues, compulsions, etc. that would interfere with your recovery period. My sister is a clinical psychologist and she and my surgeon advised me what to look for in an evaluation. My surgeon's office gave me the names of several offices and individuals that already specialize in bariatric patients. TAKE CONTROL of your care, don't let her send anything in to your surgeon or insurance. She sounds like she is trying to drum up business for her own practice $$$$. Good Luck!
   — Deborah F.

July 17, 2003
I agree with all the other posters--RUN, do not walk, to a different psychiatrist!! Therapy did me a world of good, but I had to look long and hard for the right therapist. There are plenty of good, qualified ones out there, so don't settle for a quack, especially when it comes to something as important as this.
   — Maggie T.

July 17, 2003
I can't imaging a worse therapist. She is someone to absolutely disregard anything she had to say. I would let your surgeon know exactly what you shared with us so she does NOT get on a list of referral psych docs and hurt other people. One visit or two visits should be enough for a counselor to have enough info to form some opinions. Not 20 minutes, not 4 visits -and why is it $150 a pop? That seems really high to me. If they recommend ongoing counseling, that would be something to consider, because without the counseling I would never be where I am today, but I can NOT imaging how this person got her degree. If you haven't worked out issues about childhood and rape, I would definitely find a NURTURING counselor to help you get a clear perspecitive on these things and that may take some time, but if they are part of why you eat, it is important to get it resolved before the surgery. I complete disagree that psych providers are just in it for the money - I have never met one personally who was like that and I have worked in medical care for years. Of course they are out there, but they are just like any other occupation - jerks get all kinds of jobs.
   — bethybb

July 17, 2003
My psych. eval. was done in one long session-- and completely paid for by the behavioral health arm of my HMO. Something is wrong with the cost of this, not to mention the fact that she sounds controlling and sadistic!
   — Wendy T.

July 17, 2003
First let me make a couple of statements. Not all folks in the psychiatric profession are "money hungry grubs" as has been stated by a previous poster. That's an objective statement as I am not in the psychiatric profession nor are any of my family or friends. Just because someone is a psychologist or psychiatrist does not mean they are the appropriate person to treat you and OBVIOUSLY this person is not cut out to treat morbidly obese people as she has no understanding of the issues associated with our disease. It's a real shame that someone would be so cold-hearted, judgemental and downright mean. I agree wholeheartedly that you should immediately seek out another person for your psych eval. However, I just hate to see it when we publicly bash ALL psychiatric professionals just because ONE behaved badly. Our program finally found the "right fit" with a psychologist after trying a few in our area. So don't give up - you'll find the right person and you'll achieve your goals. Best wishes to you in every step of your journey!
   — ronascott

July 17, 2003
My doctor does not require a psych. He spoke with a psychiatrist who does them and asked if he had ever did not pass someone for surgery and his reply was "no". My doc said he wants test done that keep a patient alive on the table. (No surprises) I think I would find another person to do the evaluation since your doc requires.
   — Kelly P.

July 17, 2003
NO, this is NOT normal for a psych eval!First, I'd tell the doctor everything (or forward this info to him)ASAP - he'll be especially interested in knowing she's trying to talk his patients out of surgery! If he continues to use her, and especially if he wants you to return to her, I'd switch surgeons because there will be other problems down the road with this group. Secondly, I would run this by your Department of Professional Regulation (your state licencing department for medical professionals) to see if they want to investigate this doctor's competence, because I've never heard of such bizarre behavior by a psychiatrist! I'd also check on-line to see if this woman is actually licensed, and if she's under investigation for any allegations against her (with this behavior, I wouldn't be surprised). How she can make these sweeping statements, and after such a brief amount of time seeing you, is beyond me. Do this for yourself and the protection of the next vulnerable patient who could be hurt. I wish you all the best.
   — Postop_nurse

July 17, 2003
It's already been said, but I'll say it again. Find another shrink. You DO NOT have to put up with being treated that way. I'd also report her to the medical board, and request any records she may have on you. I would also tell your surgon about it. The only reason you are being required to have a consult is to show informed consent. That you do know what you are doing, and are realistic about it. I didn't like my shrink, (personality differences,) but he was professional enough to put any differences aside and treat me with respect and courtesy, and give an acurate evaluation to the insurance company
   — mellyhudel

July 17, 2003
I am in therapy, and have been very happy and successful with it. That being said, I think you need to file a formal complaint TODAY. And get another therapist. One that comes highly recommended. Ask for references. And talk to your surgeon about this (you shouldn't have to go into details). He should just know that s/he shouldn't refer people to her under any circumstances.
   — kultgirl

July 17, 2003
Darling, get a new psych!!!!!!!! Find SOMEONE else who knows what they are doing. An evaluation for this surgery should simply be questions about your eating habits (Ie if you've had a disorder), weight in your family, mental health in your family and the reasons why you want this surgery. Find a doctor with more experience in this area. Aside from requiring 4 appointments (Which is a waste of time and money) you shouldn't be getting charged for the doctor to write a darn letter! That's insane. And from the sound of it, she doesn't understand what obesity surgery entails, as she clearly isn't for it. When looking for a psy in my area, I called about 30 psy's who, over the phone, made some of the comments this women is making to you about WLS and cosmetic stuff. I hung up. I know its a pain in the butt to hunt for a new doctor and wait for the appointment, but doesn't sound like this woman will be giving you the ok. She's already made up her mind about you.
   — Renee B.

July 18, 2003
apperently they will give any IDOT a degree to screw people up!!! lol. All kidding a side get a new psyc. I have my eval. on the 24th it is a 1 time 4hr. session 2-21/2 to take a test and 1 1/2 hrs to go over it and it will be completed and sent out w/in two business days. Good Luck
   — Toni R

July 18, 2003
Stephanie, IMO...find a psych outside of the Springfield area. Especially if this psych is in anyway associated with the Cox or St. Johns networks. And the majority are. St. Johns especially has previously threatened individual doctors for supporting such surgeries. Why do you think that WLS is not available in the Spfd. area? You will also have to do some serious research on internists in the area to find one that will not only be willing to take you as a patient, but one that knows something about the surgery itself. Both my mother (had WLS too) and I lived in the area (I moved 4 months ago) and we both had a terrible time finding anyone educated and willing. I would strongly suggest speaking with your surgeon regarding a new psych. ---Becky
   — RebeccaP

July 18, 2003
I agree! Find someone else! You don't have to go to one of the psych's suggested by your surgeon. I contacted my insurance company, got names of covered psychs., called various offices, made appts. with three of them and then went to see the one who could get me in quickly. (of course, I cancelled the other appts.). I contacted my insurance's mental health benefits number, told them which psych I was going to see and got a referral. My visit only cost me a co-pay. I didn't even have to take the MMPT as many other members had to. Those who commented that the ONLY reason to have a psych eval is to make sure you understand the surgery and don't have unrealistic expectations. (And really, shouldn't we then have to have a psych eval for EVERY surgery?? I mean, do I REALLY have realistic expectations about what a hysterectomy will do for me??) My visit was short and sweet and I got my letter without any additional monies because the psych was familiar with the surgery and often saw people for evals. Run, don't walk, to another psych.!
   — Liz R.

July 18, 2003
The computer ate some of my typing. I meant to say, "those who commented.....ARE RIGHT".
   — Liz R.




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