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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