Psychiatry & Psychology--General/ethics


QUESTION: I live in Gainesville Fl. We just moved here in November. Just a couple of months ago. So the first time I took my daughter to the Dr, she (the Dr.) immediately noticed that my daughter had psychological problem.  She is going on 31 and acts about 7. She has PDD. So the Dr took it upon herself to refer us to a counselor. And I don't have a problem with that. But at the same visit, my daughter mentioned that her head hurt. Its an all over type of pain. We know the muscles are bunched up but not why or how to treat it. So I called on another date to get a referral to a neurologist. The part that I resent is that the Dr took it upon herself to refer us to a counselor but not the neurologist. Its like my daughters 'mental status' takes priority with her. And I'm writing because I'm not sure if I should resent it or even say so to the Dr or find another Dr.. or what I should do if anything. I also have an anxiety disorder and I'm not sure if I making too much of it? Can you help? Maybe its the mother in me.

ANSWER: Hi Joyce

It sounds like you really have your hands full, so it's only natural that you'd be a bit on edge. But it seems to me that your doctor did the proper thing.

A major part of a doctor's job is to know when a referral is called for and who to make it to. Not being a physician myself, I can't tell for sure, but do you really think that a complaint of a generalized headache, one that is apparently muscle-related and not easy to treat, requires a referral to a brain specialist? A neurological workup is very costly and I'd wonder who would fund it.  

What I suggest you do is to discuss this issue with the counselor after an assessment has been made. This may take some time, as the counselor might want copies of previous assessments. In the meantime, you could ask the doctor about treating the pain (although if it was just mentioned in passing, it might not be very severe). And she might also need to see previous medical records.

I hope my comments set your mind at ease a bit, and that you both find whatever help you need.


---------- FOLLOW-UP ----------

QUESTION: you kind of missed the boat on this one. Everything was fine up until the last paragraph. You suggest discussing what with the counselor? The head pain? My daughter is not so bad that she doesn't know when she is hurting! Even one day old babies know that much. And why would the counselor want to see the MEDICAL RECORDS?

2nd, I am not upset with the Dr for making the referral to a counselor.
What I am upset about is that my daughters 'mental status' seems to be more of a concern than her pain.
We told the Dr she has PDD and the Dr of all people should know its not something that can be CURED. We also mentioned to the
Dr (at that visit) that the hosp did a CT scan a couple of weeks prior and couldn't find anything. And it irritates me to no end that my daughter's 'mental status' was more important than her pain. And one of the reasons that it bugs me so much is that I've been down this road before with 'professionals' not taking her seriously. I've had some Drs think for some strange reason that because she is 30 going on 7 that she doesn't know her own pain. My sister also has a disabled child and she has been down that same road.
Another thing I want to mention to you is that for some reason, Drs all think she has just normal headaches. Its not normal headaches or even headaches at all. It is an all over generalized PAIN! So I called this same Dr to ask for a referral to a neurologist.
last but not least, she is on Medicaid and Medicare for insurance.

Sorry for the misunderstanding. I did not get from what seemed to be a casual mention that the purpose of your medical visit was the headache. And I assumed she had been seen by medical professionals where you lived before (from the talk of it being caused by muscles and not knowing how to treat it), hence the need for your present doctor to have her records regarding the headache.

Perhaps the doctor did not feel competent in the medical treatment or referral of someone with PDD without an assessment by a specialist in that disorder. You might ask the counselor to help secure a visit with a headache specialist, who may or may not be a neurologist.

The best of luck in this difficult situation.  

Psychiatry & Psychology--General

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Alan Auerbach


Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.

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