Psychiatry & Psychology--General/ethics

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We just moved to Gainesville Fl in November 2013. About a month ago, I took my daughter to her first primary care Dr for this neck of the woods. The Dr immediately noticed she had a problem. (She has PDD) I explained this to the Dr and that I haven't gotten her into counseling since we moved. So the Dr took it upon herself to refer us to a counselor. I don't have a problem with that.

At this same visit, my daughter mentioned that her head hurt. Not general headaches but all over head pain. We also mentioned that she had been to the hosp a few weeks prior. They did a CT and couldn't find anything. (she is almost 31 but can act like 5 on occasion- but still, even 5 yr olds know when they are in pain)

The Dr didn't seem worried. So about a few weeks later, and my daughters head still hurt, so I called and asked for a referral to a neurologist and her apt is in Febuary 2014.

What I have a problem with is that we DIDN'T have to ask for a referral to a counselor. But we DID have to ask to see a neurologist. That's where my problem lies.

It irritates me to know end that the Dr seems to think her 'mental status' is more important than the PAIN.

Now what I don't know is if I am overreacting, or if I have a right to be irritated. Maybe its the mother in me that is mad. Mostly because we have been down this road before with people not taking her seriously or thinking that she doesn't know when she's in pain.
So it is just the mother in me that is unm2tspset or is the Dr wrong?

Answer
You are overreacting.  You tell me the pain had already been evaluated with a CT scan a few weeks prior, and nothing was found.  Thus, the chance a neurologist will find something is close to zero.  Actually, I think he just placated you by referring you to a neurologist, which I do not see as needed at this time.

The PDD was clearly present.  The doctor clearly asked what treatment she was getting for this, and when you said none (you were new to the area), he made a referral.

Since like an absolutely appropriate response on the doctor's part. "All over head pain" is NOT a neurological sympmtom -- no neurological problem corresponds to this complaint.  Rather, "all over head pain" corresponds to anxiety problems -- hence the referral to the counseelor was sound, and he probably only made the neurologic referral because you insisted -- this I think is the only error the doctor made.

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.

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Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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