- Joined
- Jun 23, 2003
- Messages
- 5,786
- Reaction score
- 912
I honestly think I should do something about the psychiatrist I replaced. The more and more I see, the worse everything gets, and I have specific examples. I'm not really sure if I should, and wanted to see what others thought. If I should, what can I go about doing? This is just recently:
11yo male with ADHD and, “bipolar” (not really) who was started on Abilify and continued on it for 4 years without any attempt to taper. Now weights 140# with likely obstructive sleep apnea. OSA sxs have been present for approx. one year or more. These concerns were reported to the previous psychiatrist who did no further evaluation and never referred patient for a PSG or sleep specialist eval. In fact, parent stated I was the first physician to even ask more questions about his sleep problems. No labs had been checked on this kid since May 2015, and even at that time were abnormal.
9yo male with ASD and ADHD who was started on abilify titrated to 15mg daily and left on it for the past 3-4 years. During that time, had onset of “tics” and other involuntary movements worsened over time. Currently, I am pretty sure he has TD. This was never discussed with parent.
10yo male, previous psychiatrist inexplicable ordered a CBC amongst other labs for unknown reason approx. one year ago. CBC returned as abnormal, with low Hgb/Hct, abnormal MCV, and review by pathology who recommended additional labs to include an iron panel and, if normal, plasmaphoresis for thalassemia. Pt had notable c/o fatigue. Psychiatrist reported to parent that labs were NORMAL, documented NORMAL labs in the chart, did not order f/u labs and did not refer patient back to PCM for additional evaluation. I had to discuss the results with mom, repeat the cbc with f/u iron panel, and then refer back to primary care for further eval/tx if needed. Oh, yeah, surprise dad has a thalassemia which I easily found out by simply asking.
This list could go on and on and on. I haven't been out of training very long, but this is borderline negligence to me, if not clearly crossing that line.
11yo male with ADHD and, “bipolar” (not really) who was started on Abilify and continued on it for 4 years without any attempt to taper. Now weights 140# with likely obstructive sleep apnea. OSA sxs have been present for approx. one year or more. These concerns were reported to the previous psychiatrist who did no further evaluation and never referred patient for a PSG or sleep specialist eval. In fact, parent stated I was the first physician to even ask more questions about his sleep problems. No labs had been checked on this kid since May 2015, and even at that time were abnormal.
9yo male with ASD and ADHD who was started on abilify titrated to 15mg daily and left on it for the past 3-4 years. During that time, had onset of “tics” and other involuntary movements worsened over time. Currently, I am pretty sure he has TD. This was never discussed with parent.
10yo male, previous psychiatrist inexplicable ordered a CBC amongst other labs for unknown reason approx. one year ago. CBC returned as abnormal, with low Hgb/Hct, abnormal MCV, and review by pathology who recommended additional labs to include an iron panel and, if normal, plasmaphoresis for thalassemia. Pt had notable c/o fatigue. Psychiatrist reported to parent that labs were NORMAL, documented NORMAL labs in the chart, did not order f/u labs and did not refer patient back to PCM for additional evaluation. I had to discuss the results with mom, repeat the cbc with f/u iron panel, and then refer back to primary care for further eval/tx if needed. Oh, yeah, surprise dad has a thalassemia which I easily found out by simply asking.
This list could go on and on and on. I haven't been out of training very long, but this is borderline negligence to me, if not clearly crossing that line.