Future ramifications of seeing a shrink?

[sunni]

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I'm sure this really doesn't belong here, but I was debating on here or the psych forum & here won.
Okay, so I'm deciding I need to talk to somebody about some stuff but I wanna know if it might have any type of impact on my match or board liscensing & getting a job. Can anyone find out about it? I know the whole confidentiality thing, but it doesn't mean they can't say yup, we saw her & then I not get hired b/c they think i can't handle the pressure or something.
I might wanna try to match at my school (not sure yet)- so should I forgo the student health person & get a private one?

 

[criminallyinane]

I'm sure this really doesn't belong here, but I was debating on here or the psych forum & here won.
Okay, so I'm deciding I need to talk to somebody about some stuff but I wanna know if it might have any type of impact on my match or board liscensing & getting a job. Can anyone find out about it? I know the whole confidentiality thing, but it doesn't mean they can't say yup, we saw her & then I not get hired b/c they think i can't handle the pressure or something.
I might wanna try to match at my school (not sure yet)- so should I forgo the student health person & get a private one?

No health professional can disclose any information about a patient, including mental health professionals. Your therapy is your business. It won't affect residency apps because they will never know.

 

[aamartin81]

No health professional can disclose any information about a patient, including mental health professionals. Your therapy is your business. It won't affect residency apps because they will never know.

My advice: Pay cash, there will be no paper trail to insurance companies.

Congrats on recognizing and addressing your need,

Adam

 

[criminallyinane]

My advice: Pay cash, there will be no paper trail to insurance companies.

Congrats on recognizing and addressing your need,

Adam

This is silly. People give the weirdest advice around mental health treatment.

No professional program, educational program, supervisor, hiring manager, program director, or administrator has any right whatsoever to your personal medical history and information, including mental health treatment. No insurance company has the right to disclose your PMH to any employer, school administrator, or residency director for any reason other than a legal matter, and even then, they cannot just hand out your history willy-nilly. No medical practitioner has any right to disclose anything about your treatment to ANYONE under any circumstance except the insurance of your safety, the safety of another, or in a legal situation.

Saying, "don't leave a paper trail," implies not only that this information can be disclosed (IT CAN'T), but also that it is something that needs to be hidden or ashamed of. Attitudes like this perpetuate the stigma against mental health treatment in this country and need to be corrected.

Get the treatment, get it paid for by insurance if you desire, and don't think twice about whether it will affect your professional future, because unless you are into criminal activity or have publicized suicidal gestures, IT WILL NEVER BE DISCLOSED, PERIOD, END OF STORY.

 

[dopaminophile]

There are a couple of important points to be made on the issue. First the LCME, which accredits all allopathic medical schools in the United States has recognized that it's important for medical students to seek confidential help when they need it. They also recognize that avoiding conflicts of interest as you described above is unusually difficult if the student is trying to get help within their school's helth system.

With that in mind, the LCME requires all medical schools to make available to students therepists and psychiatrists 1) who are not involved in the evaluation of medical students, ever, 2) who's professional contact with the student never involves other students or even residents, and 3) who's patient records for the medical students aren't available on the hospital's record system or anywhere outside of the counselor's own office.

This is not to mention the fact that it is illegal for residency programs to discriminate against you even if they did find out, it is illegal for the counselor/psychiatrist to divulge that information without your permission, and it's completely beyond the bounds of any ethical standard in the psychiatric community for them to even acknowledge their treatment of you.

Residency selection committees will acknoledge, too, how important it is for people to take an active and mature approach to their own mental health. I would think that even if they could discriminate against someone seeking professional mental health care, most wouldn't. I'd imagine licensing committees for residency programs encourage counseling as much as the LCME does.

If you can't tell, we just got a long, hard, lecture about the mental health services available to us and why they're there. Good luck and get the help if you need or want it!

-dope-

 

[uspostal]

hey!
I am gonna second amartini and criminallyinane. Dont leave a paper trail, sounds crazay but if your butt is on the line in a courtroom, be pretty sure that your credibility is gonna be dragged into it. Some might disagree but read "the medical students survival guide" by steven r. polk who is an MD himself. There is a section there about this and he actually says the same thing amartini said.
I def am not sayin dont get help, get the help you need but the fact that you posted this question here shows that you are thinkin ahead and are probably gonna address this carefuly. Good luck man.

 

[sunni]

Thanks for the replies; I was really nervous about this b/c although everyone talks about how important it is to "keep your sanity" there is a legend around here that some one did & tried to match & didn't b/c of their mental state (though for all I know they could have been a serious issue rather than some stupid quarter life crisis, high standard over-achiever meltdown).
Thanks for the info, it definately gonna help me decide who to see.

 

[tigershark]

This is silly. People give the weirdest advice around mental health treatment.

No professional program, educational program, supervisor, hiring manager, program director, or administrator has any right whatsoever to your personal medical history and information, including mental health treatment. No insurance company has the right to disclose your PMH to any employer, school administrator, or residency director for any reason other than a legal matter, and even then, they cannot just hand out your history willy-nilly. No medical practitioner has any right to disclose anything about your treatment to ANYONE under any circumstance except the insurance of your safety, the safety of another, or in a legal situation.

Saying, "don't leave a paper trail," implies not only that this information can be disclosed (IT CAN'T), but also that it is something that needs to be hidden or ashamed of. Attitudes like this perpetuate the stigma against mental health treatment in this country and need to be corrected.

Get the treatment, get it paid for by insurance if you desire, and don't think twice about whether it will affect your professional future, because unless you are into criminal activity or have publicized suicidal gestures, IT WILL NEVER BE DISCLOSED, PERIOD, END OF STORY.

Horrible advice. Good luck getting life insurance if you've ever filled a prescription for an anti-depressant, you're gonna pay through the nose for it if you are even insurable. Dont leave a paper trail, pay cash.

 

[criminallyinane]

hey!
I am gonna second amartini and criminallyinane. Dont leave a paper trail,

No, I didn't say that. I specifically said the opposite 🙂

sounds crazay but if your butt is on the line in a courtroom, be pretty sure that your credibility is gonna be dragged into it. Some might disagree but read "the medical students survival guide" by steven r. polk who is an MD himself. There is a section there about this and he actually says the same thing amartini said.
I def am not sayin dont get help, get the help you need but the fact that you posted this question here shows that you are thinkin ahead and are probably gonna address this carefuly. Good luck man.

Mental health counseling is not going to be something that affects you in a courtroom, unless you have something like psychosis and during a psychotic episode you thought a patient was Satan and killed him. I mean, other than that, seeing a shrink for adjustment disorder/depression/anxiety/stress/etc, isn't going to have any effect on malpractice suits, and in most cases, such "evidence" wouldn't clearly be admissable based on patient confidentiality law and such.

This nonsense about not leaving a paper trail is just that - nonsense.

 

[criminallyinane]

Horrible advice. Good luck getting life insurance if you've ever filled a prescription for an anti-depressant, you're gonna pay through the nose for it if you are even insurable. Dont leave a paper trail, pay cash.

Oh, that is crazy. I can think of a hundred medical conditions that would be more problematic in obtaining life insurance than a simple MDD diagnosis treated with a short course of SSRI therapy. Does that mean that people "shouldn't leave a paper trail" with regular medical care, either? Should everyone pay out of pocket for everything out of fear of not getting life insurance?

Life happens, we seek the care we need, and people who seek mental healthcare should NOT be made to feel as though mental health care is something that needs to be covered up, hidden, or ashamed of, any moreso than regular medical care.

 

[Smurfette]

application for state medical licenses can ask if you have ever sought psychiatric care. My state does (and if the answer is yes you are supposed to provide documentation by the psych provider as to the nature of the problem). The issue here is that 1. if you lie on a medical license app it is a criminal offense, but 2. the licensing board does NOT have the right to access your medical information. I am sure that legally you need a release of information form to get a psychiatrist to provide said documentation. IT's just a murky question on the form that I was very glad I could say no and not have to deal with the aftermath. It's so vague it's hard to say if they wanted depression or anxiety treatment as an outpatient to be reported as well. (?!)

Seeing student health/counseling services would NOT count as psychiatric care IMO. However, if you ever were in an inpatient facility, you prob need to reveal it for licensing purposes. Anything in between is murky water...

I guess my answer to the original question is that state licensing boards MAY ask you about your mental health history. It just depends on what state(s) you end up in.

 

[criminallyinane]

Seeing student health/counseling services would NOT count as psychiatric care IMO. However, if you ever were in an inpatient facility, you prob need to reveal it for licensing purposes. Anything in between is murky water...

I guess my answer to the original question is that state licensing boards MAY ask you about your mental health history. It just depends on what state(s) you end up in.

I agree with the first paragraph quoted above. Simply seeking counseling does not constitute "psychiatric care." Adjustment disorders, dysthymic disorders, grief, anxiety (non-clinical), etc, are all things that mentally healthy people can experience from time to time, and seeking help to sort out those troubles does not necessarily constitute psychiatric treatment in the truest sense of the word. Many people who seek care may not even qualify for ANY DSM dx, but simply want to talk out their issues with an impartial advisor. People should feel free to do so without worrying about the stigma or future effect on their lives.

If you are hospitalized with major depression, psychosis, bipolar, severe anxiety disorders, schizophrenia, etc, that would constitute psychiatric care and should be disclosed; however, if you have been treated and are better, I see no reason that psychiatric care would prevent you from getting a medical license. Of course, ongoing severe psychiatric problems may be more of an issue than a one-time hospitalization, and would certainly be far more of an issue than simple outpatient psychotherapy.

 

[thackl]

Saying, "don't leave a paper trail," implies not only that this information can be disclosed (IT CAN'T).

May not be able to disclosed the details, but when my wife went to get life ins, they could see that she had mental health care in the past and they demanded that she disclose. When she admitted it was for depression, her monthly rate for $250k of coverage jumped from $11/month to $23/month.

At the same time, she could have refused (which she should have) and few extra buck is a drop in the bucket compared to NOT getting treatment. If you need to speak to someone; then do it. Most of it can be handled by a counselor/social worker type and will never be referred to a shrink.

 

[Ross434]

May not be able to disclosed the details, but when my wife went to get life ins, they could see that she had mental health care in the past and they demanded that she disclose. When she admitted it was for depression, her monthly rate for $250k of coverage jumped from $11/month to $23/month.

At the same time, she could have refused (which she should have) and few extra buck is a drop in the bucket compared to NOT getting treatment. If you need to speak to someone; then do it. Most of it can be handled by a counselor/social worker type and will never be referred to a shrink.

Wow. from $11/month to $23/month. The thought of that kind of fee increase gives me anxiety attacks right there

 

[Blade28]

hey!
Some might disagree but read "the medical students survival guide" by steven r. polk who is an MD himself. There is a section there about this and he actually says the same thing amartini said.

I was thinking of the exact same book. In it, Dr. Polk recommends paying cash, and seeing a psychiatrist/psychologist out of town, so you don't start generating rumors. Apparently these things could potentially come back to bite you in the ass if you're on the stand in a lawsuit.

 

[criminallyinane]

The improtant thing, however, is that you get the hlp you need. Most medical students cannot afford to pay cash to a psychiatrist/psychologist and will need to utilize the free counseling at school or their insurance provider. It is more important to get help than to worry about not being able to pay out of pocket and leaving a paper trail. If you are sued for malpractice, there are worse things I can think of to be concerned with than whether you were ever treated for an adjustment or dysthymic disorder.

 

[thackl]

Wow. from $11/month to $23/month. The thought of that kind of fee increase gives me anxiety attacks right there

Yep, it sucks..... but things would be much worse if she didn't get the help and meds.

 

[Boris Badenov]

Get help, but be careful.

At first glance you might be inclined to believe that we've got all this great privacy and everything is nice and rosy, but that isn't the case at all for doctors.

As a healthcare provider, you will NOT have the same privacy rights that any other regular person would have. The thinking is, since a doctor is entrusted with the lives of thousands of people, anything that could adversely affect patient care (e.g. depression, psychotic d/o, substance abuse, psychiatric hospitalization) must be identified. In fact, if you suffer from any of those things at a given time, you're not even allowed to see patients.

For licensing and for all sorts of other things, you will be asked this question for the rest of your life. It goes on your record.

Like others have said, if you need help, find some way to get it without leaving a paper trail.