2+ Year Member
- Jul 5, 2016
My private practice is just getting established and someone (who's insurance I unfortunately do not accept) asked if I see patients with ADHD because their PCP recommended they get treatment for ADHD. Although I know I won't be able to see this patient for logistical reasons, ADHD is a topic I feel strongly about. Obviously, it needs to be treated. But I also see a lot of people getting incorrectly diagnosed with ADHD. For example, many who are depressed, have PTSD, personality disorders, sleep disorders, even psychotic disorders, or have an anxiety spectrum disorder get incorrectly diagnosed. I find ADHD can be particularly hard even as a psychiatrist to diagnose without a good thorough history that includes collateral and preferably some neuropsych testing (e.g. CPT). I am tempted to advise this person to get a thorough evaluation before putting all his eggs in a basket by looking for someone who specializes in ADHD to evaluate for other possible disorders that may either be co-morbid or not ADHD at all. Although I would hope someone who claims they are well informed in treating ADHD would be able to see what is versus is not ADHD, I also see many attendings over diagnose ADHD and put patients on stimulants when on the contrary my impression (along with other psychiatrists) is that it is another disorder affecting their concentration. On the other hand, I feel awkward advising him to seek a thorough evaluation preferably with formal testing if I've never even seen this person but feel it would be in his best interest. Do you think it would be appropriate even though I haven't formally evaluated him? I just kind of feel like it would be benign psychoeducation, that what looks like ADHD could be ADHD or there could be other disorders involved and I'm just advising to be careful and ensure to get a thorough evaluation. It would be completely different if I just said to him to find a provider to trial an SSRI first...that would be obviously inappropriate.