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Forums / Treatments, health professionals and therapies / "No you prescribe it" My GP and Psychiatrist are at odds

Topic: "No you prescribe it" My GP and Psychiatrist are at odds

19 posts, 0 answered
  1. silicontrip
    silicontrip avatar
    20 posts
    5 December 2019

    I saw a psychiatrist for a medication review, and they recommended a particular drug. However my GP doesn't want to prescribe as it's not a commonly GP prescribed drug and they've had no experience with it. So eventually I went back to the psychiatrist who asked why I hadn't started on the drug saying that they had provided detailed instructions so my GP should know what to do. My GP is still not comfortable prescribing it, saying I should be seeing a psychiatrist regularly for medication reviews. Of course I'm stuck in the middle not able to get a recommended drug.

    Has anyone else been in this sort of situation? Or know what my next steps would be.

    I'm a bit uncomfortable contacting a new GP saying "will you prescribe blah?"

    I don't know what to do.

  2. white knight
    Community Champion
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    white knight avatar
    7867 posts
    6 December 2019 in reply to silicontrip

    Hi

    my first thought is that your psych should write out the script.

    I would contact his office and explain the situation with his secretary and he/she might get through to the psych your meat in the sandwich position

    Such a ridiculous situation

    TonyWK

  3. silicontrip
    silicontrip avatar
    20 posts
    6 December 2019 in reply to white knight

    I forgot to mention that the psychiatrist isn't taking on new patients and only saw me for a medication review. I did contact another medical centre but their reception said that I'd need to see a doctor before they would decide if they would prescribe it. My GP has written me another referral to the same psychiatrist clinic, they have contacted me but said I probably won't get to see someone until early next year.

    I feel like I've been backed into a medical corner that I don't know how to get out of, is there some sort of medical advice line I can contact?

  4. romantic_thi3f
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    romantic_thi3f avatar
    2547 posts
    6 December 2019 in reply to silicontrip

    Hi silicontrip,

    Thanks for your post.

    I agree with TonyWK agree - this situation is really ridiculous. I don't personally understand why your psychiatrist would ask your GP to prescribe the medication?

    The only thing I can think of is that your psychiatrist is too wary that he's not seeing you regularly (as you mentioned it was a once off) so maybe he thinks if it's prescribed by your GP it can be easily altered dosage wise without too much of a hassle.

    I wonder if it might be worth leaving a note with the receptionist at the psychiatrist clinic. While they may not be able to see you again, given they've already spoken with you they could potentially do the script and have you come and pick it up. (I've done this before) Having your GP leave a note with the clinic would be ideal of course so it has more authority.

    There is an advice line that you can call, but I think there's every possibility you are backed into a corner until next year. 1800 022 222 - for Health Direct Australia.

    Best of luck

    rt

  5. Nurse Jenn
    Health professional
    • Health professional
    Nurse Jenn avatar
    381 posts
    7 December 2019

    Hi silicontrip,

    I just wanted to drop in an 'apologise for the system'. I have seen this all too often where GPs are not comfortable with managing mental health issues. This occurs so often that there is some new services available to GPs across the country that look like this.

    https://ncphn.org.au/archives/media/new-gp-psychiatry-support-line-will-help-improve-mental-health-care-on-the-north-coast

    I just wanted you to know that this is a common issue and there are things around Australia that are trying to address improving the support for GPs.

    This, of course, doesn't help your particular situation. It may be an idea to get a second opinion and talk with a different GP and gain another opinion about your psychiatrists medication suggestion. The care they are able to offer may be more suited to you. At least you will have something to compare it to.

    It should not have to be this hard and I am terribly sorry that the system is not collaborating well for your care and healing needs. Please be assured that there are some health care professionals that pick up the phone and call other health care professionals and collaborate to get the best outcome for their patients.

    In the mean time, the suggestions from RT and WK are sound. Please keep us posted on your journey.

    Wishing you the best possible outcome,

    Nures Jenn

  6. silicontrip
    silicontrip avatar
    20 posts
    10 December 2019

    It's almost comforting to know that this sort of thing isn't unusual. I sometimes feel that my medication route has me singled out.

    I spoke to my Psychologist and they also said that the psychiatrist should be writing the first script at least. Also spoke to a pharmacist who said I should get a script from the psychiatrist. I have called the psychiatrists reception but they are not in so won't hear back until at least tomorrow.

    Interestingly enough I saw a psychiatrist about 12 months ago who also recommended the same drug, however again the GP I was seeing at the time (different to now) also did not want to prescribe it. Not sure what GPs have against it.

    As another annoyance my GP doesn't seem to be able to get authorisation for my current antidepressant and because of the dosage I'm taking, I have to keep getting a new script filled every 9 days, is this sort of thing normal too?

    thank you

  7. romantic_thi3f
    Community Champion
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    romantic_thi3f avatar
    2547 posts
    10 December 2019 in reply to silicontrip

    Hi silicontrip (and a wave to Nurse Jenn),

    I have all my fingers and toes crossed that you'll have some positive news tomorrow. Like Nurse Jenn mentioned, unfortunately this is a problem in the system.

    As to your other medication, hopefully Nurse Jenn will offer some more advice - but the only think I can think of that requires new scripts so regularly makes me think that maybe the medication can be abused and so there are new policies to prescribing it. I know with my own medications and dosages it's more complicated for even my psychiatrist - as even my psychiatrist has to ring (somebody?!) and get authority.

    Best of luck for tomorrow

    rt

  8. silicontrip
    silicontrip avatar
    20 posts
    16 December 2019
    The reply from my psychiatrist is "find another GP" I can write a letter to them. So how do I go about seeing a new GP who doesn't know the history and is being asked to prescribe medication on a first visit. Is this sort of thing done? Does anyone know a GP who might do this (Eastern Melbourne area)
  9. Matchy69
    Matchy69 avatar
    1544 posts
    16 December 2019 in reply to silicontrip
    No drama changing GPs happens all the time and they will give you scripts on first visit.With me they checked with my previous GP who confirmed my medication i was on.Got my medication on first visit.
  10. silicontrip
    silicontrip avatar
    20 posts
    26 December 2019 in reply to Matchy69

    So I found a GP who said they would prescribe it, if i became their patient. it makes sense now but I didn't realise this at the time. I'm not that comfortable talking to that GP about my mental health, so I now have to start my GP search over again.

    I have booked in to see a psychiatrist on the 3rd, but I assume that I'll need to see them every time I need a script or want to report how my medication is going and that's not going to be cheap.

    (really wishing my original gp would prescribe it)

  11. Matchy69
    Matchy69 avatar
    1544 posts
    27 December 2019 in reply to silicontrip
    Yes it is so important to find a good a Doctor that you feel comfortable to talk to.I was lucky and found one straight away but unfortunately for me she is on marternity leave at the moment.I didn't like the doctor i saw just before Christmas but he did give me my medication after asking a million questions.Their is one there i do like at that practise and i will see her next time.
  12. silicontrip
    silicontrip avatar
    20 posts
    21 January 2020

    It's a new year and I did finally get to see a new Psychiatrist, who prescribed something totally different.

    So two different psychiastrists recommended a particular medication, 2 different GPs said they didn't think it was a good idea. Now another psychiatrist not recommending that medication either. I feel like I'm in a tug of war.

  13. Hanna3
    Hanna3 avatar
    1302 posts
    21 January 2020 in reply to silicontrip

    Hi silicontrip,

    I feel your pain believe me. I'm on a drug which needs a phone-up authority prescription and having moved from where I had a good GP who happily prescribed it for me, I'm now going through a nightmare of trying to find a GP who will prescribe it for me and not keep cutting the dosage as well. Honestly it's important to keep looking for a really good GP, I am still looking for one and I've tried three here so far.

    I don't know what you do about the two psychiatrists disagreeing about your medication, again I think a good general practitioner should be able to help sort things out but finding one is the problem. All I can do is wish you luck as I'm finding it tough out there as well! Keep trying!

  14. Matchy69
    Matchy69 avatar
    1544 posts
    22 January 2020
    I understand completely about doctors not wanting to prescibe medication.My Doctor has gone on maternity leave and the young doctor i saw filling on was not to keen on prescribing my medication but hesitantly adventually prescribed it.I also had the same problem getting my sons medication from him as well.He never heard of it and did not want to prescribe it.I said my son needs that medication and wont be able to see the phychiritis to after christmas.Their are a lot of doctors happy to prescribe the medication that a specialist has prescribed but then their seems to want you to get the script off the specialist who prescribed it.
  15. littleboots
    littleboots avatar
    29 posts
    22 January 2020 in reply to silicontrip

    Hello Silicontrip,

    I think your assessment of the situation is accurate. You are in a tug of war.

    My suggestion is you let go of the rope and in doing so all of these health professionals who either don't want to or feel they don't possess the history & expertise to prescribe the meds.

    Choose one psychiatrist who can recommend you to a GP that they know will be assist and ask that psychiatrist to write to that GP regarding your meds.

    A short report stating what meds they are wanting you to take, dosage and why isn't asking too much. And just in case they are unavailable can the GP prescribe in their absence. They could do the report in the office whilst you are in the consultation. Or fax it to the GP.

    This way your GP knows exactly what is going on and should, in the absence of the psychiatrist, be able to see why you need the meds.

    Alternatively, be extra vigilant with having enough scripts available if the psychiatrist is going to be unavailable. That means asking them if they are going to be away before your current script runs out.

    I've been in your situation too and it's not easy to navigate at all.

    Keeping the amount of people prescribing meds to a minimum and make sure they are in contact with each other by report is the only way of reducing the risk of this happening. Mind you, it may not be enough for some GP's but that may mean contacting the psychiatrist and taking their advice on a GP they know.

    What a way to start the NY. I hope it gets better!

    Good luck silicontrip.

    Take care,

    Littleboots

  16. silicontrip
    silicontrip avatar
    20 posts
    30 January 2020 in reply to littleboots

    At the moment, I'm (a little too) frequently seeing a psychiatrist, as the wallet is taking a pounding.

    Does anyone have a suggestion as how this should be better managed? I mentioned that my GP has gone through their arsenal of medication and cannot recommend anything further. They are saying I need to see a specialist (aka psychiatrist in this case) but frequently seeing them is quite expensive. I haven't seen much benefit in the new medication although it's only been 4 weeks. And I suspect I'll need to see them until it does start to work.

    Is there something in between?

  17. littleboots
    littleboots avatar
    29 posts
    9 February 2020 in reply to silicontrip

    Hey Silicontrip,

    Since your GP has run out of ideas and the psydoc is hitting your wallet too hard the only thing I can think of in between that is a Community Health Service. Do you have one in your area? They have GP's, psychologists and usually there is a low cost or perhaps even no cost to see them.

    Do a online search and see what comes up for you.

    Hope this idea helps,

    Take care,

    littleboots

  18. Nurse Jenn
    Health professional
    • Health professional
    Nurse Jenn avatar
    381 posts
    17 February 2020 in reply to silicontrip

    Hi Silicon trip,

    Your situation sounds frustrating. I wonder if you have found some different supports as yet. littleboots made a good suggestion regarding a community health clinic and I will suggest a few more.

    These may be helpful 'in-between' your psychiatrist sessions depending on your circumstance and symptoms.

    One is a program called Mindspot - you can google it by going to the webpage www.mindspot.org.au

    It is free for anyone over 18 and will do a screening to see if any of the programs are suited to you. It is a combination of online and telephone support but you can just chose to communicate with the therapists electronically.

    Another program is the Developed by Beyond Blue NewAccess program which you can read about here https://www.beyondblue.org.au/get-support/newaccess 

    NewAccess is only available in some locations across the country and you can check on the site and see if its available in your location. It is free and you get 6-sessions with a Coach which focuses on practical solutions and strategies on goals that are important to you using low intensity Cognitive Behaviour Therapy.

    Another suggestion that may be of benefit is learning to practice Mindfulness. You could give it a try on an app called Smiling Mind which has been beneficial for many people. Learning Mindfulness (no matter what symptoms you have) can help the mind have some rest and space from the stressors and worry that is around them.

    I wish you the best on your quest to find support. Please keep us posted on your journey.

    Nurse Jenn

  19. Guest_201
    blueVoices member
    • A member of beyondblue's blueVoices community
    Guest_201 avatar
    1294 posts
    17 February 2020

    Hi silicontrip, welcome to the forums.

    I'm so sorry that you're dealing with this, it's an issue that shouldn't happen with anyone. Funnily enough though, I'm in the same position as you, hence me coming onto your thread, to seek advice myself and try to offer you support from me, so I hope that's alright. I'll read through everybody else's comments here aswell.

    What I would suggest is picking whoever you trust and feel more comfortable with, and who you think has more knowledge of the meds - dosages, side effects, etc. to prescribe it for you.

    As for getting a new GP, I personally think yes, it could be a good idea, but it also may not, because some GPs will think that some people are just going to Doctors to get prescriptions for the sake of it (I'm experiencing that now with my GP, which of course isn't the case at all), so if you were to see a new GP, I'd see one that someone you know is seeing so you can say "I know (name), I was wondering if you'd please prescribe (med name)" etc. That's just my opinion and suggestion though, I'm sorry I can't be of much help because I'm dealing with the exact same thing you are.

    For me personally I trust my Psychiatrist more and would rather him prescribe me things. The reason why is because from the first time I saw him, I trusted him and I felt comfortable and that's hard for me with therapists since I've had so many bad experiences unfortunately, he's the only good health professional I've ever had, and I'm thankful. I don't feel comfortable or trust my GP at all, because she has no knowledge of anything, not even that my Psychiatrist gives me therapy, how Medicare works including paying for me to see my Psychiatrist, what meds I'm taking, etc. (I explained all of this to her).

    Whereas my Psychiatrist tells me what meds I can try, the dosages (one to take at the time and then if I tolerate them, make the dosage higher), the side effects (although it's different for everybody, some may get all side effects, some may not get any or only a few), how they work and what they're for, and just general knowledge of it, he always asks me how I'm feeling and if they've helped too. My GP doesn't care at all.

    So hence me saying I'd choose who you feel most comfortable with and who you think has more knowledge of the drug to prescribe it to you.

    Either that or you could ask your local Pharmacist about the drug, and who you think may be better prescribing it and explain the situation to get their thoughts?

    Tayla

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