Posted by banga on December 26, 2004, at 13:25:58
In reply to Re: Involuntary/voluntary 'treatment'.... » banga, posted by ed_uk on December 26, 2004, at 12:50:08
Funny you should ask, as I posted I thought "I should comment more on the pdocs specifically." They deserve it.
I personally found them very competent and knowledgeable and concerned about patient wellness. Of course and obviously, I am sure there were many that weren't so good that I did not meet. Many are quite burned out due to ridiculous salaries and understaffing. I had expected them to be significantly behind on the newest drugs, but I did not factor in the drug company's push to do trials of newer drugs there--nice guinea pig place. They provide meds for trials but also give some amounts of samples for use in non-participant patients too. So whereas I'd have thought they would stick me on some old old horrendous med, I was put on Lexapro and Risperidone. Mind you, I was treated a little like a "special" patient, given my US background (and connections, so much there still is based on connections), so I don't know they have enough of these newer meds to help out a significant number of patients. I assume it is all in the hands of how many free samples the drug companies handed them. No way the state paid for such expensive drugs. I am sure they often hear of a new treatment and wish they could try it, but they have little control to get these new treatments unless the drug company can be given incentives. Psychiatrists are perhaps more concerend with other aspects of treatment--salaries and staffing, amenities, and confidentiality issues. And of course patients' ability to seek and then afford proper treatment. If I get better and stronger, I hope someday I could be an activist over there to help lessen stigma about mental illness, assure proper confidentiality issues, and most of all--promote coordination of care for dual diagnosis (alcohol plus mental illness).The general picture--it is much easier to get to med prescriptions there. There are other types of practitioners who can write psych prescriptions--though I couldn't quite understand which ones--some psychologists? Addiction specialists? You get the advantages and disadvantages of a looser approach. Easier access, but less oversight--cautionary statements about side effects, tapering, etc. US pdocs seem to be much more conservative and cautious. I am sure liability issues play in tremendously. Many meds are easy to get in any corner pharmacy over there--prozac, etc. Some I had to order through a pharmacy run by a German company.
As I was then still in the fantasy world that an SSRI or SNRI will solve all problems, I did not get to test the practitioners in how willing they would be to prescribe/acess drugs not typically used for ...well in my case depression. So I dont know about stimulant, MAOI, dopamine agonists, etc.--how easy they are to get.
And lastly, one has to mention that alternative medicine is very big over there. Some methods are clearly based on superstition and magical thinking, but of course much is also based in reality-tried and true folk remedies. BUt it was at times hard to understand that highly educated, people knowledgeable in modern medicine would be willing believers in some of these obvious charlatans. Mind you, I believe in alternative methods, and do not negate spiritual healing at all, I still wish I could access such help more in the US--but they didnt seem to have the critical eye to distinguuish the real thing from total fakes. It was wierd.
poster:banga
thread:433249
URL: http://www.dr-bob.org/babble/20041223/msgs/434315.html