Due to my health history, I’ve had more health care providers over the years than most 40-somethings. I have a neurologist, a dermatologist, a dentist, a gynecologist, and a rheumatologist. I’ve gone to most of these doctors for years now, and I feel very comfortable with and cared for by them. But finding -- and keeping -- a primary care doctor who’s in my insurance network (and whose office isn’t a long drive from my house) has posed a challenge.
In late February of this year, I met my new primary care doctor for a basic checkup. The next week I saw him for a second time with the goal of getting evaluated for ADHD (or of getting a referral for a physician who could do the evaluation if my primary care doctor was unable).
Even though my therapist had already done an ADHD screening for me and said the diagnosis was clear, I needed a medical doctor to reach the same conclusion to make it official.
But I was still nervous to talk to my doctor about my possible ADHD. I was worried about what he’d think. He didn’t know me yet; we’d only met once 10 days before. What if I came across as someone faking a condition with the goal of scoring some prescription drugs?
My worry wasn’t unfounded. Having dealt with chronic pain for most of my life, I’ve been prescribed my fair share of drugs, many of which are classified by the FDA as controlled substances. As a health writer and patient advocate since the mid-2000s, I’m aware of how doctors and pharmacists in any health care system need to keep a keen eye on potential drug-seeking behavior.
When it comes to controlled substances, my unique positioning as a “patient expert” helps me see things from both patients’ and health care providers’ points of view. I believe patients should have access to treatments that help them with their conditions. I also understand it’s essential that doctors do what they can to ensure that patients don’t get prescriptions they truly don’t need.
All of that was swimming through my head as I waited for Dr. S. to enter the exam room in March. During my evaluation, his poker face gave nothing away. After he declared my ADHD diagnosis, he told me that he, too, has ADHD. We talked about behavioral, lifestyle, and drug treatment options. I left with a prescription for a 1-month supply of a stimulant.
It takes a long time for a patient to find the right ADHD medication (if one works at all). Also, many ADHD meds are classified as controlled substances, so I’ve had regular checkups with my doctor over the last few months.
I want to make sure I get the most out of my doctor’s time (and my ADHD makes me likely to forget to mention all my concerns if I don’t write them down), so I show up at every medical appointment with notes about my health as well as things I want to address with my doctor. I urge you to do the same.
If you use your phone or a notebook to jot down notes about your ADHD-related concerns as they pop up between appointments, you’ll be less anxious about the possibility of forgetting something important once the doctor is in the exam room.
The night before your appointment, look over all the notes you made since your last visit and decide what you’d like to discuss. When you bring your notes out, the doctor will see that you’re taking an active role in your treatment. It’s also possible the notes will help them see patterns where you don’t.
At my most recent appointment in July, I expressed my frustrations with my current medication’s side effects. Dr. S. outlined the different things we could try next, and I finally said what I’d been worried about: “I want to be persistent and try to find what works for me, but I’m worried that this process of trying multiple medications will make you think I’m a drug seeker.”
My confession opened the door to a candid conversation that cleared the air. Dr. S. and I have developed a good rapport over the almost half-year I’ve been going to him, and the talk we had at this visit made me feel even more grateful to be in his care.
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