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by Mom, Evergreen Park,
on Mar 9, 2007
I can't recommend anyone specific because our doctor is not part of PAMF (insurance reasons) but make sure you choose a psychiatrist who specializes in child and adolescents - not just a pediatrician or adult psychiatrist to treat you son's ADD.
Try CHC in Palo Alto by Stanford. They now have a specialist ( name can't come to my mind right now) running the children's psych portion of CHC who just came over from SF last year who is well know for his expertise in ADHD. The only problem is that the Fellow ( Dr. Rossi) who works for him is a bit aloof and condescending with parents. But, for the ADHD part of your son's care, the team would be better than a generalist.
All the PAMD doctors know each other. so ask your child's pediatrician--or ask any doctor you know/like for a recommendation. If you know what characteristics are important to you, tell the person who you're asking for a referral what those are. If you don't know, then ask the referring doctor what qualities you think will be helpful.
I agree that you want an adolescent psychiatrist. Pediatricians can prescribe, but they aren't trained to recognize anything but the most obvious symptoms. They may not recognize the more subtle symptoms, and don't have the in depth knowledge to rule out other possibilties. For example, if that "ADHD" turns out to be bipolar disorder, stimulants would be a very bad move. A psychiatrist should take a careful history, child and family, before prescribing stimulants. Symptoms of many medical conditions can mimic ADHD, so the pediatrician & psychiatrist may need to collaborate.
Also, consider your son's preferences for male, female, or other characteristics.
Seems to me there are some good tips up here about how to find and choose a doctor, but I don't think it's such a good idea to post comments about individual job performance and personality traits. Who among us would want to go through our day concerned that we're being scrutinized for potential online review in a wide open public forum?
"Sarah Jones, the cashier at Subway, doesn't smile at anyone, and once gave me incorrect change and didn't apologize."
"John Smith, middle school teacher at our local school, was unreceptive to parent input and doesn't do his job with enough enthusiasm. And he gave my child too little/too much homework."
"I went to City Hall to file my permit, and the clerk, Bob Anderson, made me wait a long time and then acted like I was troubling him with my presence."
-- We all know from experience how subjective these things are. Please put yourself in someone else's position and consider if you really need to name names when publishing critical comments in a public forum. Or wait for the backlash, when servers, clerks, cashiers, or neighbors, start reviewing your performance! Who's a bad tipper? Who's obnoxious and imperious? Who blames others for their inability to follow instructions?
As a local doctor (not speaking on behalf of PAMF where I'm a partner) I actually appreciate public comments about how people perceive me. If enough people were more open about how they felt about professionals who served them, a greater aggregation of opinions could give a more realistic gague of how a community feels about an individual.
Overall, I think it takes a lot of courage to speak up about negative experiences in public forums, and would encourage them. Many people restrain themselves at the risk of increasing the reluctance of that profession to treat them equitably, but I don't think they have to worry too much. Many professionals are pretty used to a small number of complaints and take what is true from the complaint as action points to improve their professional performance, and ignore anything of a more personal nature.
I agree, Dr. Choi. As a community volunteer serving people affected by ADHD, I've learned that it is critical for people to share information regarding their care providers, especially when it involves a specialty such as ADHD.
When you really think about it, many private-practice physicians and therapists are alone with a patient, with no one overseeing their performance. And because the patients seeking psychiatric care are often distressed and unsure of their problems, they often don't feel confident enough--or educated enough-- to know when their care has been mishandled. These people are also seldom in positions where they can follow through and report poor clinical care to any licensing agency. Therefore, subpar clinicians go unchecked (including those who are just sloppy AND those whose efficacy is severely mitigated by untreated disorders of their own)--unless their errors are extremely egregious. But with conditions like ADHD (which is often comorbid with other conditions), it doesn't take an egregious error to deprive someone of their best-functioning brain.
To meet others in the community dealing with ADHD-related issues, I encourage the public to attend a local meeting of CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). It's important that you educate yourself about ADHD standards of care before even starting to "shop" for a physician or therapist.
Silicon Valley CHADD, coordinator (volunteer)
Morrissey/Compton Education Center in Palo Alto has an ADHD School Resource Program. They also have a very helpful and friendly group of psychologists and educational specialists. They work closely with physicians, schools, and the county on several of their programs.
J. D. Daniels at 650-328-4442, 550 Hamilton Ave #205 in Palo Alto is a psychologist who has been an excellent ADHD coach for our teenage son.
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