Dani Donovan 👩🏻🎨 ADHD Comics@danidonovan
This is the least-nice email I've ever sent, but whatever. I'm fucking fed up with this bullshit. 🤬
TL;DR summary:
While trying to find an affordable/effective ADHD medication covered by my insurance, I went to a new clinic where I experienced numerous administrative errors, a lack of expert guidance from a novice nurse practitioner, and a dangerous oversight of potential drug interactions that I had to flag myself. Despite these issues stemming from professional inadequacies, I'm now being asked to commute 2 hours for an in-person appointment. This month-long process, marked by frustration and distress, underscores systemic issues in managing ADHD treatment.
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Subject: Urgent Request for Adequate ADHD Management and Treatment Plan
Hi there [NAME],
I trust this message finds you well. I am writing to express my deep frustration and concern regarding the process/outcomes of my treatment plan at your mental health clinic thus far.
For over a decade, I've relied on ADHD medication for symptom management. Recently, however, the side effects of my current medication coupled with its prohibitive cost ($900/mo.) prompted me to seek alternatives. In light of my complex medical history, I had hoped to receive guidance and a treatment plan from an experienced psychiatric professional.
Transitioning to your clinic—necessitated by changes in my insurance coverage—has unfortunately proven to be a tumultuous process. I have been met from the start by a host of administrative missteps, ranging from the abrupt rescheduling of my original appointment, to a significant delay in receiving the necessary intake paperwork, which subsequently led to the cancellation of my original appointment for “incomplete forms,” (through no fault of my own). While untangling this issue, I discovered that my appointment had been erroneously scheduled as a child’s visit, and my name and birth date were incorrectly recorded.
Further compounding my frustrations, the need for a hurriedly scheduled new appointment to resolve your office’s initial missteps resulted in the deletion of my previously completed intake forms, requiring another two-hour commitment to fill them out anew that would not have been necessary if these clerical procedures had been carried out properly in the first place (which a member of your office staff openly admitted and apologized for). This challenging initiation into your clinic has added considerable stress to my already complex situation.
But to add to my distress, instead of consulting with a seasoned psychiatrist as initially anticipated, I now found myself in the care of a nurse practitioner in her first year of practice who asked me, "Well, what do you want to try?"—a question that baffled me, as I am not the expert here.
While I am aware that everyone starts somewhere, [NURSE PRACTITIONER]’s inability to provide authoritative guidance on my ADHD medication options and leaving the decision to me seemed out of place. I am a patient seeking medical expertise, not an expert in psychopharmacology.
I initially suggested Adzenys-ODT as a potential replacement based on the advice of my previous psychiatrist, an option [NURSE PRACTITIONER] admitted she had never prescribed before. When I got to the pharmacy and realized this wasn't covered by my insurance, I suggested Strattera (Atomoxetine) in hopes of resolving the generic availability / cost issue.
To my dismay, the potential drug interaction with Wellbutrin, my existing antidepressant crucial to my mental well-being, was overlooked prior to prescribing — despite my express concern about its compatibility. This oversight is particularly troubling, considering that despite my request that any prescribed medications be screened for potential contra-indications due to drug interactions, it was not a member of your team who flagged this danger, but myself.
What's more, the advised abrupt discontinuation of Wellbutrin by [NURSE PRACTITIONER’S PSYCHIATRIST BOSS] contradicts common medical guidance due to potential withdrawal symptoms. By all appearances, my alternative suggestions were accepted with scant professional scrutiny, leaving me feeling unsupported and mistrustful of my treatment with your clinic.
I want to clarify that I am not simply 'requesting different medications' for the sake of it. I am desperately trying to find an effective, affordable, and safe solution to manage my ADHD symptoms. I am not a healthcare professional, and the apparent necessity for me to research and propose my own treatment options while working with your office is not only a direct consequence of the lack of guidance I have received thus far, but a dangerous precedent to set with regards to my treatment, considering I am not a medical professional.
Regrettably, the series of events thus far have been extremely disruptive and distressing, leaving me without an appropriate ADHD medication alternative. Now you're asking me to make an additional in-person appointment, involving a significant commute—despite the root problem of the issue being professional oversight and insufficient guidance, not patient compliance or a complex clinical situation.
I am convinced that these matters can be adequately addressed through a telehealth appointment. It appears that the requirement for an in-person visit is an attempt to rectify the administrative and professional missteps that have occurred, not a medical necessity. The convenience of patients should not be compromised due to systemic inefficiencies within the clinic.
Please understand the profound impact this ordeal is having on my wellbeing. I have been understanding, patient, and proactive for over a month, yet I've been brought to tears multiple times by these negative experiences. I trust that my frustration is understandable given the circumstances, and hope to receive prompt attention and solution-oriented action from your end.
The situation necessitates the formulation of a comprehensive treatment plan, crafted by a professional well-versed in ADHD management, that takes into account my medical history, ongoing medications, and insurance coverage.
I look forward to a resolution that prioritizes my health and respects my time. Thank you in advance for your consideration of my concerns.
Best Regards,
Dani
