I realize psychiatrists only usually have so much time for the patient, but for new patients it is imperative to know the situation well through important probing and relevant questions to the patient. Unfortunately many doctors do not do this, but make assumptions and decisions too soon based on quick inspection or without asking the right things, to what the patient wants or needs. And patients may mainly just need a formal evaluation first, to see if they can feel comfort with the medical provider's views and recommendations first.
Also, for the disabled or for such applicants who may apply for benefits, the medical community often does not want to get involved there if they think the patient mostly needs reports. It is partially likely because it is too much work for them to fill out the government medical forms, or because they worry the patient may not want long term care then with them. Also,it may not be best for their reputation if the patient says none of their treatments may be suitable for them, or if a disabled patient does not do better under their care.
How many psychiatrists or other doctors will ever write in a report that the condition is permanent, chronic and poor prognosis, even if the facts lead to that? There is nothing in it for them to be truthful like that. Or they may think they are some huge miracle worker and fix everything, or be too proud to admit they can not help. Sometimes patients need that truth instead of hidden lies to trust doctors, to reduce medical anxieties, and yes, to get benefits. Sometimes that is validating the patient for all they went through and for all the adversity they face.
Patients have a right to get just either a second medical opinion or a diagnosis first-- without treatment expectations--if they need to see the medical person's findings first to see if they agree or not, or if there is no treatment that can reasonably better their medical situation if either overlapping conditions are involved, past such treatments failed, as bettering one condition or sign and symptoms could worsen others, or if the treatment would be such to not really help the main issues the patient needed to be helped, but was given as they specialized in that or to satisfy insurance or legality fears..
Sometimes patients see psychiatrists too just to feel medically heard as past attempts failed, and to find one that can be worked with. Not all conditions require treatment, but sometimes insurance or government bureaucracy requires an MD and treatment to be involved. That puts pressure on the patient to do so or else you have no case. The doctor should not assume the reason the visit was scheduled, but inquire and then refer to other professional if need be, to make the right decisions there, instead of acting like the patient did wrong.
In the original poster's case, it is certainly fair for her to just want a medical opinion, and to see if this could help with a disability case. If she did not want medications for any reason, that is her right. If Autism is the diagnosis or expected one, since when are medications required for that? Now, if the psychiatrist says, " Well, I only do evaluations with some sort of treatment, and I do not get involved with disability cases", as many doctors look down on such persons, that doctor, if ethical,should refer that patient elsewhere, not act like the patient was unreasonable.
The medical situations that usually fall through the cracks are the ones where severe disability is involved and where the patient cannot either handle the rigid medical and government system protocols, policies or procedures and those people who assumes their treatments will only help but not hurt. For mild and moderate cases, perhaps, that is a reasonable assumption that some treatment could better things, but sometimes the severer and chronic disability cases or where genetics is mostly involved, other nonstandard solutions are needed.
True care and reasonable accommodation could involve for instance a thorough doctor diagnosing that condition in the patient that may have been overlooked by others, documenting then their functional and day-to-day limitations, to bring the patient the relief that way, asking the patient how they can be helped and truly listening there as each patient can be different, with that doctor then carefully considering that to benefit the patient.
I can just say for many disability applicants and beneficiaries, those with chronic conditions affecting them in many ways, their worries are often just as much about getting those needed benefits and maintaining them, as without such they could be forced to do something they cannot do, leading to worsened health. Tell a person who is about to live on the streets or that has no food or shelter or who fears that all could be gone without getting or maintaining those benefits that they should just accept medical negligence, lack of empathy, rigid protocols , dragged out appointments and inaccurate or incomplete diagnoses, reports, and treatments, and of course the anxieties in that patient can skyrocket.
Does the medical community know or care that the SSA bureaucracy will nitpick every detail, regarding such diagnostics, reports and treatments and try to spin that to justify denial? That could mean the difference between a patient getting benefits or not, and being able to abide by a treatment or not, and whether beneficiaries already getting disability benefits will be no longer receiving such or not. If we do not abide by medical recommended treatments, the SSA can say we did not cooperate, so it is very important what the diagnosis and treatment is.
So, for any such doctor to be so apathetic to such a situation, or to be so assuming when we walk in the door what we want or need , without probing further or be willing to individualize things more, we can start fearing medical people more and more, or need things done more our way than theirs. I guess what I am saying is, for every great doctor out there there is at least one that can do better. Not all people will ever desire or be able to be integrated with society to typical functional levels, regardless of treatment which may even worsen things, and in those cases and others, the doctor needs to be more understanding and flexible, putting the benefits of the patient first.
Traditional medical people won't even often consider alternative treatments, for those patients wanting or needing that, based on their numerous sensitivities or past traumatic experiences, so for those who want or need that, it's often their way or the highway according to such MDs. So in this case a psychologist might be best for those who want non-med treatment with evaluation.
