We, as general pediatricians, are asked on many occasions to provide services that fall outside our realm of expertise. Such is the case with the prescribing of psychiatric medications to some of our pediatric patients. Straightforward AD/HD with or without hyperactivity can at times be managed by the general pediatrician with success. However, AD/HD with comorbidity (ie depression, anxiety, pervasive disorder, tic disorder et.al), clinical depression, bipolar disorder, pervasive disorders, social anxiety disorder, oppositional defiance disorder etc. fall outside this practice's comfort level with regard to managing these patients' medications. We are board certified PEDIATRICIANS and not board certified child psychiatrists or board certified pediatric neurologists. Please do not be taken aback with our request of you seeking such care from a child psychiatrist or pediatric neurologist who specializes in the needs of these children.
Many times parents seek out psychological testing from our community child psychologists. These health care providers are doctors of philosophy(PhD) and thus NOT medical doctors(MDs). They have the capability to provide diagnostic testing and therapeutic counseling, but they are unable to prescribe medications. They place these awesome responsibilities on an MD. The consideration of placing a child on psychiatric medication that affects the neurochemicals in the child's brain is a daunting thought and should not be made without careful review. We try to set aside significant extra time in our schedules for such consultations. In order to block off such time please schedule these appointments months in advance. It is presumptuous to assume that after receiving an AD/HD diagnosis from a local psychologist, one of us is simply going to write for a psychiatric medication right away without careful review of the testing and without thorough consultation with the patient and the patient's parents. Please respect this conservative philosophy.
Ongoing management of our uncomplicated AD/HD patients requires frequent and regular review with face to face office visits. Since each case is unique, some patients may require more office visits than others. Medications must be handwritten, and requests for refills ALWAYS require greater than a 24 hour notice.