Posted in Health, news, Politics

“Does my Valium prescription mean I have a ‘psychiatric diagnosis’?”

By Daliah Wachs, MD, FAAFP

Updated Jan 7, 2016

At the beginning of the year, the Obama administration gave health care providers the legal go ahead to report their patient’s “mental illness” to the FBI firearms background check system.  Up until now HIPPA laws protected patient’s privacy and doctors could not forward any patient information without consent.  Now Americans are concerned that not only their private medical information will be shared but a psychiatric diagnosis will be shared that may not be accurate in the first place.

Many of us can agree that severe mental illness, or those who are in danger of hurting themselves and/or others should not be wielding a firearm.  But what if a medical provider is not adequately trained in the vast field of psychiatry, or uses a psychiatric diagnoses code for insurance claims during a visit in which a patient asks for a medication that he does not use for a psychiatric condition?

 

For example, many shift workers have difficulty sleeping during the day and their medical provider may prescribe them Valium to help them sleep since its a cheaper alternative to some sleeping medications.  The diagnosis the provider may use, or the insurance company may interpret, is “Anxiety” when in fact the patient doesn’t suffer from anxiety but a sleep disorder.

I had two male patients one with recalcitrant high blood pressure that would not come down on three blood pressure medications and another with severe heartburn that was not relieved by PPI’s or acid suppressors.  As a last resort I tried both patients on Zoloft, a selective seratonin reuptake inhibitor FDA approved for depression and found huge success in controlling the blood pressure and heartburn symptoms respectively.  Both men have moved out of state and if their new provider does not discuss with the patients why they are taking the Zoloft and instead lists a diagnoses code of “Depression”, it could inaccurately describe their medical conditions.

Now here’s a different look a the situation. A female patient of mine was previously diagnosed by another physician with generalized anxiety disorder.  After I performed a routine physical I realized this might not be the case, and eventually diagnosed her with Lymphoma.  Once cured of her cancer, her breathing and heart rate normalized hence her “anxiety” symptoms improved.

The debates that will now ensue include “What constitutes ‘mental illness”, “Is my primary medical provider qualified to diagnose me with a mental illness”, “How much privacy does a patient deserve when it comes to mental health”, and the list goes on.  Another concern is the lack of people being forthcoming with their medical symptoms in fear of being reported. An untreated psychiatric patient is an unhealthy situation all around.  And many medical illnesses can present with “psychiatric symptoms”.  Open and honest discussions with medical providers and treatment compliance may not occur if patients fear they will be reported.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

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Author:

Nationally Syndicated Radio Host, Board Certified Family Medicine Physician, Assistant Professor Touro University Nevada

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