Posts by Brandon Lopez6

Pillsbury wants to be an actual psychologist doing real psychotherapy, not some bartender playing therapist behind a counter. So, this whole idea of her hiding under the guise of "counseling" just doesn't hold up legally.

Look, I’m no legal expert when it comes to the US legal system, but inciting criminal activity is a huge no-no, and this whole situation feels like it’s heading straight there. He could have easily just said, "Hey, hire two employees instead of one and report the other guy." But faking paperwork? That’s fraud, plain and simple. Nobody should be encouraging that kind of shady business, especially not some moderator who claims to be a "psychiatrist" or whatever his actual title is.

Pillsbury said:Wait, seriously? You can actually get licensed and open your own psychotherapy practice? For real?
I can't believe I actually had to sit through that whole meeting. Total waste of time. Honestly, if they think just throwing more paperwork at us is going to fix the burnout, they're dreaming. It’s like when my old boss at Starbucks used to try and solve staffing shortages by giving us "wellness seminars" instead of just hiring more people. Like, thanks for the breathing exercises, but maybe just give me an extra hand on the morning rush? Anyway, back to the point. This new thing with the Psychology Practice Act is such a mess. It feels like they're just adding layers of bureaucracy for the sake of it. It doesn't change how we actually work with people; it just makes the admin side a nightmare. Just my two cents.

redharbor9 said:Sure, they can open an office for intellectual services and go ahead with psychotherapy, but that's a whole different ballgame. Just don't go putting that on my tab. 🙂

Pillsbury said:/cut
Look, I’m talking about this whole unlicensed practice thing for anyone thinking they can sneak into psychotherapy under the guise of providing "intellectual consulting" or whatever. If even one of those patients decides to call the cops on you, you could end up behind bars. Seriously. Under the Psychology Practice Act, that's straight-up practicing medicine without a license. I know, I know—you probably think I'm being dramatic, but I've given you fair warning. 🙂 Don't say I didn't warn you. 🙂

redharbor9 said:Nah, you can actually run psychotherapy under intellectual services. The thing is, between the Psychology Practice Act and how things work on the ground, there’s basically no way to tell the difference between actual psychotherapy and just basic counseling. 🙂

Look, the bottom line is you can't legally list psychotherapy as a service on your invoices. You just can't. But honestly? What you’re actually doing once you sit down with a client... nobody can really tell the difference from the paperwork. It’s the same thing. It’s like how psychologists write "counseling" on their bills because they aren't licensed for therapy, even though they're basically running therapy sessions all day long. 🙂

Pillsbury said:Basically, you can't call yourself a psychotherapist if you don't have a license. Doing it without one is essentially working under the table, which is totally illegal. It’s clearly laid out in the Psychology Practice Act to prevent people from practicing medicine without a license, and the law actually carries jail time for that kind of thing. But honestly, I'm done arguing about this. If you're smart, you'll get what I'm saying.

What I really want to know is—has anyone here actually done that PhD program at the state university, or is it just a joke? How was it?

redharbor9 said:That isn't working under the table. You have a registered business, you're issuing invoices, so everything is perfectly legal.

I only opened this thread because I wanted to see if I could tell someone they could open a boutique specialized in selling denim jackets, but then start selling meat out of the back room instead. Because, to quote the logic above—"That isn't working under the table. You have a registered business, you're issuing invoices, so everything is perfectly legal." Like, if the receipt says "denim jacket - $83" instead of "pork - deer weight xy kg - $83", who cares? A sale is a sale.

Here’s a new article, though I honestly don't think they've broken any new ground here—it feels like everything in it has already leaked out somewhere else.> click.

Raymond Moore17 said:Well, my family and I already caught Microsporia from our cat, and now it’s spread to the dog. I’m reaching my breaking point. We’ve been making slow but steady progress using Lamisil, but now there's this issue with the dog. He has a large scab on his leg that I peeled off, leaving a circular mark behind. I’m fairly certain it’s Microsporia, so I’m going to treat it as such to prevent it from spreading, even though I’ve already washed him twice with Ketoconazole as a precaution. So, what's the move? Should I go back to Ketoconazole and then apply Plymicol 2?

Maybe ask a vet about the pets since we're talking about a dog? 🙂

bolddriver21 said:Maybe swap out BANJALUKA for Birmingham or call it an Birminghanian?
It just doesn't look right like this..

stop rambling 🙄

Just popping in to say I'm having a hell of a time even logging in today. Sometimes I have to punch my password in five times in a row—even when I know it's right—only for the site to kick me back to the home page while I'm still logged out.
I'm using someone else's computer, so I really don't want to click anything that saves my info or remembers my login.

slycrane94 said:Look, I don't really care, but if you want something, you've gotta pay up somehow.

I just wanna be an admin so I can troll, spam, and—well, let's just say "cause some trouble"—without getting banned. What's the damage? 🍿

If they don't even offer that procedure anywhere else—and you literally just said they don't—then there’s zero point in them shuffling you off to some local hospital near your house that can't even perform the surgery 🤷

Amanda Chavez27 said:Here is the question I am trying to get an answer to.
I have schizophrenia and receive treatment at the Mayo Clinic.
I’ve completed four psychiatric evaluations following my hospital stays, as I have been working under a medication regimen prescribed by my psychiatrist at Mayo Clinic, which my primary care physician then implements.
I need to know if I will continue seeing specialists at Mayo Clinic starting September 1st, or if my primary care doctor will take over those follow-ups.

From what I gather:
1) If you have a specific specialist at Mayo Clinic = you keep seeing them.
2) If you don't = they shuffle you off to whatever local hospital is in your area.

Elizabeth Fowler46 said:Is there going to be any shift regarding the other doctors in primary care? Basically, can my gynecologist still write me prescriptions or lab referrals, or is that all going to have to go through the AMA now?

Man, I really hope not.

Morgan Morgan5 said:From what I understand, there are five psychiatrists at the Sisak Hospital and one more in Petrinja—with at least three of them specializing specifically in psychiatry. My point was that it would be much better to have psychiatric services located at the PZZ (just like general medicine, OB/GYN, and dentistry) because there's really no reason for these clinics to be tucked away inside hospital buildings.

I was actually talking about the community health centers, since not every town has its own hospital. In Sisak, you're looking at an 8 to 9 month wait just to see someone at the Hospital.🙂

Morgan Morgan5 said:There’s also the option of having psychiatrists available through the PZZ—just like we already have gynecologists and dentists. It’s a safe bet that we'll see more of them once some of those specific psychiatric wards in general hospitals are eventually restructured. Right now, there are roughly 500 psychiatrists in the US, and honestly, a huge number of them are just stuck in hospital bureaucracy without actually doing much of anything. Their specialization takes four years, after all—and let's face it, severe psychoses are typically handled via hospitalization anyway, or through outpatient care if they're in remission. For everything else, day hospitals are right there. BTW—just give private psychiatrists a shot at the capital, and you'll see how quickly things start moving.😉

It's not available in every city, though. In Sisak, there's only one (I repeat, ONE) psychotherapist working, and she's a psychologist, not a psychiatrist—which basically means you're screwed. And yeah, she works with kids and teens, so anyone over 18 is stuck choosing between Popovača or driving all the way to Washington, D.C., especially since there isn't even a bus running to Popovača. Figure it out yourself, buddy.😍
And don't even get me started on the smaller towns, because Sisak isn't even that small.

Kyle Lee7 said:That is clearly possible too.
In a way, it makes sense if the doctor believes it's necessary, since sometimes you really do need to rule out physical factors.

I originally went to psychotherapy convinced that my symptoms (vision issues) were just caused by work stress, rather than what was eventually suspected—Multiple Sclerosis. I actually refused neurological testing because I was terrified they might find out I have the same condition my mother has. After a few months, my psychiatrist managed to nudge me into getting the tests done, and it turned out I really do have MS, and those symptoms were indeed somatic in nature. By then, we had already heavily invested in therapy, so I continued with it; it’s definitely helping me cope with the MS diagnosis. And I've been going to the Mayo Clinic from day one, and I'm very happy with the care there.

What I wrote earlier was prompted by reading a thread on a psychology forum where most people described the opposite: having a new symptom every single day and begging doctors for referrals, even though they already have a diagnosed anxiety disorder.
Also, I remember once when my therapist's phone rang; he picked up, and I sat there listening to him spend ten minutes explaining to someone that his daughter didn't need a full-body MRI or "some kind of infusion." The guy was trying to pull strings with the hospital director, and everyone was yelling and applying pressure. It was all because no one in the family wanted to accept that her problems were actually psychological, even after every single test came back negative.

I deal with different symptoms too, and yeah, it's not the same thing every day, but I know 99% of it can be traced back to anxiety (for example, I don't get my period because of PCOS, not anxiety—that's the 1%). You just have to weigh whether more testing is actually justified. That should be the primary care doctor's job. Personally, it doesn't occur to me to run straight to my GP for heart tests right after having a panic attack where my heart is racing. It's a different story when people refuse to accept that your mental state can cause actual physical sensations, but again, doctors really need to put a stop to that cycle.

My doctor looked pretty annoyed when he saw how many referrals I needed him to write. We both knew it was overkill and that I was fine, but since it was the "next step" I had to take, he wrote them and I went through with the tests. The only thing is my blood work isn't great, but I've known that for a long time since I get checked once a year. Everything else is fine—thyroid hormones, brain CT, EEG, all good.

Kyle Lee7 said:In principle, the idea behind this is actually quite good because there are so many logical gaps in the current system. Of course, new ones will pop up, they'll just be in different places.

The worst part, though, is the patients themselves—people who visit doctors, get a whole stack of prescriptions, and then just DON'T TAKE THEM. Or they don't finish the course, or they take them incorrectly. I actually overheard a guy bragging to a pharmacist the other day about how he keeps his medication sitting right in his desk drawer, yet he still makes sure to pick up one or two boxes every single month regardless!

Then you have the patients who get a tiny little twinge in their ear and suddenly demand a full-body CT scan and every diagnostic test known to man.
Or the hypochondriacs and people with severe anxiety who spend YEARS cycling through doctors, running enough tests on the healthcare system to cover ten people, when all they really need is for someone to finally refer them to a psychiatrist. But no, these same Primary Care Physicians insist on writing referrals for heart checks, blood work, thyroid panels, brain scans, this and that... even though the patient is clearly just anxious. It’s like these PCPs should be psychiatrists instead, because every single one of these patients just wants physical proof of a disease. Do we realize how much that costs us?

As for asthma, it’s just "lovely" to hear people dismiss it as some minor, insignificant condition that doesn't require a specialist.
I’ve been on the brink of death a couple of times—struggling to breathe, my oxygen saturation levels tanking... but heaven forbid I actually see my own pulmonologist!
Generally speaking, it feels like the shortage of pulmonologists isn't even a result of this new reform; it's been bad for a long time. Specifically:

I have my own pulmonologist. She sees me maybe once every two or three years just for routine maintenance. My asthma is under control, and my PCP handles my prescriptions. However, if my condition starts to take a turn for the worse—I CANNOT GET TO HER!!!!
I can get an appointment in a month. Wtf? The nurse tells me, "If it's an emergency, call 911; if you're feeling slightly worse, go to your primary care doctor." So what is the point of having a specialist pulmonologist managing my care? If I can't see her exactly when a flare-up happens, what's she there for?
Is she just there for routine checkups when I'm feeling perfectly fine? I don't even need her for that!

The only time I actually want to see a pulmonologist is when I feel my asthma worsening, but BEFORE it reaches the point where I need to call an ambulance!!!!!

It was the same thing back when I was a student and had my records at the campus health clinic; they had a habit of scheduling appointments a month out.
The only way you got seen the same day was if you had a high fever or active bleeding.

That just isn't normal. Even if you have a minor inflammation or something is aching or burning... what is the logic in waiting a month for an appointment, letting everything get worse, spread, and complicate itself, and just suffering through it for thirty days???
Especially since gynecological issues aren't things you should wait on, aside from regular screenings.
It’s like going to a PCP with a throat infection or a bladder infection and being told to come back in a month because it's "not an emergency."

That’s actually how I ended up finding a private gynecologist whom I can see the same day or the next. And that was the first time in my life someone actually asked me, "Have you had your swabs done?" What do you mean, swabs? Heaven forbid a government doctor would suggest that a sexually active person might actually need to get tested once in their life.
☕

Look, I have a totally different take on this as someone living with anxiety. I've been dealing with this for years, and after getting burned by private doctors earlier this year, I went back to a social psychiatrist at Mayo Clinic. I know I have anxiety. I know it's purely mental. I know exactly when it started and how it feels. But the doctor didn't just suggest—she insisted—that I undergo about 10 different tests, including a brain CT.

It's easy to blame the patient, but there are plenty of cases where the doctor is the one pushing for more testing*. It isn't always (or even intentionally) the patient demanding every single scan. ☕

*She literally told me she wouldn't see me for follow-ups until I finished all the tests because she "couldn't" move forward with my psychotherapy without them.

I honestly have no clue, look...

Back in January (after my condition had finally leveled off for a bit), things took a nasty turn for the worse. I stumbled upon some info online about how even primary care doctors are doing some kind of psychotherapy now and prescribing meds for mental health stuff. Personally, I’d much rather just talk things out than pop pills, so that would be perfect. Plus, dealing with a mix of mild agoraphobia and this phobia that keeps me from going anywhere solo, being able to see a doctor right here in my hometown would be a lifesaver.
So, I went to see my doctor and explained what I'd read. He basically told me I should probably head to Washington, D.C., because my issues were "too much" for him to handle. I tried booking an appointment in a nearby city, but when they told me they weren't taking anyone new until late August or September, I just gave up. Sure, it's closer and easier to get to, but I couldn't deal with waiting that long.
Even if my doctor suddenly decided he was down to do counseling sessions with me, I’d be pretty skeptical. If he didn't get it yesterday, why would he suddenly get it today? The only real move is what you guys suggested—switching to a different doctor. But in a small town like this, nobody talks about whether someone is "crazy" (there are only two categories here: crazy or sane), so I have no idea which other doctor to pick or who might actually be more specialized than my current one.
Don't get me wrong, he's a great doctor. He does everything he can to help me out, but when it comes to this side of medicine, he either doesn't understand it or he's too afraid to "play around" with those kinds of things. 🤷

Nicholas Myers said:Of course they won't. It’s pretty clear from the paperwork—referrals for follow-up exams are already being planned out.

And do you really think there are enough psychiatrists to handle everyone struggling with mental health issues?

The same logic applies to patients dealing with diabetes or hypertension. If we have specialists dedicated specifically to diabetes or blood pressure, why should someone with less expertise try to treat them? Surely those patients deserve the top experts in their specific fields.

It brings up the question: what is the role of a family doctor in this setup? Wouldn't it be more efficient for patients to go straight to a specialist? At the end of the day, a specialist is an expert in a specific disease, organ, or system. They know significantly more about their niche than a general practitioner ever could.

So what, we’re just supposed to sit here and take it because—what?—there aren't enough doctors available? 🤷

People could ask the exact same thing about diabetes or high blood pressure. If there are specialists specifically for diabetes or hypertension, why should they be treated by someone who knows less than those experts? They deserve the best specialists in their fields too, right?

In my book, "high blood pressure/diabetes" doesn't really fall into the same bucket as mental illness. Honestly, unless you've been through it (and I don't mean just feeling a little down), it's hard to get how much someone needs constant contact with a psychiatrist. Sure, if the local clinic handles it, problem solved, right? But can I just drop by and hang out for an hour? And what about the folks with blood pressure or sugar issues who are just waiting on a prescription?

I’ve gotta say... it just doesn't sit right with me that the government would run any kind of mental health program. I mean, what’s even the point of having psychiatrists then? I could go on and get pretty nasty about it, but I won't. It isn't the doctors' fault—it's the people running the show above them. They’re (thank Bog) perfectly sane, so they couldn't care less about the rest of us. Honestly, their best move would probably be to just lock us all up in some asylum or hospice and call it a day. ☕

I live in a tiny town where the doctor situation is pretty thin on the ground... but yeah, I’ll definitely give that some thought.

Total nonsense. Even the guy at LOM told me himself he had no clue what was going on when I was asking him about the Ad, so now suddenly he’s supposed to be an expert overnight?

Whatever. I’ve still got some credit left, so I might just go private.

Moderate anxiety, some phobias, a bit of OCD... maybe even a personality disorder in the mix?
(No psychosis, though)

What’s the deal with mental health care lately? How can some random layman be out here running the show on psychotherapy and meds?

I was half-listening (and half-reading 😬) all this talk about the new medical law—or whatever it is—saying that primary care doctors will be running the show for chronic patients now. It’s got me wondering where I actually fit into this whole mess.

My GP is a sweetheart, really, but whenever I brought up any kind of mental health stuff, he’d immediately tell me to head over to Washington, D.C. to see a psychiatrist. How am I supposed to trust that he'll make the right call for me when he's already admitted he doesn't know enough to even tweak my meds?

* I think I saw someone mention somewhere that a GP can prescribe a new antidepressant if the current one isn't working, as long as it's in the same class. Dammit, I can't remember the specifics right now. 🙂

Also, word is we won't get to "pick" our hospitals anymore; everything is being assigned based on where you live. The closest hospital to me (Sisak) has a nine-month waiting list just for psychotherapy.
Basically, I need to know: do I still have the right to go to a major center like Mayo Clinic, or am I just stuck waiting to drop dead at home as far as they're concerned?