The Top 10 Questions to Ask a Potential Doctor for ADD Diagnosis & Treatment

Originally Submitted on 12/17/96.

When asking the following questions it is important to remember that you don't care about the particular answers as much as you care about how comfortable this doctor is with providing information in response to direct questioning -- and how willing s/he is to take the time to establish a relationship with you, take your questions seriously, and provide thoughtful answers.(For example, many highly knowledgeable ADD doctors started working with ADD children and don't have a lot of experience with adults since they have become known as being a great doctor for kids. An answer like, "To tell the truth, most of my ADDers are kids. But I'm eager to work with the adult population because I think I can help." would be a doctor I'd recommend in a heartbeat. A response like, "I wish I had the time to be more involved. The demands of being a practicing ADD Doctor don't leave me a lot of time to do extra work in the ADD community," would lead me to believe that I'm probably dealing with a caring professional who spends a lot of time with the patients.)

1. How long have you been working with ADD?

2. What percentage of your practice is ADD & what areas of focus make up the rest of your practice? (What they're used to seeing will tell you a lot about some of the "filters" through which they see the world and may provide some additional expertise in distinguishing ADD. A doctor who deals with both clinical depression and ADD would probably be pretty good at distinguishing a depressed ADDer from a clinically depressed non-ADDer, for example)

3. How familiar are you with the minute-to-minute, season-to-season functioning issues of ADDers? (Are you ADD? Is someone you live with? A close friend or relative?) What made you target ADD as a practice focus?

4. How much knowledge do you have about adult ADD? (What is the percentage of adults to children in your practice? How long have you been working with adults? How many adults have you treated? What are some of the differences in the way you work with ADDults and children with ADD?)

5. How familiar are you with MY kind of ADD? (i.e., hypo-active ADD, ADD with dyslexia, late-life ADD diagnoses, ADDers who are recovering alcoholics, etc. You are listening for an awareness that there are a lot of different ways that ADD can show up, more than specific familiarity with any one of them. There is a "first patient who..." for every doctor and it's ok to be that first patient if the doctor is open to new presentations. The doctor to be wary of is the one who uses "always", "never" and is full of "shoulds" about ADD.)

6. What is your treatment philosophy? (What is your attitude toward medication, diet, nutrition, self-care, education, non-traditional approaches? Beware of the doctor who has a *formula* approach, but every good ADD doctor has some basic approaches they can articulate. Above all, your doctor should be comfortable with the kinds of treatments you believe in. Its ok if they are skeptical about a particular treatment or two, as long as it is mixed with the attitude that there are a lot of different ways to make a difference with ADD and that medication is not a magic bullet that can make a difference all by itself. Remember, once we give a child "glasses" we still have to teach her to "read." The glasses just help her to focus so that she can learn!)

7. How willing are you to partner with me in my care? (How accessible are you? What forms of patient feedback have you implemented? As I learn more about ADD and my ADD in particular, would you be willing to try new approaches with me?)

You're trying to weed out the doctor for whom adequate functioning is "good enough." Optimal functioning is your birthright.

8. How do you determine an ADD diagnosis? (NOTE: There is currently NO test for ADD. Some doctors do use tests for the knowledge they provide about your functioning, for baselines to help measure improvement, and to rule out some other possible diagnoses, but if testing is presented to you in a way that sounds like the results of the testing are going to give you an ADD diagnosis (or rule it out), you are working with someone who is not really knowledgeable. All good ADD doctors use a patient history as a large part of the diagnostic procedure, often with reporting from teachers, parents and significant others as well. Until we have a test where a high percentage of individuals with ADD fall within a unique statistical sampling, we don't have a test for ADD. Right now, bona-fide ADDers score all over the map on the tests that are available, and there are far too many exceptions to consider the tests themselves diagnostic.)

9. How will we work together if we decide to continue? (Is this doctor a psychopharmacologist or does s/he include talk therapy as part of your treatment plan? Does s/he do the therapy, will you be provided some referrals to therapists, or are you expected to locate one yourself? Is being in therapy a pre-requisite for medication? How often will you see each other? What is the procedure for reaching your doctor for questions between appointments? How much will it cost?)

The kind of guidance you receive as an answer to this question will let you know a lot about how much guidance you can expect as you work together. A cursory, "Let's just see what the tests say first," is not very nurturing and a good indication that your working relationship will be equally dismissive. Unless you are equally pressed for time and unusually knowledgeable about ADD yourself, you'd probably be wise to interview another doctor.

10. How up-to-date is your knowledge base? NO, you can't ask that question directly and expect to get an answer that will be useful. But you can find out by asking questions like the following: a. Do you speak to ADD groups? Which ones? On what topics? b. What ADD organizations are you a member of? CH.A.D.D.? ADDA? Others? c. Do you attend ADD conferences? Which ones? How often? How recently? d. Do you have a website? Participate in any of the ADD newsgroup discussions or ADD Physician email lists? Are you "web-published"? e. Can you give me a referral to a coach? (It's ok if they can't -- ADD coaches are still a bit scarce and not all doctors have referral relationships with coaches. But if they don't know what a coach is or don't understand how a coach could be useful, you know they haven't read much published in the last couple of years. Dr. Edward Hallowell & John Ratey have been extolling the value of coaching for ADDers since Driven to Distraction, published in 1994, and many of the books since then make some mention of coaching. The ADD world changes rapidly and you want your doctor to be one who stays current.) You can also say, "Would you be willing to speak to my coach?" to elicit the same information and to find out how comfortable the doctor will be working on your team.

There are no "right" answers. Listen for the care and involvement behind the answers. You're screening for a doctor who is straightforward, has a consistent theory about ADD s/he is comfortable with but not stuck on, and for a doctor who will take the time to listen to you and answer your questions. With that kind of doctor you will have the relationship you need to work out any details of your care as you proceed. Nobody really "knows" exactly what's going on with ADD yet, so any doctor will be learning as s/he treats you, no matter how knowledgeable s/he seems right now. You just want to make sure that the learning that goes on will be interdevelopmental. (REMINDER: Make sure you bullet-point your questions -- no doctor has time to listen to rambling. And make sure you don't jump to a request to get to the bottom line with lack of interest in your question.) Madelyn Griffith-Haynie is an ADDer, an ADD Coach, and trains ADD Coaches in a comprehensive 9-month program through The Optimal Functioning Institute, a company she founded to help ADDers learn to develop their own unique systems to work around the ADD Challenges -- so that their lives can be about something bigger than ADD management. She is a graduate of and senior trainer with Coach University, Inc. and facilitates the CU ADD-SIG. She also runs the only national ADD support group, the ADD Hour, by TeleConference. It meets on the third Thursday of every month at 8 pm Eastern. To participate in this free support group, email mgh@addcoach.com with your contact information (email, name, address, phone & fax). Also, drop by the new ADD Coaching Website to watch it grow! http://www.addcoach.com.

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