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DrRussMD
DrRussMD, Board Certified MD
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Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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4 year engagement with Child Guidance agency - Parents assessment

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4 year engagement with Child Guidance agency - Parents assessment that child way more mature, advanced than peers, bored in school, opting out of learning. Connors Questionnaire at age 8 - 9 revealed no problems in behaviour, etc. Agency not helpful. engagement terminated on a positive note when child aged 11 (still not fully engaging in learning but coping better with challenges posed to him because of his accelerated development. Three years later I accidentally found out that my son had been diagnosed with O.D.D. - 8 months after terminating engagement - and that diagnosis had been issued to a GP. Psychiatrist unable to explain why she made diagnosis, could give no symptoms, etc. Retired and withdrew from Med Council. Med Council would not get invovled. Review carried out by her Administrative Psychiatrist this year - he has confirmed that he has found nothing to either confirm or refute diagnosis - so on that basis he stated that " it is not possible for me to definitively confirm or refute the diagnosis however it is my view that it was reasonable for Dr. ----- and the team to consider a diagnosis of ODD (no tests, examinations, observations, etc. ever carried out by diagnosing Psychiatrist. No engagement as such with her - engagement with Health Care Official). A Psychologist for the school diagnosed my son as having "exceptional intelligence and of being seriously underachieving a couple of months after Psychiatrist's diagnosis (Psychiatrist diagnosis not known to me until 3 years later. I know my son never had ODD (school reports, school behaviour records prove behaviour ok) is there any way of definitively disproving the diagnosis
Submitted: 3 years ago.
Category: Medical
Expert:  DrRussMD replied 3 years ago.
Hello

Opositional defiant disorder is a diagnoses made based on observation clinically and based on history.
Misdiagnoses is common.
The only way to refute it is by having a clinical psychiatrist and/or psychologist do a careful assessment, over say 3 visits, and then documenting that the criteria are not present at this time.

There is no definitive "test" that rules it in or out.

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Customer: replied 3 years ago.

Unfortunately ODD is a childhood disorder and I understand that symptoms have to be present at age 8 -9 (they were not and school Connors questionnaire and all school reports, school behaviour records give indication of good behaviour) My son is now almost 18 - so even a diagnosis of no ODD now will make no difference - as it might be stated that he "grew out of it". I need to know if a Psychiatrist can make a diagnosis just like that - without substantiated verification, tests, observations, etc. we never asked for or knew that an assessment was being carried out. the Psychiatrist never examined nor observed my son

Expert:  DrRussMD replied 3 years ago.
Yes
A psychiatrist can make a diagnosis just like that.

However, you can have the medical chart reviewed and get other opinions as to the appropriateness of the diagnosis at the time, in retrospect.

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Customer: replied 3 years ago.

The diagnosis has had detrimental consequences and continues to have detrimental consequences - we were given no advance warning - we went for help to cope with the challenges imposed to our son due to his accelerated developement - we got no indication of possible outcome of potential harm It is a conviction, a life sentence, a death sentence

Expert:  DrRussMD replied 3 years ago.
I understand that a misciagnosis from 10 years ago is disturbing, but it is hardly a "death sentence"

I told you how this can be corrected....
However, I am not sure why you are not considering the fact that
a. His medial records are private.
b. He does not have it now, so it is irrelevant to anything as far as I can see....

?
Customer: replied 3 years ago.

The diagnosis was given to the school and the school Principal took the diagnosis to mean that my son was a psychopath. He mishandled and mistreated my son on that basis, told parents "as a duty of care" not to allow their children to associate with my son (my son was never told by me about the diagnosis). The diagnosis prevented his proper make up ever being identified, i.e. exceptional and or gifted. My son, zoned out in school, got into bother over this, started mitching, for which he got suspension, when he returned got into trouble for not having homework done, mitched, suspended, mitched, suspended, left. Now at home all day doing nothing thanks to this diagnosis. Proving misdiagnosis is an impossibility. However, I fail to see how a Psychiatrist with no examinations, etc. can casually slap a diagnosis of this detriment (wrongly blaming mother for "inconsistent parenting)" thereby damaging family dynamics and destroying my son's life. A criminal at least would get to give his account and he would have a right of appeal. We had no idea. We had terminated engagement. I understand from the agency's files that the Psychiatrist had a conversation with the Principal (an unscrupulous man with a grudge against the family) in late 2007 , the diagnosis was made public in early 2008 - an inebriated woman said that "the principal said your son has a disorder" I thought that she was simply mistaken. It seems to me the Pyschiatrist made a rash diagnosis on the Principal's lies.

Expert:  DrRussMD replied 3 years ago.
I have no doubt that the psychiatrist could have made a rash diagnosis, and in fact a psychiatrist currently could examine the chart to see if proper criteria were considered.

You are correct in that nothing can be done to go back in time and prevent your son from experiencing the difficulties in school that this might have caused.

So I am unclear as to what your question is at this point?
Customer: replied 3 years ago.

The point is that I sought and was granted a review. However, while the review is saying that there is nothing on the original psychiatrists records to indicate that my son had this disorder there is also nothing there to refute it - I disagree (parents assessment 2004 which was never investigated by psychiatrist - who by the way initially diagnosed his sibling in 2005 as having Aspergers - after a 20 min conversation with her - but then following tests at my insisting found that sibling was on other side of spectrum, advanced for her age, highly resilient, etc. ), stays I don't think that witholding the diagnosis in the circumstances is fair or ethical - especially as the diagnosis is on GP medical records which allows it further potential to harm. I am afraid that my son will find out to his detriment, that he will hate me for causing it by my "inconsistent parenting", for having him assessed in the first place, that the medical records will hinder his career. I am sick with worry and distress. I owe it to my son to give him back his good name. I should have fought harder for him and had him assessed with his true assessment of Giftedness ( a couple of teachers thought him to be gifted. (A Psychotherapist who also viewed my my son's Connors questionnaire, school reports,school behaviour records, wrote to the reviewing psychiatrist on my behalf saying that had their been more communication between psychiatrist and family that the outcome would have been different). I I fail to see how a Psychiatrist who is allowed operate under the noble integrity of medicine, under cover of goodness, is allowed to harm an innocent little child, to destXXXXX XXXXXves. There has to be some way of getting positive resolution. mitigating the damage and stopping cruel and incompetent (and I believe ASD Psychiatrists) from doing harm

Expert:  DrRussMD replied 3 years ago.
The psychotherapists assessment can be placed in the medical records.
As can any other review of the chart, or current assessment.

There is no way the medical records could affect his career, unless he gave his records to his employer, and then again, why would an employer even care?

It seems to me that you need some assistance.

Have you had any family therapy for yourself and your son, assuming he is also distressed?
Customer: replied 3 years ago.

My son's educational experience was so bad that he disengaged. I cannot get him to re-engage. I know now that he is gifted and that, as his teacher in Primary school said, he is essentially special needs, he needs to be taught in a way that challenges him otherwise he will opt out. She was right He was opting out in Primary school and that was why we engaged with the agency. We engaged with a number of agencies, too many and this may have done more harm than good, though some highly commending of my son. Unfortunately because of the diagnosis, the school wouldn't heed my assessment. At one stage I thought that while truanting he might be involved in substance abuse. I went to an agency and the lady said "you needn't tell me I am tired of this I see it all the time highly intelligent children opting out and that agency is notorious for labelling the child and blaming the parent. My son wont go for therapy. the last Psychologist we say said he saw nothing wrong with him and that he didnt need it. My son seems ok but I am worried for the long term prognosis. A withdrawal of the diagnosis would at least let me off the hook to a degree. I feel that this is all my fault. I trusted an incompetent psychiatrist to help my son.

Customer: replied 3 years ago.

y son's educational experience was so bad that he disengaged. I cannot get him to re-engage. I know now that he is gifted and that, as his teacher in Primary school said, he is essentially special needs, he needs to be taught in a way that challenges him otherwise he will opt out. She was right He was opting out in Primary school and that was why we engaged with the agency. We engaged with a number of agencies, too many and this may have done more harm than good, though some highly commending of my son. Unfortunately because of the diagnosis, the school wouldn't heed my assessment. At one stage I thought that while truanting he might be involved in substance abuse. I went to an agency and the lady said "you needn't tell me I am tired of this I see it all the time highly intelligent children opting out and that agency is notorious for labelling the child and blaming the parent. My son wont go for therapy. the last Psychologist we say said he saw nothing wrong with him and that he didnt need it. My son seems ok but I am worried for the long term prognosis. A withdrawal of the diagnosis would at least let me off the hook to a degree. I feel that this is all my fault. I trusted an incompetent psychiatrist to help my son.


Expert:  DrRussMD replied 3 years ago.
Then since your son is not particularly distressed, and since the old daignosis really has no bearing on anything, and since you already have professionals willing to denigrate that diagnosis, and since you appear unable to let go of your own feelings about the past, and unable to move forward, why have you not gotten help for yourself?

That is what I would recommend.
It seems to me that this has been very traumatic for YOU, regardless of how it might have affected your son.

In addition, if you find a family therapist who is good and teaches you a methodology to process emotion, this is going to improve communications with your son, and your son in fact can be invited to any of the therapy sessions at any time.

That is what I would recommend at this point, just listening to your story.
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Customer: replied 3 years ago.

I want to know if there if the reviewing psychiatrist is entitled to refuse to withthdraw the misdiagnosis in the circumstances. He agreed to do a review and the findings of the review was that he could see s basis from the information on file to support the diagnosis - but that he was retaining it anyway because he couldn't refute the diagnosis. That is like saying I investigated but found no basis for calling you a thief other than someone else called you a thief though couldn't give me a reason as to why - but no matter I will uphold your label as a thief. I will do what I like. Or a doctor saying I will give you this severe medication which will have detrimental repercussion for an illness for which I can find no symptoms. where is the logic in the reviewing psychiatrists findings? Why do a review if he was going to uphold the original psychiatrists findings anyway? Why knowingly let me go to the ends of the earth to prove my case when he was going to disregard all evidence to the contrary anyway? And there is more I foolishly brought my son back to the same agency - sought a different team in 2011 (no other agency would take on the case because of long history and they knew that original diagnosis wrong - no one will refute a diagnosis in this county - we have to go to the UK to get a second opinion). The psychologist said that my son "had a phenomenal understanding of people for a child his age, that he had great self control in a open family discussion with the agency team where peer age group would have got up and left, that he could see how teachers were bamboozled with him. This psychologist said that he saw nothing wrong with my son, that he didn't need therapy and that he would intervene with the school in order to stop the negative cycle of suspension followed by absenteeism. However,the Psychologist did a reverse turn, wouldnt explain, breached confidence -wrote a report badmouthing the family and our attitude towards the school I complained to the PSI, he withdrew registration, deleted all his records on my son (FOI investigation) and resigned. I went back for more - sought a new team - a new Psychiatrist agreed to intervene with the school. Changed her mind on instruction of the Head Psychiatrist (this reviewing Pscyhiatrist) who wont explain why he gave this instruction. I asked for a review of the diagnosis in 2012. review commenced August 2013 - result 02/02/04. I dont want or need therapy I want justice

Expert:  DrRussMD replied 3 years ago.
No
A reviewing psychiatrist is allowed to put another opinion in the chart, based on the review, point out deficiencies in the diagnosis, and state a likely alternate diagnosis...if there is enough information.

He is also allowed to uphold the findings.

He is also allowed to state that it is inconclusive.

You are allowed to have anyone else review the chart, or at least your son is, if so desired.

That is about it though. As far as medical question go...

If you think you have a legal issue, then you need to consult a lawyer.

The fact that your son is not particularly distressed, but that you continue to be so distressed on behalf of your son is concerning.

Therapy would be very useful for you, I believe, if only to help you approach the situation from a far more calm and integrated standpoint.

Medically speaking, you can continue to add things to the chart based on review, but you can not change the past.

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Customer: replied 3 years ago.

The reviewing Psychiatrists reason for upholding the findings make no sense - if there are no symptoms how can there be a diagnosis,if there is no treatment, no strategies, prognosis, how is there a diagnosis. I gave all the deficiencies (the diagnosis psychiatrist actually told lies, pretended that there was a school observation - I had asked for a school observation because my son was being mistreated - but the mistreating teacher wouldnt allow one - saying my son's behaviour was fine - but it was her behaviour that was the issue - not my son's). My son had very high sten tests scoring up to 9 - the possiblility of giftedness was pointed out very high. I asked diagnosing psychiatrist to do tests - she didn't . It is acknowledged that she misdiagnosed one of my children - which would have devastating effects if I hadnt intervened. with regard to the Law I will have to prove that the diagnosis has affected my son - but how can I do that without telling him. How can I prove that the teachers acted unjustly on the basis of the diagnosis. They will all deny this and saying my son deserved their mistreatment - making the situation much worse. Surely any rational person can see that failure to remove the diagnosis from records in the circumstances(my son may seek them one day - to his detriment - and I have the worry of this - and of his finding them on his medical records) is unjust and harmful. What about the Primary Rule of Medicine First Do No Harm. You lure us in with this noble Truth - a big fat lie - let us suffer the consequences - and then tell us to get over the harm done - admit you now have a psychiatric problem - and so go get therapy - Hughely unjust and offensive

Expert:  DrRussMD replied 3 years ago.
Hi
You have already stated all of this previously.

My answers remain the same

Is there any other medical information or question you need at this point?

Customer: replied 3 years ago.

You didn't answer my question.


 


A review was carried out - with a finding that there was no indication as to how a diagnosis was made - no symptoms, no treatment, no prognosis, four year engagement - no help to child, family, no helpful intervention with school - nothing - sheer neglect - no mention of diagnosis, no request for assessment, no indication as to likely outcome of engagement - nothing. Diagnosis upheld. I asked you for your opinion on validity of upholding diagnosis in circumstances. What should I do to get it removed? Would you uphold a diagnosis in these circumstances? If yes, why, if not, why not?

Expert:  DrRussMD replied 3 years ago.
I can not state what I would do without reviewing all of the medical diagnoses.
You can not get the chart altered, but you can add opinions to it.

I believe I have mentioned this.

There is, frankly, no way to remove a diagnosis that was made 10 years ago and that no longer applies to anything because the person is now an adult.

As to the other aspect of your question, if there is no indication in the chart of any testing, exam, history, or any other element that shows how the diagnosis was arrived at, then I would consider this invalid as far as documentation.

It does not mean the diagnosis was incorrect, but the doctor who made the diagnosis would have a hard time defending it legally at this point, since there is no adequate documentation.
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Customer: replied 3 years ago.

I agree with your opinion that the diagnosis is invalid as far as documentation - however the reviewing Psychiatrist had the option of discussing the matter with the diagnosing Psychiatrist. He gave no indication whether he did or not (he could also have discussed the matter with her Team mate the Health Care Official). The reviewing Psychiatrist (also Head Administrator) was copied from the outset of my discovery of the diagnosis in 2011 - by the diagnosing psychiatrist, my queries and her futile responses to me on the basis for for making the diagnosis (the diagnosing psychiatrist also copied our communications to her Complaints Officer - who subsequently tried to answer my queries but failed - he told me to get the answers by seeking FOI request of my son's file - a copy of which I eventuallly got after second attempt - and which only showed the neglect of that agency in their dealings with my son. No chats, conversations or anything recorded. Observations in group settings revealed nothing of significance - educational testing revealed low scoring and reluctance to engage. that was it - then a diagnosis 8 months after terminating engagement on a positive note - a report on file sent to a GP we had long since terminated engagement. The review Psychiatrist, in his role as Head Administrator, at the outset of the queries to the diagnosing Psychiatrist, essentially his employee, saw her futile attempts at explanation - so on that basis what possible valid exaplanation has he for withholding the diagnosis. He saw that she had opportunity to explain her diagnosis, couldn't do so. If a Psychiatrist cannot explain their own diagnosis then how can another validly uphold it?

Expert:  DrRussMD replied 3 years ago.
I don't believe it was upheld.
The reviewer according to you said they could not refute it or confirm it.
that is a valid opinion.

Is there another medical question here?
I certainly can not second guess doctors without being part of the situation, talking with them, and seeing their notes.
Customer: replied 3 years ago.

I don't think that it is a valid opinion in the circumstances. As you said he could have point out deficiencies in the diagnosis ( as illustrated by me) he could have stated a likely alternate diagnosis as there is enough information. And he could have said that the diagnosis was inconclusive - any one of these would have been reason enough to have the desired and harmful diagnosis removed - at no cost to him or his incompetent Psychiatrist who withdrew registration from the Medical Council to avoid investigation and disciplinary procedure. A diagnosis should only be made for the benefit of the patient, to allow for treatment, etc. And the psychiatrist has a duty of care to a patient, there are a lot conditions to be adhered to under this rule including prior information that an assessment is being carried out, the potential diagnosis and consequences of making that public. This diagnosis was and continues to be harmful. It is widely accepted as a spurious diagnosis, the eminent psychlologist and author, Dr. Dorothy Row disputes its validity as do my others. No right and fair thinking psychiatrist , psychologist would make such a diagnosis in the first place and to do so in the circumstances I described and to uphold it - the review was carried out because my complaints were considered legitimate - legitimate enough to warrant review - then what happened - if my complaints warranted a review of the diagnosis for the purpose of removing it retrospectively then why didnt the actual evidence I provided to back up my case - have no effect whatsoever? It is obvious that the review Psychiatrist never had any intention of removing the diagnosis his exercise was merely academic - to make himself look good as in "I always treat complaints seriously and I carry out full and proper review" He doesnt have to do anything, no paperwork- no proof of review, no explanations of his findings - just sit back - wait six months and then issue a no findings result - highly paid by the taxpayer for this review - no questions asked and his incompetent staff can continue to convict innocent little children to their hearts content, innocent little children who can only prove that the wrongful diagnosis detrimental to them by proving that they now have developed an even worse disorder now as a result - catch 22 There has to be something wrong when a psychiatrist can by removing a detrimental diagnosis - one that he cannot uphold - at no cost to himself or the diagnosing psychiatrist and fails to do so. It is not ethical

Expert:  DrRussMD replied 3 years ago.
OK
Any other questions?
Customer: replied 3 years ago.

I was hoping that you would be able to advise as to whether or not there are any regulations and or guidelines with regard to needlessly keeping on record, inconclusive and or unproven diagnoses which serve no medical purpose but are harmful to the patient and or his family. Too many people know about this diagnosis - an unkind neighbour made a sly comment to me recently - it upset me and I wouldnt like if she or her sons made similar comments to my son. At least if the diagnosis was removed we could stand our ground and challenge such comments - instead of hanging our heads in shame. For a caring organization to have as its Primary Rule - First Do No Harm - not to have contingencies for situations such as this - seems very remiss

Expert:  DrRussMD replied 3 years ago.
No
There is peer review
If you want the chart reviewed, it can be reviewed, which I think you have had done.

If you get into legal areas, you need to talk with a lawyer.
I have not heard any medical rule that is broken here.
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Customer: replied 3 years ago.

So there are no rules - Psychiatrists etc. can under disguise of helping, harm innocent little children with impunity, can slap diagnoses on children, and to do this can use the lure of the lie of the First Do No Harm rule A school principal can simply phone up - I'd like this diagnosis on this child how much do you charge. Any disputes from parent can be dismissed with I cannot confirm or refute diagnosis. Pity my son wont go back to school, go into medicine

Expert:  DrRussMD replied 3 years ago.
I would not say there are no rules
Any doctors work can be reviewed by the peer review committee at his hospital, for example, or by the medical board.
So that happens when complaints are filed.
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Category: Medical
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Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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