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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 18537
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am writing to a former Neurologist. I want to be

Customer Question

I am writing to a former Neurologist. I want to be re-accepted as a patient. I would like a Neurologist who has experience with Traumatic Brain Injury to review my letter and advise me on how to improve it, and what changes to make, if any.
The letter is as follows:
I am writing to you today to appeal to your humanity, Hippocratic Oath to treat patients in need, and am asking for your mercy in helping me achieve my dream of full-time employment, becoming a lawyer, and starting a family.
My Mom and Dad are getting old. I am ashamed that I continue to rely on them for support. I have no other option because I am not presently able to fully support myself. I need your help. Please have mercy on me, and forgive me for the troubles of the past. I was not receiving appropriate psychiatric treatment.
I was a patient of your practice from July 2009 to November 2011. Psychiatric problems caused me to be discharged from your practice.
Looking back, I do not believe I the psychiatric medications I was prescribed were effective. I continued to have problems on them. There were psychiatric hospitalizations. At times, I behaved and spoke inappropriately. I had active delusions and paranoia.
For the past two years, I have been on an excellent psychiatric treatment plan. There have been no psychiatric issues. I do not have the urge to say inappropriate things or behave inappropriately. I do not have the urge to abuse my medication and have not been abusing my medication. The medication makes me completely aware of the mistakes I made in the past and prevents me from making similar mistakes now. I rely on these psychiatric medications for my well-being and take them in compliance with my treatment plan.
There has been remarkable success in these past two years. I have paid off all my debts. I have been able to save money. I graduated from a Paralegal Certificate program. I started a part-time job as a paralegal.
The issue is that I am not being prescribed the amounts of Methylphenidate necessary for me to seek out full-time work or to plan to re-take the Bar Exam. The medication is effective for only one and a half hours, up to, and at most, two hours. After that, it is noticeably ineffective. For example, my employer could be talking to me and I could be looking at him and hearing at him, but my mind would unfortunately and involuntarily start to wander. I would not comprehend what he said. Also, I lose the aptitude to take on tasks that require sustained mental effort.
My Neurologist prescribes Methylphenidate 60mg four times a day. He is not willing to increase the dosage or add Concerta to supplement it.
When I was a patient in your practice, I was prescribed Methylphenidate 60mg every two hours at 7am/9am/11am/1pm/3pm/5pm/7pm/9pm/11pm. I believe the same treatment option, at this time, would greatly improve my ability to sustain full-time employment, study for the Bar Exam, and complete all other tasks requiring sustained mental effort that I continue to delay. I believe it would make an important difference in my life. It would be the difference between continuing as a dependent on my parents and becoming independent, able to fully support myself, and to have a family of my own.
I am aware I abused Methylphenidate, in the past, while under your care. I am also aware that such abuse sometimes contributed to psychiatric hospitalizations. Each psychiatric hospitalization would try to challenge your integrity because the psychiatrists at the Brunswick Hospital and South Oaks Hospital disagreed with your treatment plan. Those psychiatrists are not educated or qualified to evaluate or treat a Traumatic Brain Injury. For example, I once asked Dr. Sial of Brunswick Hospital if she knew what Diffuse Axonal Shearing Injury was. She responded “No”. I explained it to her. I advised her that Methylphenidate was an effective treatment option. She responded “addiction”. Ironically, many years prior to that time, she was the first doctor to prescribe Methylphenidate to me. I had complained of Attention Deficit problems. I was unaware they were related to my brain injury.
I am 43. I am not interested in abusing Methylphenidate at my age. Plus, the Clozapine makes me unwilling to abuse it because I am sensible and have good mental hygiene.
The point is, if you accept me back into your practice, there will be no more psychiatric hospitalizations. There will be no more failures, on my part, that would cause anyone to challenge your integrity. I would come into your practice with two years of success on Methylphenidate. For example, I achieved a 4.0 grade point average in my Paralegal Certificate program. If at all, my successes will prove your treatment is both appropriate and effective.
Submitted: 1 year ago.
Category: Neurology
Customer: replied 1 year ago.
THE FOLLOWING IS THE REMAINDER OF THE BODY OF THE LETTER:My goal is to establish full-time employment and to study for the New York Bar Exam in the evening hours. New York State requires that I re-take the Bar Exam since the Bar Exam I passed was thirteen years ago. I believe I can pass it again but I need enough Methylphenidate to last into those evening hours of studying.The law says I am entitled to work in the field I was educated or trained. I was educated and trained as a lawyer. If there is medication that would help me be able to practice as a lawyer, then according to the Supreme Court Committee on Character and Fitness, I am entitled to that medication so that I can practice law. That means if the prescription amounts help me in my goal to practice law, they are justified by administrative policy and law.I do not have the time, money or patience to search around for Neurologists who are ready, willing and able to prescribe the doses I received in the past. Most do not have the integrity or intelligence to provide an adequate defense to support the required amounts. You do. That’s why I am respectfully ***** ***** you to accept me back into your practice. However, if you accept me back into your practice, I will not tax your time or patience by creating any situations where you have to defend your prescriptions. There will be no psychiatric hospitalizations. There will be no abuse. I will be a decent patient who visits once a month.I recognize the mistakes I made in the past. I am not interested in anyone in your office either romantically or as a friend. I want only a professional relationship with your office. I will not ask for anything except medical care and professional service. I will be polite, as best I can. I will be on time to my appointments. I will patiently wait my turn on the day of my appointment and not speak with other patients, unless spoken to, and if so, will reply with something pleasant and simple.I have enclosed a check for $3,000.00. It represents payment for processing me as a returning patient to your practice. “Processing” includes anything from paying for malpractice insurance costs; any additional expense you would incur for re-accepting me as a patient, including the time and effort to process health insurance prior authorizations for prescriptions; and/or creating a new file for me.I believe the $3,000.00 represents good faith. I expect you will have to process health insurance prior authorizations. I am paying, in advance, for you to take the time and effort to do so in a manner that will result in success, including peer-to-peer conferencing, if necessary.Please accept payment and process me as a returning patient.Respectfully,Salvatore Trapani
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

No Neurologist has yet responded, however, with my experience as a Medical Director, I have several comments about the letter.

I would vastly simplify the letter, apologizing for previous behavior, asking for return to the practice, and making a brief statement that you are better from a psychiatric perspective, but instead of going into detail, asking for the Neurologist to discuss your case with your current Psychiatrist. It would be more persuasive for the Neurologist to hear of your improvement from your Psychiatrist, rather than from you.

I also would recommend that you do not enclose a check for any amount of money. It would be fine to include a statement that you would cover any expenses involved in returning to the practice in advance, but the Neurologist can let you know of the expense.

If I can provide any additional information.

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