by Meg McDonald, Executive Director, ADD Resources* –
Why is it so tough to find a medical provider that understands Adult ADHD? This phenomenon is particularly noticeable in the Puget Sound Region and it’s evident all across the country. Where are the medical providers that are trained in diagnosing and treating Adult ADHD and the conditions that often go with it?
The medical professionals that both diagnose Adult ADHD and prescribe medications are:
- Physicians (including psychiatrists and neurologists)
- Nurse practitioners
- Physician assistants under the supervision of a physician
Other professionals able to diagnose Adult ADHD but not prescribe medications include psychologists, social workers and licensed counselors and therapists.
1. Many Adult ADHD Medical Practices Are Full
Most of the qualified medical providers for Adult ADHD who accept medical insurance have full practices. If we are fortunate enough to find a qualified medical provider who excels at diagnosing and treating adult ADHD and is accepting patients, the next hurdle is to find a practice that accepts our medical insurance (if we have it). In many cases open practices don’t and we’ll have pay in full out-of-pocket if we want help. In the years to come not only will the current adult population need care but so will our children as they transition through adolescence to adulthood.
2. Medical Providers Unexposed to Adult ADHD Shy Away
As is often the case, medical providers aren’t any different from us, shying away from areas they don’t understand. The medical treatment for Adult ADHD usually involves prescribing Schedule II controlled substances. Stimulants such as Ritalin, Concerta, Vyvance, and Adderall are often incorrectly associated with the sale of illegal drugs rather than vital treatment. Most medical providers never get the chance to see the beneficial turnaround in an individual properly treated for ADHD.
3. Available Training and Practice Guidelines for Adult ADHD Is Lacking
Adults are the most under diagnosed. The understanding of ADHA was in its infancy while we grew up. In recent years more we have come to know more about the prevalence of ADHD in adults. However, there is little or no exposure to students in medical schools to Adult ADHD. In the Puget Sound region medical students may spend part of a day with an ADHD practicing physician and that’s the extent of their exposure. Many of the practicing primary care physicians have little or no training in identifying and treating Adult ADHD today but could be a tremendous resource with training.
The American Academy of Pediatrics (AAP) has developed the Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. AAP recommends primary care clinicians evaluate any child presenting with behavioral or academic problems as well as hyperactivity, inattention, or impulsivity for ADHD. There isn’t anything similar for adults currently. It seems that pediatricians are ahead of the curve in treating ADHD.
Of Great Concern
Why is the scarcity of adult ADHD-trained medical providers cause for great concern? Adult ADHD can profoundly affect the achievement, wellbeing and social interactions of adults. Qualified medical providers are our first line of defense when we suspect we have ADHD. We both need to eliminate medical conditions that mimic ADHD from the equation and then proceed to a full ADHD evaluation and treatment. This gives us a solid foundation to begin to make the best of our gifts and address our challenges.
About the Author
*Meg McDonald is the executive director of ADD Resources. She has written or co-authored articles for a book and journals on topics such as hospices, physician extenders and medical algorithms as well as an annotated bibliography on epidemiology of breast cancer, Meg was diagnosed and properly medicated for ADHD only in the last few years. She holds certificates in Nonprofit Management and Fundraising Management from the University of Washington and received her BA cum laude from Syracuse University.