Deciding Whether to Place Your Teenager on Psychiatric Medication

Wondering if your teenager needs medication is something that can weigh heavily on the minds of parents. Parents often wonder about medication if their teenager begins behaving differently, is struggling with being able to pay attention in school, has significant mood swings or seems to have a very low mood much of the time. Placing children on medication is a big decision and one which deserves both information gathering and a lot of thought.

Since every situation is different and there are no clear lines that dictate when a teenager should or should not be placed on medication, I cannot give specific advice about which types of behaviors warrant medication. However, I can give some guidance about how to make sure you are making an informed decision about medication.

1. Clearly outline the reasons you are thinking medication may be helpful. It is often helpful to keep a log of your child’s moods or behaviors that will help clarify what the concerns are, how long they have been occurring, how long they last each time they are present, how often they are occurring, what the response is, etc.

2. Look online to gather preliminary information. The internet is a great resource for information gathering and to begin to inform you about what your child may be experiencing, however, remember that each situation and child is different so don’t use this as your only source of information.

3. Speak with a professional. Many parents will use their teenager’s Primary Care Physician as the first professional they speak with. These individuals can be great resources for general information about what your child may be experiencing and can begin to educate you about what medications may be available if they feel they may be warranted. They may also refer you to have your child meet with a therapist (you should look for a licensed therapist who has experience working with children and teenagers) and / or a psychiatrist.

4. Therapist or Psychiatrist? Many times people are confused about these two roles. A very simple explanation is this – Therapists provide therapy or counseling and cannot prescribe medication, however, they are usually knowledgeable to some degree about medications as they relate to symptoms in general. Psychiatrists are extremely knowledgeable about medications but may not also do therapy which can be very helpful in addressing many issues with teenagers. Often times therapists and psychiatrists work as a pair to best meet the needs of individuals who may benefit from both therapy and medication.

5. Get more than one opinion. It is perfectly reasonable to get more than one opinion about the decision to have your teenager use medication. If something does not make sense, you should not hesitate to ask for clarification.

6. Make sure your teenager is informed. It is really important that your teenager understand what is taking place if you do decide to move forward with therapy and / or medication. This can be very scary for them or may make them feel “abnormal” which can result in resistance, sadness or anger. Being able to work with professionals who are sensitive to this will be critical for your teenager.

A book that I have found useful and which I have recommended to parents with whom I have worked is Straight Talk About Psychiatric Medications For Kids by Dr. Wilens. Being well informed is critical if you are in this situation so that you make the best decision you can for your teenager.

Medical Transcription Standard

MTIA (Medical Transcription Industry Association) along with AHIMA (American Health Information Management Association) recommends a standard unit of measure for medical transcription of patient medical records. It recommends the visible black character (VBC) measurement standard to be the best document counting method. What was the purpose of having such a standard?

The final goal was to implement a standard for content measurement that the health information management (HIM) practitioners can use to evaluate in-house transcription staff and external transcription service suppliers. The earlier 65-character line standard (also called as the AAMT line) had previously been a standard industry wide unit of measure for content measurement that includes space bar, shift key, bold, underscore, and other keystrokes. With this system the cost for the line/character goes beyond just labor as the cost of the technology is bundled along with domain knowledge and human resources. Thus it became mandatory to develop/choose the best possible Industry standard. The benefits of having such a standard include ease in maintaining service level agreements, better business relationships and having a better tool for evaluation.

According to The MTIA /AHIMA task force among all the different counting methods like ASCII line, the 65-character line, gross line, gross page, per minute pricing, and visible black character (VBC) measurement standards, VBC is the only counting method that can be easily understood, verified, and replicated by all parties in the medical transcription business processes.

Whenever a transcription document is reviewed for quality what are the principles that establish the quality of the documents?

  • The transcribed report should be reviewed against the actual dictation. Reading the report without listening to the dictation does not provide an accurate comparison of the transcription to the dictation.
  • The review should apply industry-specific standards as provided by current resources and references. When evaluating style, punctuation, or grammar, The AAMT Book of Style is the industry standard.
  • The review should encompass attention to risk management issues and the documentation standards of accreditation and healthcare compliance agencies.
  • Accuracy scores (ratings) should be quantified with the use of a numeric calculation that weights varying degrees of error against the length of the report. AAMT recommends the following quality goals: 100% accuracy with respect to critical errors; 98% accuracy with respect to major errors; and 98% accuracy with respect to all errors in the report, including minor errors (see below for definitions of “critical,” “major,” and “minor” errors).
  • The reviewer (or the review process) should provide timely and consistent feedback to the medical transcriptionist in order to eliminate repetition of errors.
  • All measurements, standards, and benchmarks should be disclosed to the medical transcriptionist and should be set forth in written guidelines by the healthcare provider or transcription service.
  • On-line Health Insurance Application

    Applying for your health insurance coverage on-line has gotten easier and faster. Nowadays, as everything is becoming paperless, some health insurance carriers may require on-line application. In a way, it is good for you since you don’t have to wait for an agent to come in to your home or work place and take-up anywhere from up to two hours of your valuable time. Most health insurance companies, and the agents that represent them, may have their own websites where you can directly apply on-line.

    Still, I Recommend Going Through an Independent Agent

    Here’s why:

    • If you have a question, you can just pick up the phone and call your agent or send an email to get an immediate response.
    • Most Independent Agents are available after hours to help their clients with insurance needs.
    • An Independent Agent represents more than one insurance company and will find you the best combination of price, coverage and service.
    • An Independent Agent’s website allows you to compare multiple premiums and plans from different companies, whereas the health carrier’s web site does not. This way you can pick and choose the health insurance plan you want for you and your family.

    Know Your Needs Before You Apply – An Independent Agent Can Help

    Before picking a plan, make sure you know this:

    • That the insurance premium fits your budget.
    • The cost of the monthly premium, deductible, co-insurance and the co-payment is going to be. First of all, you have to make sure the insurance premium fits your budget.
    • The deductible requirement applies each year of the health insurance policy and it should be met prior to coverage begins. Higher deductible plans usually have lower monthly premiums.
    • Co-insurance is usually a percentage (i.e. 80/20, 70/30 or 50/50) of the cost that shows how much the insurance carrier will pay for your medical bill. Co-payment is a specified dollar amount a patient is required to contribute toward the cost of covered medical services.
    • Both co-insurance and co-payments generally are applied after the patient has met any applicable plan deductible.
    • Based on your health situation you must consider what type of doctor’s office visit and prescription drug coverage you may need. Health plans are usually cheaper without that coverage.

    Once the right plan is chosen, you need to gather all of your personal and medical information; i.e. primary care physician’s name, address, phone number, your last visit, reason for last visit, any medication prescribed, name of the prescription, etc. If you cannot recall the dates, my advice is to contact your doctor’s office to obtain that information (the same should apply in case you have been hospitalized). This will expedite your application process tremendously since it usually takes two weeks to hear back from the insurance carrier once you have submitted you application. If you already have an existing policy through a different carrier, I’d advise you not to cancel it until your new policy has been approved.