Medications are best managed in an appointment where effectiveness can be assessed and possible side effects can be monitored. We aim to provide enough medication to last until time for the next follow-up appointment. If medications are running low, you may need to contact our office and schedule an appointment with Dr. Portteus.
Please allow 2-3 full business days (48 to 72 hours) for medication refills to be processed. Medication refills are made at the discretion of the doctor and will not be authorized if an appointment is past due. All refill requests are managed at the main office on Monday, Wednesday, Thursday and Friday afternoons. Refills are not processed on Tuesdays when the office is closed.
Patients who need medication refills before time for their next appointment may request a refill in the following ways:
have the pharmacy fax a refill request to 214-696-3161
For refill requests, please include the following information:
patient's name
patient's date of birth
medication requested
dose of medication
preference for pick-up, mailing, or pharmacy call/fax with phone number
ADHD Medication Refills:
Stimulant medications for ADHD are controlled substances and refills can not be called into a pharmacy. A paper prescription form must be submitted to the pharmacy for ADHD stimulant medications to be filled.
In keeping with recommendations from the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics, patients taking stimulants who are stable on their medications are typically seen at 4 month intervals. (Patinets who are stable on their medication and are not recommended for additional follow-up are able to pick up three monthly refill prescriptions from the office before needing to be seen again by the doctor.) Follow-up appointments may be more frequent if new medication is being evaluated, specific symptoms are being monitored, or factors impacting school/work performance, behavior, or mood are being addressed. (Dr. Portteus wants to ensure that the medications are working optimally, and that potential adverse effects such as decreased appetite and weight loss, increased pulse or blood pressure, mood problems such as depression or irritability, sleep disruption, or unwanted changes in personality or activity level are appropriately monitored.)
All medication changes and dose adjustments are made during scheduled office visits.
Refills for controlled stimulants are not provided if patients have not been seen in 6 months or more.
Before a follow-up appointment for ADHD, it can be helpful for a child's teacher(s) to complete the Vanderbilt teacher rating scale. Teacher's may return the completed form to a parent of fax it to Dr. Portteus at 214-696-3161.
Appointment Cancellation Policy:
To cancel or reschedule an appointment, it is necessary to call the office one full business day (24 hours prior to the appointment) to avoid unnecessary charges. To change a Monday appointment, it is necessary to call on the Friday before the appointment, prior to the appointment time. Missed appointments and late cancellations are billed at the regular appointment rate.
As a courtesy to our patients, we try to provide appointment reminder calls when possible. However, we are not able to guarantee this service. Patients are responsible for recording and keeping scheduled appointments.
Phone Calls and Emergencies:
The telephone number (214) 550-3367 is answered in person or by voicemail. Your calls are very important to us, and every effort will be made to return phone calls in a timely manner. Due to appointment schedules, messages left during business hours may not be returned until the following business day. Messages are not obtained outside of regular office hours. Messages are not obtained on Tuesdays when the office is closed. Weekend calls are generally returned the following Monday. Messages are generally returned in the afternoons; please provide us with a number where you can be reached between 1:00 pm and 5:00 pm.
In a psychiatric emergency you may wish to call 911 or go to the nearest psychiatric hospital or emergency room for evaluation and treatment. You should also contact your primary care physician if you or your child has a medication reaction that requires immediate attention.
Office closings for inclement weather, vacations, holidays are posted on the home page of the website.
Release of Records and Completion of Forms:
Records may be released by providing a signed written request. Please provide a name and fax number of the provider to whom records should be sent. Allow a minimum of one week for all requests to be processed. A $25 administration fee is charged. Additional copy charges may apply if a paper copy of records is requested.
Letters to providers, completions of forms, and accommodation letters for schools require a minimum of 1 week to process and are handled on a first-come first-served basis. Additional time for transcription services may be needed. A $25 fee is charged for preparation of letters, forms, and reports.
Payment for services:
Dr. Portteus accepts payment by cash, check, debit card, Visa, Mastercard, Discover Card, or American Express at the time of service. Dr. Portteus is an out-of-network provider with most insurance companies. Patients who see Dr. Portteus are expected to pay the physician at the time of service. Families will be given a statement that they may submit to their insurance plan for reimbursement. Dr. Portteus does not directly accept insurance payments or process insurance claims.
Risks and Benefits of Treatment:
Taking psychiatric medication(s) can have both benefits and risks. Medication(s) have been shown to provide significant reductions in feelings of distress and improvements in behavior for certain conditions. Of course, there are no guarantees as to what your experience will be, and a medication may not by itself resolve a problem or concern. There may be possible problems (side effects) associated with taking certain medication. Many psychiatric medications are used “off label” and do not have FDA indication for use in children, although they may have clinical research studies and expert recommendation to support their use. Also certain medications have safety warnings for use in children. (Antidepressant medications and Strattera have been associated with suicidal thoughts in rare instances; increased pulse and blood pressure may result from stimulant use; clonidine/Kapvay and guanfacine/Intuniv may be associated with decreases in blood pressure; atypical antipsychotics may rarely cause an allergic-like reaction including increased temperature, blood pressure changes, and involuntary movements.) You are encouraged to discuss your child’s medication with Dr. Portteus and with your pharmacist and primary care physician. Routine follow-up appointments are recommended. There may be risks associated with not taking a medication that has been shown to help with certain problems. Some forms of mental illness, if left untreated, may progress to more severe and treatment resistance illness and brain changes including decreases in memory. Some untreated conditions may cause distress, interfere with learning and productivity, compromise development of positive relationships, increase risks of substance abuse and suicide. Families should evaluate the risks and benefits of treating and not treating a problem before determining a course of action. All patients receiving psychiatric treatment should also have routine medical care with a primary care physician and should keep this physician informed of all medications they are taking.
Confidentiality:
Confidentiality will be maintained in accordance with the Health Insurance Portability and Accountability Act (HIPAA), the laws of the state of Texas, and the ethical standards of the American Academy of Child and Adolescent Psychiatry. Our office places the utmost premium on maintaining the privacy of your records and limiting access to confidential information.
You may authorize that information be released (to another physician, therapist, school) by submitting your request in writing. You may revoke your permission to release the information in writing at any time. Information will not be released without your authorization.
You may review or get a copy of the information in your medical records or obtain a summary of the health information contained in your records by written request. There may be reasons that this is not advised, and your physician can review this with you.
Within the scope of medical care, there are limits to confidentiality which include the following instances: where the health or safety of a patient is at risk; where abuse or neglect is suspected; where a patient poses an imminent risk to the safety of others; where records are subpoenaed by a court; where families request in writing that information be supplied to insurance companies or other agencies and providers.
There may be information that a child or adolescent shares privately with Dr. Portteus that he/she is not yet ready to share with a family member. In these instances Dr. Portteus tries to honor the child’s wishes and will make a determination about the course of action that best promotes the child’s heath and welfare. In the event that a minor discloses a plan to harm self or others, Dr. Portteus will not maintain confidentiality, but work with the minor to inform his/her parent or legal guardian.
Child Psychiatrist, Adolescent Psychiatrist, and Adult Psychiatrist
Serving Dallas, the Park Cities, and surrounding areas
Diagnosis and Treatment of ADD & ADHD, Depression, Anxiety, OCD, Panic Disorder, Bipolar Disorder, Eating Disorders, PDD, Asperger's, Autism, Family Conflict, and Phase of Life Problems
