Adult ADHD Second Opinion in NYC

People ask for a second opinion on ADHD for opposite reasons. Some were diagnosed after a short online visit and are not sure it was right. Others were told they could not have ADHD because they did well in school, or that their problem was only anxiety. Some have a diagnosis they trust but a medication plan that is not working. In each case the useful thing is the same: a fresh, complete psychiatric evaluation by someone who has read the earlier records and has no stake in the first answer.

A second opinion is not a guarantee of a different conclusion. Dr. Shershow may confirm the original diagnosis, revise it, or find that something else explains the symptoms better. Any of those outcomes is useful if it rests on a full evaluation.

When a second opinion is worth it

The reason questionnaires alone are not enough is statistical as well as clinical. In the study that validated the DSM-5 version of the Adult ADHD Self-Report Scale, about one in three positive screens in the general population did not have ADHD on a full clinical interview. CDC says there is no single test to diagnose ADHD. A screen is a reason to evaluate, not a diagnosis.

ADHD is also missed. A 2020 meta-analysis found that 2.18% of adults 50 and older met ADHD criteria on research scales, while only 0.23% had a clinical diagnosis. A second opinion can correct an under-diagnosis as easily as an over-diagnosis.

What a sound adult ADHD evaluation includes

A 2024 review in American Family Physician describes the standard: a thorough clinical history, an assessment of symptoms and day-to-day function using validated instruments, and collateral information from someone who knows you, where that is possible. The method of the visit matters less than what it covered. A diagnosis made by video can be as careful as one made in an office, and New York law defines telehealth to include assessment and diagnosis.

When you read your earlier report, look for these pieces. If several are missing, that is a reasonable basis for a second look. The guide article how to tell whether an ADHD diagnosis was done properly goes through them one by one.

Dr. Shershow performs psychiatric evaluations. He does not perform neuropsychological or psychological testing. If a question can only be answered by formal testing, for example for some exam boards, he can explain that and you can arrange testing with a licensed psychologist. The difference is explained in ADHD evaluation vs neuropsychological testing.

Getting your records in New York

A second opinion is much stronger with the earlier paperwork in hand. New York gives you clear rights to it.

• Ask in writing. Under Public Health Law section 18, a provider must give you an opportunity to inspect your records within ten days of a written request.
• Copies. The provider must supply copies within a reasonable time. The NYS Department of Health considers 10 to 14 days reasonable. Federal HIPAA rules separately give a provider 30 days, in general, to act on an access request.
• Cost. Paper copies may cost no more than 75 cents a page, plus postage, and you cannot be denied access solely because you cannot pay.
• Disagreeing with the record. You may add a brief written statement challenging the accuracy of factual information, and it must travel with the record when released.
• If access is denied. You can file a written appeal with the NYS Department of Health. Its Medical Records Access Review Committee reviews the records and issues a written decision, generally within 90 days.
• Old records. Physicians must keep records for at least six years after the last visit, so records from a clinician you saw long ago may be gone.

Ask for the initial evaluation, any rating scales or testing reports, the medication history and recent progress notes. Bring prescription bottles or a pharmacy printout as well. The step-by-step version is in switching ADHD psychiatrists in New York.

If you are already taking ADHD medication

A second opinion does not have to mean changing prescribers. Many people keep their current prescriber while a second clinician reviews the diagnosis and plan. It helps to be clear with both about who is prescribing, because New York prescribers must review your controlled substance history in the Prescription Monitoring Program registry within 24 hours before prescribing, and every fill appears there.

If you decide to move your care, time it carefully. Schedule II stimulant prescriptions cannot be refilled in New York, and a prescriber may not issue the next one until all but a seven-day supply of the previous prescription has been used. Book the new evaluation before your supply runs low, and do not ask two prescribers for overlapping prescriptions.

What to bring and what to ask

1. Earlier evaluation reports, rating scales and any testing.
2. A list of every ADHD medication tried, roughly how long, and why it was stopped.
3. Old report cards or teacher comments, if you can find them.
4. A short list of your own questions: what doubts you have about the first diagnosis, and what you need from the visit.

Ask the office how the first visit is arranged, the current fees and how insurance works with the practice. The new patients page and adult ADHD evaluation page explain the rest of the process.