I literally got my diagnosis in one day at my PCP as he went through the DSM 5 criteria and asked some questions about my childhood. It took 30 min and he was not a pill pusher. He does not ever prescribe stimulants. I tried his nonstimulant medication recommendations after feeling the need to have some intervention and they were terrible. When I asked to try a different treatment, he referred me to an in network psychiatrist and things were smooth sailing. The same was true for my two brothers who were also diagnosed as adults and one was diagnosed in another state also at his PCP.
All that being said, I think people make the jump to a psychiatrist too early when they can seek screening at a PCP first. I had to answer a few more questions for onboarding at my psychiatrist, but I never ran into any issues. I also did not have to pay for an ADHD screening because I had already been diagnosed at my PCP.
I'm in Canada, so things here are a bit different. On top of that, things differ greatly between physicians.
I went into my primary care physician, and I inquired about ADHD, because I'd done some learning, and thought I had it, but didn't want to self diagnose. I thought he'd give me a referral to a psychiatrist for diagnosis, instead he gave me a survey, which was maybe 20 questions at most, took maybe a minute to fill out. After, he looked over my answers, said something to the effect of "this seems consistent with mild ADHD, do you feel it is affecting your life?" Very yes. Then he prescribed me a relatively low dose of ADHD meds, and as soon as I got that prescription filled, my life changed for the better.
I've been on it ever since and much happier for it. Took like 3 minutes at my primary care physician.
Meanwhile, my brother went to his primary, who referred him to a psychiatrist, who did weeks of discussions and examinations before any prescription was provided for him. He also has ADHD.
Different physicians, different people, different experiences.
rolling through DSMV and calling it a day is wild, from my experience, at least with more off the cuff mental disorders a survey containing about a thousand or so questions is the bare minimum. Plus a few more rounds of that as you try to narrow down any other potential disorders it could be, because it turns out this is a really hard field to deal with.
There is definitely utility in getting a diagnosis like this, but i'd imagine most wouldn't for most things other than basic stuff like ADHD, depression, anxiety etc... There is a considerable risk of just being wrong about something, even if you roll through something like ICD10 which is markedly better than the DSMV. If you're lucky there are a few good localized options like the akhtar profiles for SzPD which can summarize the general disorder into a handful of specifics actions more so than a broad behavioral checklist.
