Dilemma of Differential Diagnosis

I am a Licensed Professional Counselor in the state of Texas who is in private practice and also works with a large college. I also have an adult family member who has ADHD. I have specialized in the field of ADHD for 20+ years, but here is my concern:  I diligently try to find physicians who will spend at least an hour on the initial visit with the patients that I refer so that they have the opportunity to do a thorough differential diagnosis to determine a) if a psychiatrict "disorder" is indeed present, and b) if something is present, to carefully sift through all obtainable information to determine what it is and what it is not. I advise my clients that there are a number of other issues that can also exhibit many of the same symptoms -- anxiety, depression, bipolar, etc.  and that it is of paramount importance to go to a psychiatrist who is experienced in attention-related issues. But here is the dilemma:  due to insurance constraints, it is almost impossible to find a doctor who will spend that amount of time with a patient, even on the initial exam. Most doctors in this area seem to be utilizing Nurse Practitioners. The physician may very briefly meet the patient on the first visit and will "sign off" on the diagnosis, but the NP is the individual that patients see, who they follow-up with in future visits, and is the individual who prescribes or adjusts dosages of medications. Although I respect NPs, I am very uncomfortable with this practice and understand the vital importance of careful evaluation in diagnosis and treatment. The cost of paying cash for the visits is prohibitive for most of the individuals I see, and even though I make a conscious effort to locate psychiatrists who I believe to be experienced in the area of ADHD, I find myself increasingly uncomfortable with referring. Suggestions? Thank you, Anita Peters, LPC