Been browsing some pages on social media and websites the link patients to doctors out of curiosity. By curiosity, I mean, as an end recipient of care, I wanted to know the point of view of someone seeking care.
Disclaimer:
These are my opinions and conclusions. They're not meant to be taken as medical advice. You formulate your own.
I've seen psychiatrist put in a substantial amount per consult especially initial consults. Unlike a regular medical consult that can last less than 15 minutes, an initial psychiatric consult usually goes around an hour per client. It's not just symptoms being asked but some background info about the person they wouldn't usually think of disclosing to regular consults.
It's more work than I make it sound here. But before I go into tangent, I've noted how some doctors get ratings that are almost perfect while others get neutral ones. (Negative ratings get filtered out by the algorithm so I wouldn't see names readily.)
Not only in psychiatry but in general, healthcare evolved since capitalism influenced parts of the system like decisions about care and how one has to run in with insurances. There's a shift or shove to improve healthcare in a way that it becomes customer service comes first before actual healthcare that matters.
In my practice, I've lost count how many times I had to refuse catering to some patients that insist on doing things not advisable by any self respecting physician. I usually get negative reviews from patients that suffer from substance use disorders, or patients that have been prescribed chronically by regulated medications (that have addictive properties) for a long time that they have already exceeded their intended use but patients couldn't get off it.
I try to help get the patients to taper or flat out refuse enabling their medication addiction and despite having the insight to know it's bad for them, they would still insist because they've been on this stuff for years now. It's like talking to a wall sometimes.
So I can get complaints and the hospital customer service section reads the complaints and take the patient's side (not all the time, just requires clarification but by default, it's likely the doctor's fault). If it's not substance, there's also Borderline Personality Disorders, Narcissistic Personality Disorders, and Psychotic patients.
See, if you're really out to do what is right for your patient, you have to deliver the right refusals for their own sake. This means not tolerating or enabling what's bad for them and you're going to be the bad guy. And doctors that do well in practice, get popular, tend to attract all sorts of attention include bad patients.
So if the ratings are too perfect or you hear no patient complaint, either they're really good and the public relations or are doing something they shouldn't, like saying yes to what a problematic patient wants despite the consequences being against the patient's interest. I'm exercising doubt on things that are too good to be true.
In the real world, I get patients who are clinically depressed and suicidal, but despite how much appraisal or intellectual insight they have, they'd still refuse medications. I respect their autonomy and wouldn't push the issue but it grinds my gears sometimes to hear they complain the same thing over and over every visit. Or sometimes, the same patient with addiction problems just wants the prescription to ease discomfort for their substance but will likely come back using the substance again after they felt better.
You can do the right thing and still get haters. Because if you constantly get praised to avoid haters, there's a good chance you may resort to doing stuff you shouldn't in practice.
Just my thought about perfect ratings. I'm not saying it's an absolute rule, just give people benefit of the doubt first.
Thanks for your time.
