Sunday, June 10, 2012

Take a Survey on Social Media and Doctor Dissatisfaction

I've written about a number of scenarios where doctors are negatively reviewed on-line, both on rating sites where the doctor knows the identity of the reviewer, and where the reviewer is anonymous.  Recently, we've been hearing about a number of scenarios where doctors get edgy after reading about themselves on line-- on blogs, listservs, rating sites.  I'm planning to write a blog post about my thoughts about these scenarios, but first, I wanted to takes some votes and get reader opinions.  By all means, feel free to add your thoughts in the comment section.


Sunny CA said...

These are very difficult issues, and I think what a doctor does may depend on how hurt the doctor feels. If I feel negatively about a doctor, I do not post about it online; I just leave the doctor and don't come back. I don't know why a patient would post negative comments and want to come back. it makes not sense to have the doctor have to ask the patient to leave.

Anonymous said...

I think they only time you can/should say anything if is a out and out lie to what they are saying, probably no change will please them. If a otherwise good relationship then discuss.About the blog, um how to bring it up?? lol you find a way then yeah bring it up. If you are offended and relationship damaged then refer out. Other wise maybe talk about it honestly and see if they are agreeable to changing it
That does suck tho. that is why i don't believe half the stuff people but on reviews esp. if it is an obvious bias. I only bother if I feel I had exception treatment. lol
I think most people can read between the lines and see an obvious slander job.

Anonymous said...

Well this seems to be two different issues. One, does a dr have a right to ask a patient to remove a negative review or do the dr/patient have a right to read the others social media personas or blogs.

I was only able to vote for one of the questions in the survey as I didn't feel the other questions gave me an option to vote for.

For example, I would say that a dr and patient should ask the other if it is alright to look them up on facebook or read a blog. A person has every right to blog about something if they are not referring to someone specific. (Although that creepy blog out there about the psychiatrist who blogs about his vchat patients, I'm not sure about that, although I am theoretically ok with it).

I don't rate anything for the most part (except for Amazon and Netflix because I want better recommendations), but I recently had a GP dr treat me very poorly because of my psych problems. She made disparaging remarks about the meds I was on and discounted my health concerns as anxiety issues. I thought about going online to leave a review because I think it's important for other potential patients to know that this dr has a problem treating patients with psych disorders. I went to her because a friend recommended her as being a straight-shooter (which she was). My psychiatrist had to call her to even get her to run a few rudimentary tests.

Anyway, I ask you as a dr, is that valid feedback to put online? And what would happen if she worked to have it pulled?

Anonymous said...

No idea what googling and fbooking a doc or a patient has to do with negative reviews.Agree that if I post a neg review, I have no plan to ever see that doc again. If what I write happened, it is not slander and docs get to write negative reviews about patients. Those would be our medical records, which thanks to EHRs, are not private. A doc can discharge a patient for all kinds of reasons. What does a teacher do when kids write negative reviews? Assign detention, insist the principal kick the kid out of school?What about the new resto down the road? Got a lousy review. Business will suffer.That is life. Actors and writers get lousy reviews. Profs and politicians get lousy reviews. Develop a thick skin and deal with the reviews that are libelous or slanderous. Otherwise, don't spend so much time reading about yourself. Some docs trash talk patients and breach confidentiality. Some docs need to be called out. Anyone with a public profile is asking for attention. It is like refusing to close the door to the toilet stall and being offended that someone saw you peeing. Ridiculous.

Anonymous said...

I hate to say it, but in this case I think there is a distinction between a mental health provider and a physician (yes, I am know psychiatrists are physicians, too).

Also, the internet is public. If either patient or doctor (any kind) is dumb enough to leave their blog or facebook page not under privacy controls, then the page/blog is open. That said, if a psychiatrist is aware it's te patients blog, then seriously? they shouldn't be reading it.

Ratings are a completely different ball game. You, Dinah, hold that the public does not have the right to comment on a physician, even if they are lousy and terrible. I, a patient, disagree 100%. We will never agree on this, because you are a doctor, and I am a patient.

Dinah said...

SunnyCA: I's perplexing that patients would post negative comments (non-anonymously) about a doctor they wish to either remain in treatment with or with whom their family member remains in treatment with, but these stories do seem to be coming up.

Anon 1: I'm not sure if it's always a matter of wanting it changed (especially in a case where the doctor reads what's been written on a blog without the doc's name being used) may just be that the doctor is distraught to find out how displeased the patient is.

Anon 2: Yes, different issues. I certainly believe a doctor has a "right" to ask someone to remove a review. I also believe that if you put something on the internet, it's public and that you should not put anything on the internet with an expectation of privacy.

Anon 3: Much changes in life over time, when I decided to go to medical school, there was no internet and I had no idea that I would not be permitted to ask a website to not publish my age, address, and show maps to guide the general public to my office, or that I could be anonymously critiqued for easy public view. It's not quite the same as leaving the door open, some rules change and others don't (people did pee in bathrooms back then) and while I'll go with the flow and even embrace new media, many docs didn't join knowing this was part of the deal.

Anon 4: Oh, I'm not sure how I feel about Dr. Reviews by people who are actually patients. Most doctors are also patients. My gripe with my "one star review" was that the information simply wasn't accurate, it was vindictive, and not likely to be posted by a patient as they rated my staff (I have no staff) and said the average wait was over 45 minutes (it's never over 10), and that my office is not clean or comfortable, and it is cleaned daily and it's reasonably comfortable (I'm in it all day). Valid reviews by real patients? I think I'm okay with that, but I think the ratings should include things like whether the doctor helped the patient, referred/consulted appropriately. I think the narratives are more useful than rating by stars.

But I don't think that it's right to negatively review a doctor you plan to continue seeing--I think you should a)discuss the issue with the doc Of b) talk with your feet before posting a negative review. We believe that doctors are unduly influenced by receiving a pen or a chicken salad sandwich from a drug rep. Why don't we think that the quality of care might be influenced by knowing that the patient or his family member thinks the doctor is incompetent/insensitive/mean/ugly/disrespectful

If someone puts up a blog for anyone to see, why would they assume their psychiatrist wouldn't read it, unless they specifically told the psychiatrist not to?

Anonymous said...

A site that lists your name, school you went to, date you graduated and practice address is hardly the same as a public facebook profile. You keep going back to the one fake review you got. It's time to get over it for your own sake. Tbh, medical schools are full even though these sites exist and I doubt had you known about them way back that you would have chosen to become a hairdresser instead.

Dinah said...

Anon: I'm over it. The issue of internet behavior between doctors and patients keeps coming up, either in conversations we've had with regard to our APA presentations on social media, emails we've gotten about these topics, and last month Glen Gabbard had an article in the American Journal of Psychiatry called Challenges in the Internet Era.

Sarebear said...

I have an interesting (to me) story about my psychologist and my blog. It has nothing to do with blogging about him, though.

Dinah, I can see where you are coming from but I soooo habe to fight the urge to negatively review my psychiatist online; I recently went back to her after almost a year. To be be prescribed the Lamictal which always (three times counting now) always gives me a rash, not the sunburny one, but still about which I found out on my own could still lead to organ failure and death. She'd never told me that.

On the other hand, having done some stupid stuff while off meds, this spring, and how I almost killed myself; my lability was high, an exhausting range of emotions going all over the place pretty quickly like a tv rapidly running thru it's dial of channels . . I was more suicidal than my previous attempt. I shoulda been in the hospital. Anyway, based ib that experience I'd put the chance of my death if I don't go on meds at 70%. So, the Lamictal risk is probably lower, and that's probably why I'm guessing that she forged ahead with it, sandpapery, non sunburny rash notwithstanding.

God may not play dice w/the universe, but it feels like someone's playing dice with my life. Still, it should be a dr. doing this, not a psych nurse . . . which is why she is currently my only option.

And yet I don't like her; he tries to crowbar her own value and belief system down my throat; last time whn she insisted that working on my marriage was selfish, that working on self, and family, and providing a happy(ier) home for my daughter ws selfish, that I needed to look outwards and spend enrgy out into the universe, and serve others . . . I wanted to barf.

There are so many things wrong with that on so many levels. Esp. if she believes in karma, which being buddhist, I believe she does. Such a hyppocrite, since shoving your beliefs down someone's throat does'nt seem to me like would brng good karma, only bad . . .

Anyway. I soo so so want to leave a negative review. But, I'm not sure I could be objective and keep it to the facts; I'd give he office staff a 1 out of five if I was objective, I'm tempted to say 0 though. That's mean.

Stupid keyboard, /fix one and the other starts to go . .

I think there'd be a service provided in warning other prospective patients about her, but doing it in a way I could live with myself, and be pretty sure I wasn't just slamming her to slam her, has kept me from it, so far.

My situation is a bit unusual, to say the least. Trusting a doc to walk this knife's edge of which is more deadly, medicating her with a rash on Lamictal, or not medicating her, when you don't trust her non-medicinal advise, is jarring. She's always seemed to have my best interests in mind, medication-wise; everything else, no. And of course she never warned me what the consequences of a rash on Lamictal might be that don't seem to be having immediate consequences. From what I've read, having such a rash with no other consequences doesn't mean they might not happen, and in fact puts you at greater risk of such things than those who don't get any rashes.

I'm wondering if the reason she didn't tell me was cause she thought I might not take it if she told me, OR it could be that she's treating me like a kid; this is the one area where my dubious opinion of the application of her non-medicinal psychiatric skills comes into clash with my opinion of her medicinal psychiatric skills.

Sarebear said...

Oh. What do you do if you google your therapist every couple years, and you just did, and he has a fairly distinctive name, and you see a sex offende with his name, except it's so and so the second, and he's the right age to be his son, AND you find an obit for his ex-wife (you know he's divorced) AND she's in a profession and locations that would have explained their meeting, and getting married (cause you know something about his past that was revealed in a therapeutic story he told) AND it gives his full, distinctive name as him being the former husband she's survived by, right before listing the kids they had together . . and the first kid is so and so the second. Daddy jr.

AND it lists one of the schools that's close to this sex offender, AS MY DAUGHTER's SCHOOL.

What do you do?

It's not like you just ask your therapist, is your son a sex offender?

Think about it and the ramifications for a minute.

I do not know how to bring it up. Not justifying the offender, but it looks like the mildest offense on the books. Just saying, I'm not worried about a rapist. The count was from 8 years ago or so, and no others.

This is a rather thorny issue that I discovered a few days ago.

WHY do these weird coincidences seem to happen to me? Like, what are the odds my psychologist would have been the school psychologist at the jr. high I came to when I moved to UT at age 15, was being hit by my mom, and only had the last 6 weeks of 9th grade there. Who cares about the odds, this happened. I wish I'd known there even was a school psychologist then cause I mighta told him about the abuse. Mighta not tho. It's just werid in a twilight-zone kinda way.

Weird coincidences.

Trébuchet said...

Google each other, but any more than that is stalking. If you find something disturbing, find another doctor/patient.

I had a doc who, when I met him, mentioned that he saw my kids in the paper several times. He asked about their activities, seemed to know as much as a family member, and went on to ask personal questions about our family.

~It was plausible that my kids just stood out to the general reader (LOL, —not), but it made me uncomfortable and I 'jokingly' asked if he'd stalked me. (He backed off afterwards, at least to my face.) Yes, he stalks; no, I don't return the favor (DGAF about his family life); I don't think he means any harm, but it's creepy. (And he knows I think it's creepy.)

Generally I think you can leave whatever review you want after a cool-off period. I read reviews, but generally give a doctor a clean slate. The important thing is, if a bad review is undeserved, I'll make a point to leave a positive review. If a bad review is deserved, do everyone a service and say so. (Look at Amazon: a lot of people do that.)

I use TripAdvisor for travel reviews (it's a GOD SEND!); I like how it's somewhat anonymous, but the reviewed party can respond directly (online and in blind email), and offer to make changes, thank you, etc. TripAdvisor has good system, and I pay more attention to good review systems than I do to sites like HealthGrades.

Jane said...

"I think you should a)discuss the issue with the doc Of b) talk with your feet before posting a negative review."

Dinah, at one point I would have agreed with you, but it's just not worth it. I only tried to work it out once with a doctor, and he immediately became defensive. And this wasn't even about him specifically. It was about his front desk service. He even asked me why I came back, and why didn't I just get another doctor. No offers to refer to someone else. He just became angry doc. And lets face it, most docs won't talk to you unless it's during an appointment you paid for, so if you pay for the appointment and he gets pissed and won't work it just wasted a copay. And I really think he was shocked when I walked out of there. I think he maybe thought I had lower self esteem than I actually have, and he thought I would back down. But I didn't. I left and wrote a negative review of him on the internet and got a new doc.

Writing a negative review can be good, because it warns other patients. And that was the only reason I wrote mine. I don't feel obligated to try to work things out with doctors. I think that's too much time and money that will probably be wasted. People don't feel bad anymore in my experience. They're pretty shameless, and I think a lot of docs don't want to apologize for anything

Anonymous said...

Bizarre. Wouldn't know how to proceed on those topics. I'm not that type of patient and my Doctors are not the type that would engage in any of this kind of behavior. Not even the psychotherapist. Who knows. In general, it looks like I have chosen Doctors over the years that are quite private.

Anonymous said...

I agree there is a difference between commenting as a patient if the patient is continuing to see the doctor. To me, the negative comment is implicit that the patient is not returning.

That said, I have to agree with the other poster. Time to get over the vicious vindictive malicious etc post on your name, Dinah. You've had it removed, enough already, stop using that as an example of why perfectly valid patient reports should not be permitted. It was likely some shrink rap reader annoyed at your point of view.

Anonymous said...

Jane also makes an excellent point - why should I waste my time and money to "work it out" with a doctor who has behaved in such a way that s/he has not earned my respect or trust? Dinah's getting paid anyway ,but try thinking of it from the patient view.

Sarebear said...

My psychologist was professional, even more than, going above and beyond but not inappropriately . . . He invited me to ask questions about it, and he answered them, and when I was done he invited me to ask any other questions I may have had. I didn't, so I didn't, but just him asking that finished things off for me . . .

I don't know if he explained things (not to justify, or anything) because the guy is in my vicinity, or because I mentioned that it's a wierd feeling wondering if someone is protecting a predator . . . or both.

I did tell him in a couple different ways, not overdone though, that I imagined it would be an uncomfortble thing to talk about.

I know what it's like, for my part, to have a sex offender in the family. My uncle is on the severe end of the spectrum . . .

Not that I'm confirming or denying if the guy was related to him.

Maggie said...

Are a lot of people leaving negative reviews for doctors while continuing to see those doctors? I've thought about leaving comments about a particularly horrible doctor I had the misfortune of seeing right after I moved down here, but that was after one really horrendous appointment, and actually seeing this doctor at that point was not any sort of option. There's certainly a shortage of doctors around here, but if I disliked one enough to write a bad review, I can't imagine still seeing them. I'm not sure how that would even happen. (I rarely write neutral reviews. Like Anon#2 said, maybe for things where ratings determine recommendations, but other than that neutral reviews seem pointless.)

As for blogs, if it's a public and identifiable blog, what's the problem? Privacy issues seem irrelevant for anything published for the world to see. It would get more complicated if it was intended to be anonymous, but even so.. if it's published publicly, anybody can read it. Trying to dictate who can read it seems a bit like trying to dictate who can look at a billboard.

Anonymous said...

Just goes to show that the docs are usually more screwed up than the patients.Sad, but true. My partner gets publicly dissed.No fun, but it goes with the territory.Go home, have a glass of wine and chill.

Sarebear said...

I believe there can be benefit to trying to work on issues with your doctor. At least as far as checking out how he feels/would react to learning your thoughts and feelings about what your upset or whatever about.

Some docs could just have had a bad day; others could just plain be all around jerks, and if you've had enough repeated bad experiences with em then maybe you don't want to check it out, but I think it can be beneficial in alot of cases.

Now, after checking out the thoughts/feelings/assumptions, if I didn't like the doctor's response/reaction I might not go farther (depending on how much choice I have on seeing them or not).

For mental health providers, though, especially for my therapist, trying to work through the problem(s) is beneficial for ME. Now, when I felt my relationship with my therapist was broken, if I had been upset or unhappy about his reactions to my trying to work on it with him, I would have talked about those, and if it continued on with me not being happy, I'd have left.

BUT, it didn't work out that way for me, and I've learned some things from working through that with him.

Will things be like that with everybody? no. Will many people want to invest so much time, energy, and $$ into it? Probably not.

So, whatever works for you. Now, though, I have an eye towards checking things out (except with my psychiatrist; I tried to work on our relationship by telling her I was afraid of her and she got offended and yelled at me; others may not get this, but I do not have any other option right now, not if I want to stay on meds. I do not have another option).

Some may argue w/that no option thing, but the situation is complicated, and I'm the one in it, knowing all the factors.

Anyway. There's MHO, for what it's worth or not.

Me, I'vekinda been in a wonder state since posting what happened w/my therapist, in a state of wonder that I'm worth such kindness and consideration . . . he always has been, but this is just about the kindest, most considerate thing anyone ever did (who isn't my husband. Lol.)

I don't feel as though I'm worth it, or deserving of it.

Simple Citizen said...

As far as "googling" patients or doctors - public is public.
In psychiatry the amount of insight you can gain about a patient because of their blog, myspace page, facebook account, etc... is invaluable.
I would always tell the patient what I found and I certainly wouldn't ever hide the fact that I looked.
Public is Public.

Elizabeth said...

For your survey - I think having an option for trying to resolve the issue and giving the patient the option of continuing to see the doctor or being referred to someone else would be good.

As for the issue in general - I have found simple, "If you are OK with X, this is an option" or "We can try this, what do you think?" to be effective in having a working relationship with my current and previous psychiatrists. A lot of doctor/patient issues stem from the patient feeling like they have no power and the doctor isn't listening. Sometimes this is the case, and sometimes it isn't but it feels like it due to miscommunication and a doctor not knowing how to deal with the time crunch that is managed care approved med reviews.

It sucks, but it's on the provider to keep relationships in check and to have control of their emotions when dealing with these relationships. I think patients/clients feel like they're overstepping their boundaries by talking to the doctor, or are just plain jaded. I've asked clients for feedback at the end of groups and individual sessions in a non-threatening manner. The folks were honest and sincere about wanting to work with me, and asking ended up being helpful in that I was able to improve how I presented information and responding to their concerns. It took less than five minutes, and it prevented a lot of resentment.

I've managed to bring up problems I've had with my last psychiatrist and my current therapist when I wasn't able to address concerns with my last therapist due to transference stuff. I didn't agree with a decision my last psychiatrist wanted to make for me, and I politely told him so. His position was legitimate, but it was related to a different school of thought than what I subscribed to (kindling vs. not - I tend to lean towards kindling based on watching my grandmother over the years, who has continued to experience more frequent episodes even with medication). I wanted a stronger moodstabilizer, and he didn't think it was necessary. Because I didn't agree and had addressed it in a polite manner, I chose a different doctor based on the recommendation of my therapist and I am quite happy with this person.

In regards to bogus reviews - it is what it is. Having a venue for reviewing a doctor in itself isn't bad, but it sucks that it's easy for someone to troll medical review sites. Asking a site to remove something is really all you can do.

Social media and Internet searches - I've only done a general Internet search on a client because I wanted some context on how a felony was reported in the media and how it affected this person emotionally. That was an exception to my rule of not Googling clients. I want to stay out of their personal lives. If they Google me, that's their choice. I have a few public things that are business-related, and I don't mind if those are viewed obviously. I know some folks invite their therapists to view their facebook pages. Some therapists find it helpful, and some want to stay away from it because they feel it's a boundary violation. I guess it's a gray area - facebook info isn't necessary all that different from what you'd disclose (family, friends, drinking escapades), but a client needs private space.

I've done quick Google searches on psychiatrists mainly to see if they've had any violations and what they specialize in. I did a more involved search once because I had heard from a coworker (mental health is a small world) that this person had written an interesting journal article. The person was brilliant in the opinions of a lot of folks in my area, so I wanted to read it out of interest in his work. It was fascinating! Internet searching for doctors isn't all bad.

Anonymous said...

I would find it creepy if my psychiatrist was searching for me on the internet. I would wonder if he or she needed to find some hobbies.

Anonymous said...

I'm fairly new to therapy, but have some definite strong feelings on this topic. I admittedly Googled my therapist, a lot, for the first several months. She is impossible to discover anything about, but still, I tried. Why? I've never taken the painful risk to trust someone so much before in my life. The process of revealing yourself to someone is so difficult, that I felt compelled to do what I could to learn more about this person, to determine if they could in anyway relate to me. Is it possible that they could share my same values, some of my same stories, my horrors and my happinesses? I really needed to know. As our bond started to get stronger and I grew more comfortable in therapy, that subsided. I'm occasionally curious about this person, but I am certain that the less I know the better. As long as I feel safe, understood and supported in the room, everything else is really a distraction. It makes therapy about THEM when it needs to be about me. I don't want to know. Getting involved in my therapists life (whether it's talking about it in therapy or stalking them online) will only take the focus off me, and that's not helpful. Not to say I don't in some ways genuinely care about this person, I feel like I owe her my life sometimes, but the relationship isn't confusing - she's there for me, and that's the end.

It came up in therapy once, about me being somewhat public, and my therapist made it clear that she would not look me up online. I didn't know how to take that at first, but after some thought, I am really glad for this. I seem pretty awesome, online, and that's a side of me, but not the whole story. I'm a human flailing in the waves of the deep ocean like anyone else. There shouldn't be any information about me that enters the room other than what I bring with me. That's the real stuff to be discovered. I suppose I'd especially feel that way if there were a lot of negative things online about me. Or if I used Facebook or a blog to put out a front of some kind, as I think many people do. I would want to leave that at the door in therapy, to be totally real when on the couch. Just my two cents. LOVE this topic.

Dinah said...

Maggie: I totally agree with you.

Sarebear: Your psychologist sounds like he's been through an awful lot.

Last anon: What an articulate account of your curiosity about your therapist. I liked it a lot.

I'm also left with If you put it on the internet, you expect and want the public to read it, and so why wouldn't your psychiatrist?
--I don't believe most psychiatrists are Googling their patients (creepy, other things to do), and if you're touchy about such stuff, you'd presumably have an anonymous blog. So your psychiatrist knows about it because a) you're famous
b) he did google you and your blog is under your name
c) you told him you had a blog and he assumes you told him because you wanted him to read it (why else would you tell him?) so if you wanted to talk about things happening on your blog and didn't want him to read it, maybe it would be reasonable to say "I have a blog and please don't read it."

I tell people I have a blog because I want people to read it. I don't tell my patients I have a blog, because I don't want to burden them with all of this information, but I do assume that my patients might read Shrink Rap and I always blog with them over my shoulder.

NeoNurseChic said...
This comment has been removed by the author.
Carrie said...

When I had a blog, I blasted my neurologist on it once (maybe more?) without ever naming him. Of course, if you read my blog, you could have probably narrowed it down to one of a handful of neurologists, but I didn't think it right to name names. For me, it was venting - I still see him even though he has infuriated me from time to time over the years. We seem to get along better these days than we used to.

I did go into one appointment after a slew of bad things had happened that were entirely preventable, and I was angry about him not being more attentive or listening to me when I said I was having cardiac side effects to a med he prescribed. He answered me with, "Perhaps you are too angry to continue your treatment here." That actually may have been the incident I blogged about. Instead of owning up to the fact that he'd made a mistake, he turned it on me as the angry patient. I got avascular necrosis after he prescribed steroid course after steroid course, and when I found out that was the reason for the AVN, I never once got angry with him or accused him of anything. But when things go wrong, I think it's not unreasonable to expect some sort of, "I'm sorry this happened to you" reaction.

Long story, but the bottom line is that I did blog about some of the negative experiences I've had with him, and I'm not sorry I did. I probably wouldn't have felt the need to if he had been a bit more personable when things went wrong. Things happen, and I know that (as I'm a nurse practitioner...), but it never hurts to show a bit of empathy...and even a little remorse from time to time. If you're open to listening to the issues a patient has, you're less likely to read their rant online, which is often borne out of unaddressed or dismissed frustrations.

In terms of these online reviews - first of all, when I google a physician and those results come up, I keep on scanning until I find something legit. I don't even read those. It's like Press Ganey - people are far more likely to speak up about a negative experience than a positive one, and people should have enough awareness of that to know when they see those reviews. I do usually check the licensing board, but I don't know that something posted there would entirely make me avoid that particular physician - I think it depends.

Anonymous said...

@ Dinah, this is "last anon" - not sure if your "I'm left with" part was general overall thoughts, or directed at what I had said. Either way... I guess my concern would be that any blog, Facebook site, articles, listings databases, or information that you find online about anyone is not generally going to be helpful in therapy. (Have you found it to be?)

Again, I'm a novice at the this, so what do I know. But how it feels to me right now at my stage is that it would be distracting to me to know about my therapist (other than obviously if they were proven to have committed malpractice or were somehow potentially harmful in some unimaginable way). Likewise, I wouldn't want them forming any opinions about me that I don't reveal in the room. Read about me online and you might think... dang, she really is on top of the world and seems so solid, her pains can't feel THAT bad. Or you might think, she's always talking about XYZ so those things must really matter to her (but in fact they don't). Or you might think I'm an extrovert, when I'm painfully shy. Or... Or...

I know a lot of bloggers in the blogosphere, and it's rare - really rare - to meet someone who is 100% genuine in their public postings. Don't you ever just want to rage at a commenter, but you don't? Would your therapist think you're always level-headed?

If the internet is a source for good (as in helpful) information about me, then why not ask me for my personal dairy at the start of therapy! Or have the therapist share details of their client testimonials and their attitudes and beliefs on common subjects, revealing their personalities and preferences, and let us grow together from there.

I don't think this is THAT big of a deal either way if everyone is adult about it, but personally, I just know that I would prefer to know as little possible other than that I feel really good about my therapy. If she's an axe murderer, ah well, don't wanna know. (Just kidding on the last part, kind of.)

Anonymous said...

... also, I don't have a blog, per se, but am easy to find online. I think if you talk about your public profile in the online world to your therapist, it is NOT always an invitation to them to then Google you. Maybe it's that you spend a good portion of your life on the blog, working, maybe your business is the blog, or have had stuff written about you, or... who knows what... that all then becomes relevant topic material in therapy to talk about. In my case, I brought up my "online self" to talk about public perception verses my inner reality and how far apart they felt, not to have my therapist then go google me. Though I could see where therapists may want to argue otherwise ;) I had mixed feelings when she quickly said she wouldn't ever look me up online -- kind of sad because I'd want to impress her, then ew - it's creepy. Over time I didn't feel either reaction, I was just glad she'd only know the real me, and I wouldn't wonder if she knew more than I had revealed in the room.

Anonymous said...

Also, Dinah, you're not giving patients enough credit. We know that most people comment when they have either TERRIBLE experiences or WONDERFUL experiences. If there's one negative experience, I'm going to assume it's a disgruntled individual. If there's 15, likely not. And if there's 5 or 6? I'm going to be cautious. Flip side - if there are 5 awesome reviews, I'll try them. I bet you don't mind when people review you positively......

Sunny CA said...

When reading product reviews, I have found that they on average reflect the truth about the product if there are enough reviews. I frequently read both poor reviews and good ones and make an interpretation as to what to believe about what I read. A friend and I both used the same endocrinologist, and when we discussed him, while we were both his patient we agreed 100% on his failings and the failings of his staff. Eventually she left him permanently for his partner. I left for a year and returned. Both of us did this for the same reason, that he is an arrogant and pompous know-it-all, who thinks he is God's gift to humanity. He is still that way, but I returned because the doctor I switched to had a nice personality, but wasn't as good a doctor. In the end, I decided to tolerate his personality in exchange for his ability as a doctor. (This is similar to your situation, Sarebear.) I think patient reviews probably are valid if they are genuine patient reviews, and not posts written by the doctor or posts written by a disgruntled blog reader. I did bring a complaint to this endocrinologist about his office staff's week-long delays in responding to prescription refill requests from my pharmacy, and the above mentioned endocrinologist got angry and defended his staff. He was wrong about his staff's response time and wrong to get angry at me for bringing a real concern to him. His staff has to handle refill requests from the pharmacy because this endocrinologist does not like to write prescriptions while the patient is in the office. The staff delays occasionally have caused me to go off then back on thyroid meds which is not good at all. I still go to him and would not post negatively about him, however, but I'd bet if I did, that most of his patients would agree with me. A bad review is not always an incorrect review.

Jane said...

"I did bring a complaint to this endocrinologist about his office staff's week-long delays in responding to prescription refill requests from my pharmacy, and the above mentioned endocrinologist got angry and defended his staff."

Sunny, this was actually why my last doctor got fired. Only it wasn't a week. It was 2 weeks. I forgave it. The second time, he prescribed a drug that needed a prior authorization. His staff did not respond to the pharmacy requests for 3 weeks. I also called his office multiple times. At the end of three weeks, they finally submitted the paperwork and my medication was denied by insurance, because he had try two other drugs first. I asked the front desk if he could prescribe something else. They told me to come in again for another appointment. When I complained, the doctor did not believe me at our next appointment. He told me to go get a new doc. He then decided to prove me wrong and he broke out the office notes...and was in total shock that it really did take 3 weeks from our last appointment for his staff to contact my insurance company. But he was still defensive as all hell (and the office manager is his wife), so I left and got a new doc.

Anonymous said...

Wonder why all the angst on both sides?

1. The internet is public. People can post and read whatever they like. If someone slanders, there may be a legal recourse; take it or not. The internet is just a global, electronic open-market.

2. The relationship between the patient and doctor is a mutually agreed upon, implied contract. Either party has the right to terminate (subject to legal conditions, for MDs). If the patient is unsatisfied, stop going. If the doctor is unsatisfied, terminate and refer elsewhere.

3. Sometimes the best care has poor outcome. Sometimes poor care has great outcome. It is important to know the difference.