Board complaint against a psychiatrist - advice

[anonyemous]

Hi all,

I'm completing my doctorate in the mental health field and am in need of advisement from those familiar with psychiatry and professional practice in this area.

Recently, I attended an intake appointment with a private practice psychiatrist. The session began fine, with both of us exchanging discussion amicably. I was kind, friendly, and direct. I answered their questions amicably, and they came to know that I'm completing my doctorate in the mental health profession. He asked my opinion of medications for anxiety, to which I expressed, "this is just my personal opinion, but I don't personally believe in [taking benzos] for treating anxiety" and again expressed that this is specific to ME and what I'm not comfortable with for my own pharmacological treatment. The next 15-20 minutes (of a 50 minute session) they spent lecturing me on my professional values and beliefs, and how I will be interpreted by my field for my opinions. I was told "From one professional to another, no one will take you seriously as a professional if you have those beliefs", and that my belief was "erratic". As he had spent almost the duration of this session trying to change my professional beliefs, rather than address my mental health needs, I said "I'm not sure how this connects to my mental health treatment and am concerned that we've spent the duration of my session discussing my professional beliefs, instead of my mental health treatment and emotional needs". He became extremely hostile and confrontational in response to this, and accused me of saying this because I am "unwell". I again stated that I am only hoping to receive psychiatric care, and not opinion about my professional beliefs. He asked me if I have seen another psychiatrist in town, to which I responded, "yes, it was XX". He asked why I don't continue to see XX, and I responded, "they were expensive".. They responded "Offensive??" and laughed to himself before I was able to correct.

All in all, I left this session feeling extremely disheartened, disrespected, and like I received inappropriate care. I did not come to this practitioner for benzodiazepines and am extremely confused why my professional opinions became the focus of this session instead of my immediate mental health needs. Moreover, I found his behavior and demeanor throughout the session to be extremely inappropriate and unprofessional. I attempted to address these issues and the lack of focus on my mental health treatment, and was met with an enormous degree of hostility and passive aggressive behavior. I have never encountered a practitioner like this and am extremely alarmed about the experience. I am even more alarmed that I attempted to address this with him and was told that I only am saying this because I'm "unwell".

At this point, I feel like a board complaint is the appropriate course of action. As a practitioner (in training) myself, I know that I should confer with the practitioner before I take this action. I feel like I did that, and am looking to student doctor for a second opinion. Any advice or feedback would be extremely helpful, and I am of course open to any opposing views. I just want to be as fair as possible before taking this step.

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[splik]

I am not seeing where you conferred with him after seeing him? No it is not appropriate to make a board complaint about something like this without trying to resolve the issue first (and even then this is not a board issue). It doesn't sound like you have discussed how felt about this after the session or given him a chance to apologize. He might be a jerk and not do so, but you know even psychiatrists get it wrong, I know I certainly have got into it with a patient one time where we shouting at each other that wasn't something related to clinical care at all but had pushed my buttons. I wrote a letter of apology to her later (though she said she wasn't bothered by it). There is nothing here that warrants a referral to the medical board. They deal with physician impairment, sexual misconduct, negligence, rogue prescribing habits, patient abandonment, abetting the practice of medicine without a license, fraud, breach of confidentiality and so on. I don't know what you expect the medical board to do about this. They probably wouldn't even investigate this. Your best course of action is to write a letter discussing how you felt and hope for some sort of apology. If you don't get this, you can yelp the **** out of him. The price of seeing someone in private practice is you can't complain to their employee but you can let the market decide by trashing his reputation online.

 

[keifernny2]

I agree with splik. It sounds like the encounter went quite poorly, and now you certainly have some personal knowledge about how much you like this practitioner but It doesn't meet the standard for a board complaint. You could either call/write him, Schedule a second appointment to discuss, or probably simplest, go schedule an appointment with the next name on your insurance list and forget about him.


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[anonyemous]

I am not seeing where you conferred with him after seeing him? No it is not appropriate to make a board complaint about something like this without trying to resolve the issue first (and even then this is not a board issue). It doesn't sound like you have discussed how felt about this after the session or given him a chance to apologize. He might be a jerk and not do so, but you know even psychiatrists get it wrong, I know I certainly have got into it with a patient one time where we shouting at each other that wasn't something related to clinical care at all but had pushed my buttons. I wrote a letter of apology to her later (though she said she wasn't bothered by it). There is nothing here that warrants a referral to the medical board. They deal with physician impairment, sexual misconduct, negligence, rogue prescribing habits, patient abandonment, abetting the practice of medicine without a license, fraud, breach of confidentiality and so on. I don't know what you expect the medical board to do about this. They probably wouldn't even investigate this. Your best course of action is to write a letter discussing how you felt and hope for some sort of apology. If you don't get this, you can yelp the **** out of him. The price of seeing someone in private practice is you can't complain to their employee but you can let the market decide by trashing his reputation online.

I can see this perspective. However, I did try to address this with him- both in session, and at the end of session. I was extremely direct in pointing out that he was not addressing my mental health, but rather trying to change my professional opinion on an unrelated topic. He told me I would be better suited with another psychiatrist (which I totally agree, he's an dingus), but didn't provide any sort of referral and just escorted me out of the office.

In my eyes, I feel that at the very least, this should be addressed with him in a professional capacity (perhaps by AMA). That intake was iatrogenic and I left feeling absolutely bashed for asking for mental health treatment. I was reading the Code of Medical Ethics and at the very least, it seems like he's violated the commitment to maintaining compassion and respect with patients, and I don't really see any chance in him resolving it with me if he didn't already the first two times. Nothing might come of it, but I'd rather do it in good conscience than have had that unprofessional of an experience and remain silent.

 

[randomdoc1]

I am not seeing where you conferred with him after seeing him? No it is not appropriate to make a board complaint about something like this without trying to resolve the issue first (and even then this is not a board issue). It doesn't sound like you have discussed how felt about this after the session or given him a chance to apologize. He might be a jerk and not do so, but you know even psychiatrists get it wrong, I know I certainly have got into it with a patient one time where we shouting at each other that wasn't something related to clinical care at all but had pushed my buttons. I wrote a letter of apology to her later (though she said she wasn't bothered by it). There is nothing here that warrants a referral to the medical board. They deal with physician impairment, sexual misconduct, negligence, rogue prescribing habits, patient abandonment, abetting the practice of medicine without a license, fraud, breach of confidentiality and so on. I don't know what you expect the medical board to do about this. They probably wouldn't even investigate this. Your best course of action is to write a letter discussing how you felt and hope for some sort of apology. If you don't get this, you can yelp the **** out of him. The price of seeing someone in private practice is you can't complain to their employee but you can let the market decide by trashing his reputation online.

I am LOLing at the trashing the online reputation part. That's a really humorous but also very possible alternative splik! You indeed can yelp the S*** out of someone and my guess is that it would have an impact on the referrals a provider gets. Going back to the original topic, I'm not sure there is much the board can do about this. They are more focused on cases that often put a patient or other factors at huge risk for adverse outcomes. Indeed, physician impairment, fraud, and terrible prescribing habits to name a few (e.g. putting someone on an MAOI, SSRI, TCA, stimulants, and benzos all at the same time and yes that does happen). The provider you described sounds like he doesn't have very good bedside manner but there is no evidence of misconduct to the degree the board usually investigates in. Now, obviously it would be different if say for example you were acutely suicidal and he laughed in your face and did nothing to manage your safety. But I'm sorry to say that I'm not sure what more the board would do. You are free though to share your experience with others online who may be considering seeing this provider as a patient. And it is your right to share that experience for other potential consumers.

 

[hamstergang]

Sounds like a sucky encounter and I'm sorry you experienced it, but I really don't get why this thread exists here. This is a forum for psychiatry residents and attendings to discuss our work. Your personal experience with a psychiatrist has nothing to do with us.

 

[birchswing]

The AMA does not address these issues and most physicians and the vast majority of psychiatrists are not AMA members and they of course have no recourse to do anything to people who aren't AMA members. Sorry, but it doesn't count if you don't discuss this afterwards. It sounds like you have already made up your mind however, despite being told this is not appropriate and that you have not attempted to deal with the issue yourself.

Not taking a side here, but what is the likelihood of a doctor spending any more time on this matter? It seems to be a pretty common refrain that doctors are put upon in doing work they aren't paid for. How many doctors return calls for patients of record regarding medical care, let alone returning the call of a dismissed patient to continue an argument? It might be the right thing to do in theory, but I can't possibly imagine it happening. In fact, I could imagine psychiatrists on this board giving one another the advice to not further engage with this (ex?)patient.

As to the OP, I don't know what state you're in, but this would be high-hanging fruit for my board, assuming they saw it as problematic to begin with. They have panels of drug-addicted, DUI doctors to supervise.

 

[Ceke2002]

As a patient I've had my fair share of bad encounters with psychiatrists and therapists over the years. I agree with what others have said, I don't see anything reportable here myself, and just personally I'd put a big line through his name and move onto the next provider on my short list.

 

[smalltownpsych]

For myself, when I have a bad experience with any business, I just take my business elsewhere. My time is too valuable to go much past that unless they actually caused me harm such as taking my money. Even then, I do a cost/benefit analysis and the whole "it's the principle of it" doesn't weigh into it much at all.

 

[nancysinatra]

I am not seeing where you conferred with him after seeing him? No it is not appropriate to make a board complaint about something like this without trying to resolve the issue first (and even then this is not a board issue). It doesn't sound like you have discussed how felt about this after the session or given him a chance to apologize. He might be a jerk and not do so, but you know even psychiatrists get it wrong, I know I certainly have got into it with a patient one time where we shouting at each other that wasn't something related to clinical care at all but had pushed my buttons. I wrote a letter of apology to her later (though she said she wasn't bothered by it). There is nothing here that warrants a referral to the medical board. They deal with physician impairment, sexual misconduct, negligence, rogue prescribing habits, patient abandonment, abetting the practice of medicine without a license, fraud, breach of confidentiality and so on. I don't know what you expect the medical board to do about this. They probably wouldn't even investigate this. Your best course of action is to write a letter discussing how you felt and hope for some sort of apology. If you don't get this, you can yelp the **** out of him. The price of seeing someone in private practice is you can't complain to their employee but you can let the market decide by trashing his reputation online.

Splik, you are not the arbiter of what is or is not an "appropriate" complaint from a patient to a medical board. If need be, you can consult the various state laws on this topic. Medical boards are set up to accept all manner of complaints, and it is the board, not you, not I, and not other psychiatrists, who will determine (in accordance with state law), which complaints to follow up on or not. "Appropriateness" is not a relevant concept in this context.

Some states have laws requiring that the medical board's address and the complaint submission process be posted visibly in all health care settings. The point is that it is in the public interest to keep patients informed of their right to complain about absolutely anything they wish to complain about.

Medical boards receive complaints that I'm sure range from legitimately disturbing to completely ridiculous to downright insane. They don't need us to tell patients who should and should not complain. Personally, if I were a moderator, I would seek to close this thread.

 

[Wilf]

Splik, you are not the arbiter of what is or is not an "appropriate" complaint from a patient to a medical board. If need be, you can consult the various state laws on this topic. Medical boards are set up to accept all manner of complaints, and it is the board, not you, not I, and not other psychiatrists, who will determine (in accordance with state law), which complaints to follow up on or not. "Appropriateness" is not a relevant concept in this context.

Some states have laws requiring that the medical board's address and the complaint submission process be posted visibly in all health care settings. The point is that it is in the public interest to keep patients informed of their right to complain about absolutely anything they wish to complain about.

Medical boards receive complaints that I'm sure range from legitimately disturbing to completely ridiculous to downright insane. They don't need us to tell patients who should and should not complain. Personally, if I were a moderator, I would seek to close this thread.

Nancy a lot of times your posts are a breath of fresh air but this one is absolute crap. Medical boards should not be wasting their time or our time with frivolous nonsense like this complaint would be. Medical boards should only be there for very serious/egregious issues. Being a physician has already lost a lot of the perks from years past and having micromanaging med boards is the last thing we need.

 

[lithiumland]

Report to the board, seriously...come on now
There's nothing to see here, move along.

 

[birchswing]

.
[My rhetoric ranneth over.]

 

[Shikima]

For myself, when I have a bad experience with any business, I just take my business elsewhere. My time is too valuable to go much past that unless they actually caused me harm such as taking my money. Even then, I do a cost/benefit analysis and the whole "it's the principle of it" doesn't weigh into it much at all.

Usually Axis II has more time than sense in this topic.... (excluding egregious situations where one diddled a patient or selling scripts, etc).

 

[smalltownpsych]

Usually Axis II has more time than sense in this topic.... (excluding egregious situations where one diddled a patient or selling scripts, etc).

A big part of my work with many of my patients is helping them separate emotions from rational thought. Not all emotions require a response and rational thought is the mediator between the feeling and the response. Even Freud had that concept. The danger is when all of the rational thought becomes a rationalization and justification to do the behavior that our emotions are driving us towards.

 

[sunlioness]

He sounds like a total turd, but this doesn't really rise to the level of a board complaint.

It rises to the level of "maybe I should go see that pricey guy again."


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[nancysinatra]

Nancy a lot of times your posts are a breath of fresh air but this one is absolute crap. Medical boards should not be wasting their time or our time with frivolous nonsense like this complaint would be. Medical boards should only be there for very serious/egregious issues. Being a physician has already lost a lot of the perks from years past and having micromanaging med boards is the last thing we need.

I wasn't saying that this complaint was worthy of a medical board. I was only saying that Splik (or anyone else on this site) is not the arbiter of what is or is not worthy of a medical board's time. State medical boards are, by and large, stupid concoctions to begin with. They are run by the individual states (not by doctors, but by lawyers or politicians) and their purpose is to create a semblance of "regulation" over medicine. Anyone who thinks their state medical board is there to ensure good medicine needs to take a good solid look at how they actually work in many states. Medical boards exist to appease the public, by producing some scapegoats and punishing them. Mind you - this is the same public that previously had no problem burning "witches" at the stake! Do you really think the public has changed? Do you really think medical boards are there to protect you, your patients, your friends, your children, you parents? Guess what? Medical boards are there to ensure the reelection of politicians. So maybe we should stay away from them.

I think this thread should be closed for the same reason threads started by patients seeking medical advice should be closed. The minute we start offering advice is the minute we put ourselves at legal risk. That's all.

 

[tkim]

If you've never had to defend yourself against a spurious board complaint, consider yourself lucky. All complaints to the board must be answered, and usually involves lawyers. This costs, in more ways than one.