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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by AKC on July 13, 2001, at 9:26:07
for a therapist or pdoc to say that another therapist or pdoc in his or her opinion is not very good? Last night at group, one of the group members asked for a recommendation of a therapist in the St. Louis area. One of the therapists that leads our group said that he only knew of a couple in that area and he would not recommend either - but then said it would be against his profession's ethics to give a "avoidance" type list. That makes no sense to me. I am one of those rotten attorneys. Nowhere in my legal training was I ever taught that I could not tell a person from either a legal or ethical stance that they couldn't use Joe Smith because he was somewhat incompetent. But I have heard from time to time both therapists and doctors refuse to name names of incompetent doctors. I don't get it. Any insight? This is mainly a curiousity type thing (and I know - it kills the cat!).
AKC
Posted by kazoo on July 13, 2001, at 11:46:57
In reply to Why is it ethically wrong . . ., posted by AKC on July 13, 2001, at 9:26:07
> for a therapist or pdoc to say that another therapist or pdoc in his or her opinion is not very good? Last night at group, one of the group members asked for a recommendation of a therapist in the St. Louis area. One of the therapists that leads our group said that he only knew of a couple in that area and he would not recommend either - but then said it would be against his profession's ethics to give a "avoidance" type list. That makes no sense to me. I am one of those rotten attorneys. Nowhere in my legal training was I ever taught that I could not tell a person from either a legal or ethical stance that they couldn't use Joe Smith because he was somewhat incompetent. But I have heard from time to time both therapists and doctors refuse to name names of incompetent doctors. I don't get it. Any insight? This is mainly a curiousity type thing (and I know - it kills the cat!).
>
> AKCInteresting post ... you being an attorney (which I now remember that I haven't been too kind to) questioning the ethics of another profession on nearly the same plain of existence, now let me think ...
So, who are the good and bad lawyers in your area that you can or cannot recommend?
Is it ethical for you, acting as an officer of the court, to do the same thing?
Is it ethical for you, acting as a regular person, to do the same?
(a revamped) kazoo
Posted by mila on July 13, 2001, at 13:26:34
In reply to Why is it ethically wrong . . ., posted by AKC on July 13, 2001, at 9:26:07
Hi AKC,
among other reasons it is because they know they can be wrong in their judgment of who is "incompetent" or "to be avoided".
I have noticed that in the world of medicine and therapy strange things happen and people you would never expect to might help some patients very effectively. The best psychiatric help I personally got was from a resident who specialized in internal medicine. If I were a doc, I would never recommend her to anyone for my own condition, but she definitely was a blessing in my case. So, telling people that such and such person is no good might be plain wrong, because in medicine and in therapy knowledge of drugs, their interactions, or therapeutic technics is not everything. People have to strike a good relationship, which is hard to predict, and the doc has to match some important beliefs of a patient, which are also hard to discern and predict.
mila
P.S. AKC, I owe you many thanks for something you said in other thread. I had a big confusion about trust due to something that happened recently. You said that it takes you a long time to start trusting a person. When I read it I suddently realized that I could change my trusting style, you helped me to realize that there are different trusting styles for me to choose from, and my dilemma was solved. I stayed in the relationship with the person even though my trust in them was 'irreparably' damaged. I adopted a different rule for trusting now.
i am very grateful to you for your posts. besides them being very interesting ansd always about things I personally consider important, you write beautifully.thanks
mila
Posted by Ted on July 13, 2001, at 14:16:27
In reply to Why is it ethically wrong . . ., posted by AKC on July 13, 2001, at 9:26:07
My pdoc announced his retirement and I asked if he would aid in giving referrals. He said if I brought him a list of pdocs in my insurance plan, he would "mark the ones that weren't any good". I did, but he only marked the 5 or so that he knew personally. Knowing to get multiple references, I asked a couple of nurses, therapists, counselors, and a couple of patients for their opinions. It turns out that TWO of the pdocs my former pdoc recommended were "to be avoided". Also, four pdocs considered the best in my area were NOT recommended by my former pdoc.
Go figure.
My guess is fear of slander, especially since I live in CA.
Ted
Posted by AKC on July 13, 2001, at 15:00:30
In reply to Re: Why is it ethically wrong . . . » AKC, posted by kazoo on July 13, 2001, at 11:46:57
ethical -- conforming to accepted professional standards of conduct
I guess part of my reason for this post is part of what mila and ted are getting at - it is all about having an opinion - and opinions are to be taken with a grain of salt. Being a professional in a profession that is strictly self-governed, I take very seriously my ethical duties. But that does not mean I don't have opinions about fellow members of my profession, any more than I have an opinion of a movie I saw last week or a restaurant I ate at last night.
Now if someone came to me and asked me for a name of a divorce attorney in Columbia, Missouri (where I went to law school at), right off the bat, I would provide them two names. No hesitation - two of the finest in all the state. Are there bad divorce attorneys in Columbia - you bet - but I wouldn't even mention them. If that same person came back and said, what do you know about Joe Blow, and my opinion of Joe Blow was that he was not a very good attorney, I would say so. If I said he was a lying, cheating, stealing creep - that would be wrong - in fact, it is probably slander (unless I could prove otherwise with hard, cold facts) - would not only be opening myself up to a potential lawsuit, but would be against those ethical (professional) rules that govern my profession.
It just seems sometimes that therapists and doctors won't go down that road at all. Maybe it is because too many of us lawyers have brought too many of them lawsuits and they are just too gunshy to say - Nope, wouldn't use that person. That's all that has to be said. It is not necessary for the person to even say why - No more than I can say - man, I just didn't like that restaurant. Don't want to go into it, just didn't like. That is an opinion - not actionable. Just an opinion. Doctors, therapists, lawyers, teachers, street cleaners, we all have the right to have an opinion. And the rest of us can take that opinion with a grain of salt - and can get second and third opinions.
One of the guys I work with went to the denist this week. The denist found a hole in one of his molars (one back by his wisdom tooth). Greg has a very small mouth. The denist said he can't drill, that the only thing that can be done is to pull the tooth - my reaction - get a second opinion.
AKC
Posted by Jane D on July 13, 2001, at 17:22:00
In reply to Why is it ethically wrong . . ., posted by AKC on July 13, 2001, at 9:26:07
AKC -
I'm glad you raised this. It's been bothering me recently too. I tell each doctor what I'm doing with the others - especially regarding meds. Every so often I'll see an expression in one of their faces that says they think my other doctor is nuts but nothing gets said. My doctor, who feels free to lecture me about smoking and diet, will not say a word about another doctor even though this is just as important to my health. Their ability to judge their colleagues is a part of their specialized expertise just like their knowledge of anatomy or drugs - why am I not allowed access to it? How can I trust them when their own professional organizations advise them to not to give me this information because other doctors financial interests outweigh my health interests?Jane
Posted by Marie1 on July 13, 2001, at 20:19:25
In reply to Why is it ethically wrong . . ., posted by AKC on July 13, 2001, at 9:26:07
Hmmm...I didn't realize pdocs aren't supposed to criticize their peers to their patients. My pdoc adamently discouraged me from taking my daughter to a group of psychiatrists who work at an adolescent in-patient facility where I live. He told me that everyone working at that facility were expected to tell patient's parents that their kids were sicker than they actually were. All in the hopes of making more money, of course. He knew this from having worked there. I appreciated his advice.
Marie
Posted by mair on July 14, 2001, at 9:02:06
In reply to Why is it ethically wrong . . ., posted by AKC on July 13, 2001, at 9:26:07
>I'm sure ethics has nothing to do with it and it's all about discretion at best, or at worst, the circle the wagons mentality docs sometimes have. There are ways of steering people to or away from others without engaging in slander. Your "get a second opinion" example is apt. Rather I would be horrified if my doc did nothing to steer me away from someone whom he knew to be incompetent or even, just not the right person for me. I think the doc in the group was BSing.
Mair
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