March 8, 2012
I just read an survey study about the health and well-being of medical residents that was done by a chief resident at a local Baltimore hospital. The article describes the well-known difficulties that residents face such as sleep deprivation, social isolation, etc. Then they looked at health-related behaviors including seeking medical or psychiatric care. Not surprisingly, most medical residents reported not having a primary care physician, not calling out when they were sick and not seeking emotional support. Perhaps even more disturbing than these results was the fact that many did not disclose information to their treatment providers (when they did seek treatment) or did not seek treatment because of fears of confidentiality breaches. It’s a sad statement when doctors do not trust fellow doctors to keep private their personal information.
October 18, 2011
The Wall Street Journal just ran a nice little piece on how to go about choosing the right therapist. I love seeing articles like this in publications like that. The article noted there are different types of therapists, therapies, etc and that what works for one person might not work for the next.
I loved that the author suggested becoming an informed consumer when seeing psychotherapy, but readers should know that some of the suggestion questions are not always answerable. For example, it is perfectly appropriate to ask a therapist about his training or her experience in working with your particular symptoms. It is also quite reasonable to ask about the proposed treatment approach, duration of treatment, etc. However some of these questions cannot be answered definitively after just one session. For example, new patients to my practice often ask, at the end of the initial consultation, how long will therapy take. I explain that I really can’t answer that question with much confidence because there are simply too many variables – – known and unknown variables – – that will affect the duration of our work together.
I add that there are some folks I work with for just a handful of sessions and that is all they need to achieve their desired goals, and there are other people who I have worked with for several years. A key element within longer-term treatment is regularly circling back throughout the therapeutic process and reassessing if it is still appropriate to continue treatment; I would never want to work with a patient (and charge him or her, of course, for services rendered) and have the treatment not be of significant benefit. Ethically, any good psychologist would terminate treatment if s/he feels it is no longer of benefit to the patient.
April 14, 2011
Not long ago, the Chicago Tribune ran a controversial article about the how the Illinois Professional Health Program handles confidential information. Their slant on the issue was that the Program was essentially harboring criminals by keeping secrets that could harm the public. Interestingly, several years ago, the Maryland State Board of Physician Quality Assurance (BPQA) was disbanded after being criticized for being “too physician-friendly” and subsequently the Board of Physicians was established with a renewed perspective on their primary mission: to protect the public.
Clearly those working with impaired, distressed and disruptive physicians have struggled with “how confidential” information should be regarding their physician patients. On the one hand we appreciate the need for the public to be warned of potentially dangerous docs. But on the other hand, for our corrective and therapeutic work to have any chances of being effective, our patients (those, so-called, dangerous docs) have to have some assurance that what they discuss with us in remedial coaching, tutoring or therapy has some protection from others’ eyes and ears. There needs to be a delicate balancing act whereby these often-competing needs are fully appreciated, discussed at the start of intervention and are repeatedly revisited by all parties involved. When working in these types of situations, there are essentially two primary clients: the professional in my office and the referring agency (usually a licensing board, professional society, hospital, etc) who at some level represent the interests of the public. When a treating clinician (or program) loses sight of this, problems arise.