Dr Yelp will see you now.
September 7, 2018 7:58 AM Subscribe
My GP referred me to a specialist. (I've been dealing with shifting symptoms and pain.) The specialist has horrible online ratings. Should I trust my GP and go to this guy anyway?
I live in a small city with a limited pool of medical professionals. I would actually like to change GPs but no others with decent reputations are taking new patients. I'm on several waiting lists for a new GP. Still, my GP is medically sharp and very knowledgable in many ways and has helped me get dx tests etc. that really made a difference. The most important thing to me is his medical chops which I do trust. But he is an older white man used to old school kinds of patient/dr. interaction, and he offended and cranky when I even question anything he recommends; he acts as if I've challenged his authority.
In addition, he's busy, so any question I have goes through multiple rounds of the telephone game with his nurse. The nurse called and left a vm that my doctor wanted to refer me to this specialist. The specialist's nurse then called me to make an appointment. So to ask my GP about this, I have to leave a message on the vm of the GP's nurse, and then in a week I'll get a message back from the nurse quoting the doctor as saying "Fine, DR says if you don't want to go to this specialist he referred you to, you can find someone else." I can predict this conversation because a variant of the same thing has happened any time I have a question about his recommendations.
It's frustrating. But it means that I don't have a lot to go on.
SO... I looked up the specialist he referred me to-- a physiatrist. He has terrible reviews! One after another say anything from he is rude, to he is a waste of time, to he didn't know what he was talking about.
My doctor, however, obviously thinks he's good enough to refer patients to.
Should I listen to my doctor and try this guy or just find someone else and ask my cranky bossy doctor about them? He'll probably say "fine," in a kind of passive aggressive way but at that point he won't have really recommended the person. What he won't say is "Actually that other person is good too, happy to give you a referral" or "Actually that person is not great, I'd rather you see original rec."
I live in a small city with a limited pool of medical professionals. I would actually like to change GPs but no others with decent reputations are taking new patients. I'm on several waiting lists for a new GP. Still, my GP is medically sharp and very knowledgable in many ways and has helped me get dx tests etc. that really made a difference. The most important thing to me is his medical chops which I do trust. But he is an older white man used to old school kinds of patient/dr. interaction, and he offended and cranky when I even question anything he recommends; he acts as if I've challenged his authority.
In addition, he's busy, so any question I have goes through multiple rounds of the telephone game with his nurse. The nurse called and left a vm that my doctor wanted to refer me to this specialist. The specialist's nurse then called me to make an appointment. So to ask my GP about this, I have to leave a message on the vm of the GP's nurse, and then in a week I'll get a message back from the nurse quoting the doctor as saying "Fine, DR says if you don't want to go to this specialist he referred you to, you can find someone else." I can predict this conversation because a variant of the same thing has happened any time I have a question about his recommendations.
It's frustrating. But it means that I don't have a lot to go on.
SO... I looked up the specialist he referred me to-- a physiatrist. He has terrible reviews! One after another say anything from he is rude, to he is a waste of time, to he didn't know what he was talking about.
My doctor, however, obviously thinks he's good enough to refer patients to.
Should I listen to my doctor and try this guy or just find someone else and ask my cranky bossy doctor about them? He'll probably say "fine," in a kind of passive aggressive way but at that point he won't have really recommended the person. What he won't say is "Actually that other person is good too, happy to give you a referral" or "Actually that person is not great, I'd rather you see original rec."
Do you need a referral? What country's health system is this? Is this an insurance pay, private pay, or a national health system?
The most friction-less route might be to go, see what you think, and then report back to your GP if the referral is terrible.
posted by DarlingBri at 8:11 AM on September 7, 2018
The most friction-less route might be to go, see what you think, and then report back to your GP if the referral is terrible.
posted by DarlingBri at 8:11 AM on September 7, 2018
It could mean anything... my beloved psychiatrist has a couple of really bad reviews on Healthgrades about how he doesn't care about your mental health and isn't very nice. I guess his dry sense of humor doesn't rub everyone the right way?
That said, I like local FB groups or Nextdoor for finding doctors who don't suck. It seems like as good a heuristic as any.
posted by chesty_a_arthur at 8:16 AM on September 7, 2018 [1 favorite]
That said, I like local FB groups or Nextdoor for finding doctors who don't suck. It seems like as good a heuristic as any.
posted by chesty_a_arthur at 8:16 AM on September 7, 2018 [1 favorite]
I have a similar relationship to my GP, though its her admin who is just a total hassle and makes even making an appointment a painful experience. One of the worst things about the US health system is the amount of time wasted on this bureaucratic shit, so I do my best not to waste that time.
What I would do - and maybe this is the easy way out - is to have one visit with this specialist and see what's up. Often, people who are motivated to post on Yelp have specific reasons for doing so - you aren't getting the reviews of the majority of folks who've interacted with this guy, and maybe he's overall fine.
If the specialist is indeed horrible, then you can call back the GP, and then with evidence, be able to say, your referral was bad b/c of A, B, &C, can you refer me to this specialist that has a good reputation?
posted by RajahKing at 8:21 AM on September 7, 2018
What I would do - and maybe this is the easy way out - is to have one visit with this specialist and see what's up. Often, people who are motivated to post on Yelp have specific reasons for doing so - you aren't getting the reviews of the majority of folks who've interacted with this guy, and maybe he's overall fine.
If the specialist is indeed horrible, then you can call back the GP, and then with evidence, be able to say, your referral was bad b/c of A, B, &C, can you refer me to this specialist that has a good reputation?
posted by RajahKing at 8:21 AM on September 7, 2018
One thing about psychiatrists to keep in mind is that they too can be "medically sharp and very knowledgeable in many ways and [help] get dx tests etc." while also having the kind of personality that yields those reviews. So maybe your doctor actually does know this guy, and they're two cranky old white men who know best... but they can help you out with your medical stuff.
If you can afford it, it'd be easy enough to give it an appointment to see what he's like, and if you can tolerate him. I had a psychiatrist I despised, went to four sessions with him total and they just got worse, misogynistic and transphobic in a casually genteel way that I'm sure slips past a lot of people's radar, but he got me the medication I needed, helped with dosing in a way nobody else ever had known to, and I went on my way with enough refills to see me through getting a PCP to take over prescribing. I just had to remember that he wasn't there to be my therapist. It is an option, and if it's the one that gets you the care you need, go for it.
posted by teremala at 8:43 AM on September 7, 2018 [1 favorite]
If you can afford it, it'd be easy enough to give it an appointment to see what he's like, and if you can tolerate him. I had a psychiatrist I despised, went to four sessions with him total and they just got worse, misogynistic and transphobic in a casually genteel way that I'm sure slips past a lot of people's radar, but he got me the medication I needed, helped with dosing in a way nobody else ever had known to, and I went on my way with enough refills to see me through getting a PCP to take over prescribing. I just had to remember that he wasn't there to be my therapist. It is an option, and if it's the one that gets you the care you need, go for it.
posted by teremala at 8:43 AM on September 7, 2018 [1 favorite]
(quick note - nantucket is being referred to a physiatrist, which is like a physical rehab specialist, not a psychiatrist.)
posted by brainmouse at 8:46 AM on September 7, 2018 [8 favorites]
posted by brainmouse at 8:46 AM on September 7, 2018 [8 favorites]
No no no! I have never, ever not had this be a complete shitshow. Run!
posted by Violet Hour at 8:52 AM on September 7, 2018 [2 favorites]
posted by Violet Hour at 8:52 AM on September 7, 2018 [2 favorites]
If your insurance will allow you to self refer, perhaps another physiatrist nearby with more promising reviews will be a better bet - yes, they could be awful, but you might feel less resentful about having wasted your time on the one you picked than the one with bad reviews possibly picked at random by your GP.
It does sound like the only way to know if your Dr really knows bad-review-physiatrist's work personally is to have another billable appointment where you can ask him face to face, or, perhaps, send a snail mail letter or very smart carrier pigeon. Idk, my heart aches for all of us with this shit .. it is really irritating and a huge waste of patient time/energy, not to mention emotional and physical distress for those of who are acutely or chronically unwell. As far as I can makeout thd only thing it successfully achieves is more billable hrs for the practices, which I've heard are also victims of the economies created by the health insurance industry here in the US.
If you can't self-refer with your insurance, I second what someone else said above - see if you can find a better physiatrist option yourself , call them to be sure youre in network, and contact the nurse go-between with that drs info so she can re-issue a referral to them for you. .
The other poster was right that sometimes reviews are pretty meaningless .. So you might be fine with Dr bad reviews ... my MO lately with this stuff , though, has been to try to minimize my resentment of it all, and that usually boils down to being proactivd and following whatever gut instincts I have. My instincts might be wrong or ill informed, but I'm always less annoyed if I listen to them than if I "do what I'm told" and it takes my time and ends badly. If that makes any sense ? Haven't had much coffee yet today ..
posted by elgee at 9:06 AM on September 7, 2018 [1 favorite]
It does sound like the only way to know if your Dr really knows bad-review-physiatrist's work personally is to have another billable appointment where you can ask him face to face, or, perhaps, send a snail mail letter or very smart carrier pigeon. Idk, my heart aches for all of us with this shit .. it is really irritating and a huge waste of patient time/energy, not to mention emotional and physical distress for those of who are acutely or chronically unwell. As far as I can makeout thd only thing it successfully achieves is more billable hrs for the practices, which I've heard are also victims of the economies created by the health insurance industry here in the US.
If you can't self-refer with your insurance, I second what someone else said above - see if you can find a better physiatrist option yourself , call them to be sure youre in network, and contact the nurse go-between with that drs info so she can re-issue a referral to them for you. .
The other poster was right that sometimes reviews are pretty meaningless .. So you might be fine with Dr bad reviews ... my MO lately with this stuff , though, has been to try to minimize my resentment of it all, and that usually boils down to being proactivd and following whatever gut instincts I have. My instincts might be wrong or ill informed, but I'm always less annoyed if I listen to them than if I "do what I'm told" and it takes my time and ends badly. If that makes any sense ? Haven't had much coffee yet today ..
posted by elgee at 9:06 AM on September 7, 2018 [1 favorite]
People who are super happy with their doctors very rarely leave online reviews. It's not like restaurants where you really want to gush about it. I'd pay attention sometimes to doctors' Yelp reviews if they have very specific sorts of complaints, and especially if those very specific complaints get repeated, but the things you're describing are very generic and not what I'd call a reason to not see a doctor for the first time.
Specific stuff is more credible--if a bunch of people say there were long wait times, expect a wait. But for example with my old psychiatrist (I did note you're seeing a physiatrist, psychiatrists are just the ones I have experience with seeing over long periods of time) he had some very similar reviews to that and I didn't have a perfect experience with him but the reported problems bore no resemblance to any of the issues I actually had with his practice. Things like "rude" and "doesn't know what they're talking about" are generic things people say when they've had bad experiences with service providers and they're upset but... not necessarily accurate or reflective of reasonable expectations, in my experience, with doctors in particular.
Your best bet is talking to people you actually know and seeing if you know anybody who's seen this person, but I get that that's hard with a physiatrist compared to getting recommendations for a dentist.
posted by Sequence at 9:19 AM on September 7, 2018 [2 favorites]
Specific stuff is more credible--if a bunch of people say there were long wait times, expect a wait. But for example with my old psychiatrist (I did note you're seeing a physiatrist, psychiatrists are just the ones I have experience with seeing over long periods of time) he had some very similar reviews to that and I didn't have a perfect experience with him but the reported problems bore no resemblance to any of the issues I actually had with his practice. Things like "rude" and "doesn't know what they're talking about" are generic things people say when they've had bad experiences with service providers and they're upset but... not necessarily accurate or reflective of reasonable expectations, in my experience, with doctors in particular.
Your best bet is talking to people you actually know and seeing if you know anybody who's seen this person, but I get that that's hard with a physiatrist compared to getting recommendations for a dentist.
posted by Sequence at 9:19 AM on September 7, 2018 [2 favorites]
I would take Yelp reviews for a physician with a big grain of salt. Frustrated and angry people post, happy longtime patients post, but what about all the folks who felt that the physician did their job in a competent manner and it was fine? They're unlikely to take the time to tell Yelp about it. (As opposed to, say, restaurants, where people enjoy sharing a broader range of opinions.)
I also would take the doctor's recommendation with a grain of...some other salt. Physicians know each other as professional colleagues and (obviously) don't typically see each other's interactions with patients; the impression that they give each other of how they regard patients may be VERY different from the reality. Also, they frankly just value bedside manner less than they do skills and accomplishments, which is perhaps understandable considering the intensity of medical training.
My GP is a rare bird who is aware of this bias and also highly values bedside manner as an important skill. But even where I live with a LOT of doctors from which to choose, it's more typical to hear that damn zero-sum game logic of "look, do you want the most skilled person or a nice guy who also knows how to do some doctoring?" Well doc, fuck off, I want a skilled physician who I trust, and I don't trust people who arrogantly disregard my needs. But I digress.
In your shoes, I would go see the specialist at least once. If he's terrible, THEN go back to your cranky bossy doc and ask for another recommendation. That way, you are demonstrating respect for your doctor's authority and perhaps he will be more likely to work with you to find another physiatrist.
posted by desuetude at 9:28 AM on September 7, 2018 [2 favorites]
I also would take the doctor's recommendation with a grain of...some other salt. Physicians know each other as professional colleagues and (obviously) don't typically see each other's interactions with patients; the impression that they give each other of how they regard patients may be VERY different from the reality. Also, they frankly just value bedside manner less than they do skills and accomplishments, which is perhaps understandable considering the intensity of medical training.
My GP is a rare bird who is aware of this bias and also highly values bedside manner as an important skill. But even where I live with a LOT of doctors from which to choose, it's more typical to hear that damn zero-sum game logic of "look, do you want the most skilled person or a nice guy who also knows how to do some doctoring?" Well doc, fuck off, I want a skilled physician who I trust, and I don't trust people who arrogantly disregard my needs. But I digress.
In your shoes, I would go see the specialist at least once. If he's terrible, THEN go back to your cranky bossy doc and ask for another recommendation. That way, you are demonstrating respect for your doctor's authority and perhaps he will be more likely to work with you to find another physiatrist.
posted by desuetude at 9:28 AM on September 7, 2018 [2 favorites]
Be aware that pill seekers post reviews online a lot and since he's a physical doc, re-read those with an eye to whether they might be from that POV.
posted by fshgrl at 9:49 AM on September 7, 2018 [7 favorites]
posted by fshgrl at 9:49 AM on September 7, 2018 [7 favorites]
Physiatrist, not psychiatrist, folks.
posted by SLC Mom at 10:36 AM on September 7, 2018 [1 favorite]
posted by SLC Mom at 10:36 AM on September 7, 2018 [1 favorite]
I recently was given a seemingly brilliant advice on finding a doctor, which I hope to generalize one day – call a few specialists who work “downstream” from the doctor you’re seeking (for general dentists, that would be periodontists. Not sure about physical therapy – surgeons maybe). Ask for a local recommendation. If you hear the same name a few times – chose that person. (the assumption here is that whoever has to correct the messes the person did will know if they do a good job covering the baselines.)
posted by Dotty at 10:40 AM on September 7, 2018
posted by Dotty at 10:40 AM on September 7, 2018
Just anecdotally - I had a fantastic experience with a doctor (multiple appointments, emails - a fairly in-depth doc/patient relationship) and went looking for her Yelp reviews - and she and her office were described as a "nightmare" by several people. Happy people don't leave reviews in the numbers that unhappy people do. Plus, so much of interpersonal interaction is subjective.
If you are feeling like you need to see someone NOW and it'll be covered by insurance, I say try him out. That's the only way you'll know for sure.
posted by Ink-stained wretch at 10:44 AM on September 7, 2018 [1 favorite]
If you are feeling like you need to see someone NOW and it'll be covered by insurance, I say try him out. That's the only way you'll know for sure.
posted by Ink-stained wretch at 10:44 AM on September 7, 2018 [1 favorite]
A referral to a physiatrist, whose mission is to make people more "functional" despite their problems, means that your GP has given up on finding an underlying cause or potential cure for your illness.
And I would say a physiatrist with really bad reviews is most likely to be a doctor who tells patients to stop whining, suck it up, and get on with their lives.
I think you should ignore this referral, and redouble your efforts to find a new GP.
posted by jamjam at 10:45 AM on September 7, 2018 [1 favorite]
And I would say a physiatrist with really bad reviews is most likely to be a doctor who tells patients to stop whining, suck it up, and get on with their lives.
I think you should ignore this referral, and redouble your efforts to find a new GP.
posted by jamjam at 10:45 AM on September 7, 2018 [1 favorite]
The way my insurance works is that once my PCP puts in the system that I need to see a certain specialist, it will cover any in that network, not whatever random one suggested by my doctor. Can you skip the hassle by just proceeding on your own?
posted by metasarah at 12:35 PM on September 7, 2018
posted by metasarah at 12:35 PM on September 7, 2018
I can’t tell you weather or not to go to this physiatrist but I can tell you that yelp reviews for clinicians don’t generally paint a fair picture. I’m a clinician and although I’ve never received bad reviews I know many great clinicians who have. Due to privacy laws (HIPAA) we are unable to refute claims made on review sites. So what you are reading is one-sided, subjective, and often lacking in a broader context. For instance, reviews like “so and so didn’t give me antibiotics but two days later I went to urgent care and the doc there did and I felt great within a day” lacks context that it was a viral uri and that the person was going to feel better in 2-3 days anyway. Also reviews about personality are totally subjective- what if the reviewer is actually the abrasive and rude individual? As clinicians we can’t refute that claim by saying, “actually reviewer was hostile and called my medical assistant a derogatory name.” That actually happened in our office, the patient left a terrible review and we were left without recourse. With all that said, the reviews I would pay attention to are the ones that deal with how the office is run and most definitely not the diagnostic skills or personality of the clinician.
posted by teamnap at 7:06 AM on September 8, 2018 [1 favorite]
posted by teamnap at 7:06 AM on September 8, 2018 [1 favorite]
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Find someone you want to see yourself, give your doctor's office that name and phone number.
posted by Lyn Never at 8:08 AM on September 7, 2018 [18 favorites]