Chris Kresser: Yeah, it’s a problem, and I don’t know that it’s solvable. There’s a subset of patients who feel like if they pay a certain amount of money then they should get a result that matches that expenditure. To me, I get it. It’s kind of a strange attitude, to some extent, because I’ve been a patient myself. As you all know, I was sick for many years, and for me, the way I evaluated the success of an interaction with a practitioner, yeah, of course, I didn’t want them to order a whole bunch of unnecessary testing that didn’t yield any clinical information, but if they were able to show me that the testing that they were ordering made sense and was actionable and not just for the sake of, oh, that’s interesting, but actually would affect the treatment … I think we’ve talked about this before. That’s one benchmark for deciding whether to order a test, if it’s going to change the treatment plan. If they were able to show that and they did their best and they were honest and transparent and they would listen to me and they took my opinions into consideration and they were making an effort to stay current with the research and doing what I perceived to be everything that they could for me, I’m not the sort of person who’s going to blame them for the failure of the treatment in that situation. I recognized even then, when I was a patient, that we don’t know everything yet, and as long as they’re doing the best they can for me, then that’s all I can really ask.
I feel like a lot of these patients who leave these kinds of reviews online, there’s one of a couple of possibilities. One possibility is that the patient had unreasonable expectations and doesn’t really understand that medicine is as much an art as it is a science and that there are many unanswered questions, and they’ve been conditioned with this conventional medical model that there’s a drug or a surgical procedure for every problem. They maybe don’t understand the complexity of it and the mysterious nature of a lot of these chronic illnesses.
Or the other problem—perhaps the more likely problem—is that they felt like they were inadequately listened to or they felt like a lot of unnecessary testing was ordered or the doctor or clinician didn’t give them the attention that they really wanted.
So I think, getting back to your question, how can we prevent it? I don’t think we can prevent it entirely, but I think doing all the things that I just mentioned—being transparent, being honest, staying current with the literature, training, improving your skills like you’re doing now, listening well, being empathetic and compassionate with your patients, and doing your best and really showing them that you’re doing your best—that’s not going to guarantee that you won’t get some bad reviews because, frankly, I think there are just some unreasonable people out there, and I think that some of that comes from just a sense of desperation, being sick and tired and broke and scared. A lot of times, people get excited when they hear about a new practitioner, and they—perhaps unfairly—really kind of put all of their eggs in that basket and project a lot of authority and control onto that practitioner, and then when they don’t get the result that they wanted, they blame the practitioner. To some extent, that’s human nature and there’s not much that can be done about that, but you’ll protect yourself the most by doing those things that I mentioned.