I recently stumbled across an article regarding providers that look like you and understand where you're coming from does that translate to better patient care?

This got me thinking. I often tell my clients that part of what makes me a good provider is my own mental health challenges growing up and overcoming them. Does this mean if your provider has never faced a mental health diagnosis that makes them unrelatable to you? Some clients don't want to hear about a provider's struggles in life and how they worked to overcome them, and I respect that as a provider. Other times, clients want to know, "oh, you've been through this as well, and you made it through; therefore, I can too."

I think you can be an empathetic provider and live life without challenges. I also think knowing someone has overcome life's obstacles and made it to the other side can provide people with hope.

I recently read a review that began with "I wanted to like her." Providers have to give us information that we always do not want to hear. How many times has your doctor said, "you need to lose weight." Every time I've heard that statement in my life, I thought to myself, "You don't think I know I need to lose weight?"

One of the biggest mistakes we can make as healthcare providers is trying to make our patients like us. I am not going to make everyone happy. So, while it stings to hear I did not make a patient happy, my first thought is, "Let's talk about it. What could I have done differently?" I tell everyone I'm not the right provider for all patients. Satisfied patients will tell 5 or more other people, and dissatisfied patients complain to 9 or more other people (See reference).

There are some things that are beyond my capabilities. I cannot provide you with medication because you moved to North Carolina and are about to run out. That's an issue that needs to be taken up with the prescriber who wrote the original prescription. I cannot provide emergency appointments when I am booked out for three weeks. In my early days as a practitioner, I did not say no to new clients. If you contacted me and needed an appointment, I would make it happen. Since then, I've learned a lot and grown as a psychiatric mental health nurse practitioner. I now do free screenings, which allows me to ask you questions but, more importantly, for you to ask me questions. Even in this scenario, there are times when the provider and patient relationship does not work out. And yes, that makes me sad. The people-pleasing me would go to great lengths to attempt to make every patient happy. I learned that is exhausting, and it never ends well for me as the provider or the client.

So back to the question of does a provider have to look like us and have similar values to be a good provider. A provider does need to be someone that you can open up to and discuss things that are unpleasant and sometimes embarrassing. If you find you can't do this, then yes, find a new provider.

I was taught to go into a patient relationship that's built on the foundation of trust. This means I trust you with all the information you're giving me, and you trust me to provide the best possible care for you. Sometimes, that best possible care does not mean you, as the client, are going to always get what you want. A perfect example is stimulants. I perform a lot of evaluations for ADHD. ADHD cannot always have to be treated with a controlled substance such as Adderall or Ritalin. There are other drugs that are not controlled substances that can be used to treat ADHD and come with fewer side effects. I have treated clients whose blood pressure is extremely elevated, and they still want me to give them a prescription for Adderall. The dangers of hypertension and Adderall are deadly. I've had patients who come to me on benzodiazepines prescribed by another medical provider and request to come off the benzodiazepine. We are finally making progress, I'm getting the dose lowered, and the patient suddenly goes back to the original prescriber and tells them they need the dose increased back to what it was originally, and this undoes the months of work and time we have put into decreasing the benzodiazepine dose and learning other coping mechanisms.

I hate always using the control substance medications as examples, but sadly, in my world, this is the number one reason clients fire me as a provider. The second most common reason I stop working with a client is they go to another provider and ask for medications that I have refused to prescribe for them for safety reasons. Even though we've had countless discussions as to why a medication would be bad for them, they will continue to look for a provider who will eventually prescribe the medication. This erodes the trust that was built between the patient and the provider.

I realize in the world of mental health, there are not enough prescribers to go around. I understand the wait the clients tell me they've been through before having an intake appointment with my practice. I must remind myself every day there is only so much I can do to make changes in our mental health system. There are only so many hours in a day, and if I did not take care of my own mental health, I could not provide for my current clients. I realize this means as a patient, you might get stuck with a prescriber you don't particularly like but yet they give you the medication you need every day to treat your mental illness. That could be a bridge to the right provider or, better yet, a conversation with your provider as to why you disagree.

So does your medical provider need to be similar to you? Not necessarily, but you do need to have similar goals. You need to interview the provider as much as possible and always get a second opinion if you don't agree. Sometimes it takes several visits to learn if a provider is a good fit. The best advice I can give you is to try to find providers who offer free screenings. Have a list of questions written out before that screening. Have realistic expectations meaning this is a free 15-minute screening, and there's only so much you can discuss during that time.

Do not use reviews on websites such as Google and other social media websites. The reason for this is most of those reviews are written by clients who are unhappy with the services provided because they did not get what they wanted during that appointment. I've addressed this before in a post regarding online reviews for medical providers.

We have no recourse when we get a bad rating. If we respond, we're violating your confidentiality. This rule of thumb goes against everything startup companies tell you. A startup company teaches you to always respond to good and bad reviews. We, as medical providers, cannot do that. You will see sites where reviews are responded to; however, the healthcare provider can potentially get into a lot of trouble if they respond and identify you as a client. We cannot solicit reviews either. So why you see signs on doors of businesses that read "Rate us on Google" that's not allowed with a medical provider. A patient can leave a good review on my website, for example, but I remove their name before the review gets posted. The same is true for bad reviews. My recommendation is to use word of mouth for medical providers. Ask your friends or family. Even asking on Nextdoor is better than reading an online review. Even in researching for this blog I found advertisements that pay for fake reviews and law firms that get paid to remove reviews.

                                                                                                                   References
https://luxsci.com/blog/online-reviews-and-hipaa-compliance.html
Even acknowledging that a patient had an appointment with your organization can be a HIPAA violation because it combines details of their health care with individually identifiable information in a public forum.

This means that even if a patient publicly writes about their medical conditions or treatments, you can't acknowledge them. This means messages like "Thanks so much! We're glad Dr. Smith was able to stitch you up." or "We're sorry to hear you had a bad experience refilling your anti-depressant prescription. How can we fix the situation?" are off-limits.

It's counter to how most marketers would like to reply, but for compliance reasons, you cannot acknowledge their visit or the specifics. A HIPAA-compliant message could be something like* "We really appreciate your review." It may seem impersonal, but the law is the law, and you face huge fines if you disobey it.

https://www.today.com/health/health/fake-doctor-reviews-rcna39193

How can you spot fake reviews?
Experts suggest staying on alert for these red flags:
• Watch for identical reviews.
• Beware of a large number of five-star reviews following a negative one.
• Look past the stars and skim the text to see if the details make sense for that business.
Bottom line: If you are going to search for a doctor or dentist online, take some time. Your health could be at stake.

https://www.minclaw.com/how-doctors-can-respond-to-negative-online-reviews/
• HIPAA. Healthcare providers need to be careful that the provider complies with the Health Insurance Portability and Accountability Act (HIPAA). Engaging with patients on Facebook, LinkedIn, or Twitter runs the risk of disclosing unauthorized patient information.