What to do!? On-Line Physician Bullying.

I’ve been to this great APA meeting, great that is, because of the people!  Wow!  The fellow attendees, the exhibitors, the speakers – just, WOW.

I’m going to try to share content with you but it will take me time.

bully

For today, “Are You a Sitting Duck Online?,” reminded me of our earlier discussions on the doctor-patient relationship and a previous post, on July 11, 2012, that went like this:

Hello Friends.

Please tell me how I’m doing on this.  Just out,

Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice

This is important to me as I treasure both my medical practice and our community, connection, exchanges on-line.   I don’t want to do anything that jeopardizes either, nor the implication that if I did, that means I would have mistreated a patient.

Thank you for this, what I call, a “good problem” to have – the joy of medical practice and participation in social media/networking.

So many of you resonated with this and engaged.  I am still super grateful.  I’d love to continue with you in further discussion and with your comments!

For me, one of the many reasons I was so excited about this recent talk at the APA is because of the mucho online stuff connected to my name that affects my patients and the dynamics in our patient-doctor relationship.

In my practice, these are just a few sites that have wrong information (demographics) on me:

  • healthgrades.com
  • vitals.com
  • betterdoctor.com
  • ucomparehealthcare.com
  • insiderpages.com

They didn’t ask to clarify my demographics.  They didn’t ask me if I wanted them to become an on-line reference on my behalf.  They use my practice information to drive “eye-balls” to their site so they can get advertizing money and more.  They impose incorrect information about my practice, knowing that in so doing, I will be pressed, (I call it bullied,) into contacting them with my correct information.

If I don’t do this expensive effort, (money, time, emotional expense – all in limited supply, to correct what they post incorrectly,) patients will continue to tell me that they couldn’t find my contact information.  When they Google me, instead of my website coming up, these other sham pages pop up.

Some patients call dead numbers or even drive to incorrect locations to find treatment.  Instead of whomever is behind these websites being held responsible, the medical providers are.

These are the notes I took from my colleagues, as I heard them say.

Unfortunately, I was late to the meeting so I missed two of the four speakers.  Even so, this is worth it.


Dinah Miller M.D., Author of “Shrink Rap” and writing regularly for Clinical Psychiatry News.

Dr. Miller told us about the difficulty of “patient” (or nonpatient, i.e., sham-patient) reviews online.

Who can review the physicians?

  • your patients
  • Friends and lovers
  • enemies
  • trolls – a negative internet stalker

Every practitioner has an idea that they are a pretty good doctor.  So it isn’t easy for any of us to hear otherwise ;).  After getting unsolicited feedback from a person who took the time to write a comment on a site that listed her, a site that listed her profile without asking her, Dr. Miller chose not to play the victim.  She decided to call “Health Grades,” and with her persistence, they took her information down.

On “Vitals” – she got an answering machine with a person’s voice mail and no name and number.  So she called CEO, Mitch, who stated she wasn’t able to take her profile down.  She didn’t ask to open herself up to trolls.

Dr. Miller asks, what shall we do, as physicians?

  • do nothing
  • write a response
  • try to call the company

There are many whose livelihoods depend on public opinion.  For example, waitresses/waiters – many lose their jobs if they get even one negative reviews.

The practitioners in the group responded with resonance with Dr. Miller’s ideas.  They also had thoughts that if left alone, the democratic process would win out over time, truth would come out and such.  (Maybe the nearby statue of Liberty played into our thoughts :).)


Paul S. Appelbaum, MD, Dollard Professor of Psychiatry, Medicine & Law, Columbia University

Principles that Might help physicians Identify Constructive Responses

  • Responses should be Effective
  • Practical
  • Compatible with medical ethics
  • Positive rather than negative consequences

Problematic Responses by Individual Physicians

  • Request removal by website – typically declined.  Saying you’re writing a public article on it might help.
  • Contact the patient who wrote a negative response to request removal – Patient not likely to remove response, many patients post anonymously, most websites won’t allow patients to remove them
  • Flood site with fake positive reviews – deceptive, embarrassing if discovered, ? inducing a person to rely on a statement that may be used to their detriment (fraud)
  • sue patient for libel – identify patient might be difficulty, people have a right to their opinions – would have to prove statements untruthful and not merely opinion, $$ in money/time/and emotion

Encourage Satisfied Patients to Post Reviews?  We could refer to a firm to do this.  $$

Some sites, similar to “Vitals” offer the option to the practitioner to respond to a posted review.

Negative Reviews:

If we do respond – how?  We don’t want to come across arrogant or insulting.  We fear violating patient-doctor confidentiality. In the end, we recognize we don’t have the last word.  We may respond with a soft word of concern.  “If you would call my office, I’d be happy to schedule at no fee to speak with you about this and see if I can help.”

Can Patient Reviews Be Controlled?  There once was a company that tried this.  “Medical Justice” developed a form that gives control over of copyright of all reviews to MD.  – Didn’t work.  See article, “Company tries to stifle online reviews with patient ‘gag orders’.”

Another idea is that medical practitioners help themselves by coming together to develop an internet ombudsman.  This would be a medical/mental health professional not involved in care of patient.

  • Independent (unrelated party) investigation of physician about the case.  A successful investigation may give a third party opinion.  There’d have to be a reason for the world to trust this opinion.

It is difficult for healthcare professionals to protect themselves from inaccurate complaints about their care.

Positive Reviews

Does it put undue pressure on the patients?

A sign in waiting room perhaps.  Make the information available w/o practitioner knowing if they have or have not commented.

There is a dissonance between the position of being a business person that says we must practice democratically and compete fiscally, yet stay in congruence with what tradition holds us to.


The issues addressed in the talk weren’t specifically about being bullied by sham-websites, but it included that idea, along with other difficulties physicians are experiencing in the rapid transition of 3000 years of tradition as a healthcare providers to spending the majority of their time serving patients first to now, the reckless $ burden of running a media vulnerable business.

In the practice of psychiatry, a traditionally extreme-private practice, this is dissonant to many.

Q:  How do we treat the extremely delicate practice of psychiatry as a business when we are held to currently minimally defended standards like this?  Please speak out and let it flow!  We need to hear from you!  …and, Keep on.

Self-Care Tip:  Deal with internet sham-sites and reviews in a method that is consistent with Me, and temperament, while doing the least damage to oneself. It will be better for oneself as well as others.

 

Join us at, Seams of Gold!

The University Surgery Center, Department of ECT, and myself will be joining our community at Seams of Gold, where we will share life changing stories of ​resilience, restoration and hope.

Thursday, May 1, 2014  

​6:30 pm to 9:00 pm, Doors open @ 6:00 pm

“Event is Free”

PLEASE COME!  🙂

 

A Father’s Lament  contopolos

On May 29, 2010, we lost our 26 year old son, Nick, after a 14 year struggle to find long term, affordable, quality recovery and care from mental illness and addiction. During Nick’s brief life, both he and those of us who loved him were left with a fatal absence of hope while we struggled, as do many others, to navigate our society’s haphazard, fragmented “system of care”.

Months after Nick had died, I recalled a former broadcast on CNN with a woman who had suffered enormous loss after Hurricane Katrina. The interviewer was asking this lady how, in the face of such loss, she was able to continue on and now help others. She said, “at some point, I stopped asking “why me” and began asking “what now”. That statement, in conjunction with an honest admission from my pastor that “during Nick’s life, he had absolutely no idea how to understand nor how to help us”, was what led to the “what now” of Seams of Gold community service events.

Seams of Gold is named after the ancient pottery art of “Kintsugi”. In this ancient art form of Kintsugi we find the inspiration in how we respond to the fragile beauty that surrounds us.”

Seams of Gold is a FREE multi faith, multi denominational community service event. All are invited.

We are asking that all who have been affected by mental illness and addiction as well as those who love and serve them, to come and be inspired, informed, educated and equipped. Join us, as through the prism of our tears, we pilgrimage together towards a “better day” of empathy, compassion and care for those who suffer.

Recovery is Powerful, it is Possible and it is Beautiful! 

                                                                                                                                  –  Jim Contopulos

 

The beauty of the Santa Rosa Ecological Reserve in southern California provides the backdrop for a father’s lament. Seams of Gold founder Jim Contopulos invites the viewer to join him on a journey as he reflects upon losing his beautiful son to addiction and mental illness.

“Birthed from Pain… Inspired by Art”

                                                                   

http://www.youtube.com/watch?v=VGZ1ESOlvbM

Be The Person You Would Like to be Loved By

wolf

 

Guest Post from Melissa Lesofski.

Melissa is a single, professional, and educated woman who is speaking out about what it is for her, unmarried.

“I don’t think we should live up to a list of what others think we should be.  Nor a list from a person we are dating. I think we should make our own and use it as our guide. 

Make a list of all of the qualities that we want in a spouse (because ultimately that is the purpose of dating, to discover what qualities are important to Me).  Should s/he be funny? Pretty? Christian? Confident? Etc etc.  Then go back through that list and hold ourselves to the same standard.  My thoughts were when I first did this was that I was never going to find who I wanted to be with if I didn’t hold myself to the same standards that I wanted from my partner….what if the person I end up with is making a list too?”

Does this not relate to us in any station?  Be the person we want to be loved by.  It sounds awfully familiar to us starting with Me, where everything does, where freedom is.  Me, the wonderland where we actually have power to make changes.  Me, to who whom we give, and then actually have something to give to others.

Question:  How has growing your list improved your connections?  What is on your list?  Please tell us your story.

Self-Care Tip:  Write a list of what you would like to do in your life to be the person you would like to be loved by.  Be a friend to yourself.

Involved in

Free Wheelchair Mission – raising money to give wheelchairs to people who need them.

NAMI

Kaia F.I.T

Speaking

  • Benefits of Exercise… BEYOND the Physical!!  
  • Please join us on 1/11/14 @ 8am
  • location:  Kaia F.I.T. Temecula
  • 31717 Temecula Pkwy
    Temecula, CA 92592

…working, interpersonal/family, a little bit of farming, lots of audible.com, just finished the 3 quilts been working on for many moons (need to share pictures), grieving various life losses, celebrating many life experiences, in all – believing that I am Loved.

Happy New Year, friends!

Question:  What have you been involved in?

Self-Care Tip:  Connection for life.

Words Like: Distended abdomen! and Connection

distended abdomen

A friend of mine told me the other day,

Mentally I went to a bad place during exercise on Tuesday. Like “I’m so slow, I want to go home, the other girls probably think bad things about me”. In my head space now I see those thoughts as ridiculous. But it was tough to get through.

Excuse me but she is brilliant.  She speaks for millions.

So many times we think about the rough out there.  The words that slow our swing down, that are not said right, that somehow take away points from our identity.  We are not a two-dimensional scorecard.  Speaking up does not qualify us.  Good or bad.  Speaking up does not change our value.

I loved her voice.  I am thinking she should start up her own blog.  If she can be this transparent on a blog, she is a needed voice.

If I could fantasize a little, (Now! Now!  Stop that,) I would have her and you go back to our own, here at friendtoyourself.com, and start methodically answering each self-care question, post by post, in your own authentic way.  And just you see what a stroke speaking up makes.  Just see what it does for you inside and out.  Just see what it does for others. …Me for example.  See?  I am affected by you.

As for my transparency, in brief, …I did not survive halloween.  I ate like a motor.  Chocolate.  Chocolate and more chocolate.

Otherwise.  I think this greens-and-beans-effort I am doing has been ok.  I am eating a lot of plants.  Trying to keep the simple carbs low.  Not always the fact but the goal.  I do still eat in volume which I will see if it makes a difference or not when it is this type of volume.  All that fiber is making a difference to my gut though!  my abdomen is distended!  TMI.

A couple posts ago we shared Jessica’s, “Do This.”  My question is, what is yours? What is your, “Do This?”  Please do not make me use any more golf analogies, but where are your …words?  Your words are important for you.  They bring friendship to you from you.  They bring you to connection, community, clarity of thought, and as said in a post long ago:

“And if we stop speaking, we will lose.  If we do not respect the opportunity to connect, if we do not treat it as the treasure that it is, not only will the world miss out on the ‘Me,’ we miss out on the world at large.  It goes both ways.

We have a choice.  Get friendly with yourself.  Speak.  Listen.  Connect.

Self-Care Tip – Stay connected for your sake and for theirs.”

Question:  What has speaking up done for your friendship with yourself?  How are your words kinder said than not? Please tell your story.

The Tabouli Song

Oh my freaking word! This is so funny. I am crying over here.

My Brother and his family came over today to visit with sweet moves and perfect middle-eastern minor cords coming off them. The great GoRemy is now a favorite.

I wish I had seen this before reuniting with my family from Lebanon yesterday at my parents home. They are just in from Beruit and, my word! The stories they live. I am glad GoRemy will bring a smile to their faces. They are in a terrible war and live yet with hope, although death is all around them.

“Why are you going back?!” I asked them.

I wanted to wrap each them up in some filo dough and take them home with me forever.

I cannot explain exactly why they are going back soon. Who can explain the reasons why we each want to be home. Reading, “Sarah, Plain and Tall,” by Patricia MacLachlan, with my kids the other day, I remembered their fight with the land that betrayed them during the dust bowl. I remembered their dad, as if he were my own, running out into the hard weather to save what he could. They were hungry, overworked, thirsty and looking at each other for meaning. Their fear of losing what they loved was as intense as their fear of any disaster.

“Caleb Witting: Seal was worried. The house is too small, we thought, and I am loud and pesky. Anna Witting: We thought you might be leaving us because you miss the sea.
Sarah Wheaton: Well, I’ll always miss my old home, but the truth of it is, I’d miss you more.”

And I guess for my relatives, it is no less of a conflict.

I hope you enjoy “The Tobouli Song,” with us and think about your own story. Keep on.

Self-Care Tip: Explore what makes you go back.

Questions: What makes you return… Or not? What do you call home and why? Please tell us your own story of what is worth it to you.

Canine Support Team and me – Personal Story of Dr. Yanoschik

Canine Support Team and me – my story

by James D. Yanoschik, DDS

US Navy 101118-F-5586B-144 Marine Sgt. Brian J...

What is the best thing being involved with the puppies does for me?

1.  Love.

Puppies are examples of unconditional love.  No matter what kind of day I am having, when I walk through the door, that tail is wagging and they are jumping up and down – just so happy to see me.  My problems melt away when I take the dog in my arms and they start to lick me.  Have you ever heard the laughing of a young child being caressed by the licks of a puppy?  You just smiled to yourself didn’t you?  That is who I become again too.

2.  Community.  

I enjoy is that I get to be around people that want to help other people.  

My wife and I have found some wonderful friends through the CST puppy raising programs. We have outings called “Yappy hours”  and visit various training locations throughout Southern California. 

3.  Me.

When I get into these situation where I volunteer, I wonder who really gets more out of these situations?  The person being helped or me?  I find that I feel better when I help my fellow-man sometimes in small ways and others in big ways.  But in a self-care way, I help others to help myself.

4.  Saving Dogs and People.

This organization has partnered with breeders and animal shelters to recognize the temperament in puppies that would make a good service dog.  When these puppies reach 14 to 18 months they are put into the Prison Pup program at the Women’s Prison in Chino, CA for their advanced training to become full fledged service dogs.  To date, any prisoner that has been involved in the Prison Pup program that got out of prison, has not re-offended.

My wife and I are now raising our second puppy in the program.

It hard to give up the puppy.  But what makes the transition easier is that we have met, in person, folks that have benefited from the service dogs.  For example, I met a young veteran who said that he has called the suicide hotline several times and made plans for his “transition” into the next life.  Fortunately, however, he got matched up with a service dog that helped him want to live again.  Another example is a mother who said that she saw a distinct change in her child since they got a service dog from CST.  These people are now able to have relationships and live.

Please get involved. Become a puppy raiser to a service dog. 

James D. Yanoschik, DDS

Dentist and Puppy Raiser

A little about Canine Support Teams (www.CanineSupportTeams.org).

Their goal is to provide service dogs for disabilities other than blindness.  This organization has partnered with breeders and animal shelters to recognize the temperament in puppies that would make a good service dog.  When these puppies reach 14 to 18 months they are put into the Prison Pup program at the Women’s Prison in Chino, CA for their advanced training to become full fledged service dogs.  To date, any prisoner that has been involved in the Prison Pup program that got out of prison, has not re-offended.

The program is lacking is puppy raisers.  Our job as a puppy raiser is to train the puppy with basic command skills, and to socialize them to various situations and environments that they may come into contact with in the course of a normal day.