When a Colleague’s Patient Requests a Second Opinion From You

By: David E. Drake, D.O.

It always feels good when a new patient appears for their first appointment with you and tells you how much good they have heard about you. And, in spite of working with Dr. X, your colleague in another practice in your same town, for the last 5 years, they want to try something different. They may have heard that you spend more time with your patients, that you are better at returning phone calls, or that you offer some treatment modality that Dr. X does not.

The fact is that in any community with several psychiatrists, each psychiatrist is bound to have former patients of the others in his/her practice. It can be humbling when a patient leaves your practice for a colleague, but it has happened to each of us, regardless of how highly we regard our own abilities.

When I started my first solo private practice in Albuquerque, New Mexico, back in ’91, I grew tired of waiting for the phone to ring so I began going out to meet specialist and primary care physicians, to ‘press flesh’ in the attempt to get the message out that I was new to town and was accepting new patients.

Luck would have it that the second of my first two new patients didn’t like me. We had only one session together. She had been referred by her family doctor and she went back to tell him she didn’t like this Drake guy. What happened next would stay with me for the years to follow. The referring family doctor suggested she go back and discuss it with me (I had had no clue from our first session). Well, we met- and she still didn’t like me!- but I learned from it.

Like each of you, I have new patients come to my practice who don’t like the previous psychiatrist. Typically, during the interview I learn that they have not relayed to the psychiatrist their concerns and/or complaints about their work together. Unless the behavior or complaints appear egregious, I suggest the person go back to their previous psychiatrist and tell them about their concerns-what they didn’t like about their work together. Some patients are reluctant to do this. In some cases, I suggest they at least write a letter. I tell them of the patients who have left my practice- and sometimes it’s because they report I seemed distracted that day, or they had to wait too long, or the perception that I wasn’t listening to what they wanted to talk about or a myriad of other possible complaints.

In some cases, the patients seeking second opinions have returned to see me, while in others they presumably may have worked things out to continue with their previous psychiatrist. Regardless, your colleagues will respect you for it and you get the opportunity to see what you may be up against yourself should you decide to work with this person. I also remember an adage from one of my mentors-“How you say goodbye can determine how well you can say hello”- that leaving abruptly from one psychiatrist-patient relationship may not bode well for the next one.