Patients are people just like everybody else. Time to treat that that way!

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Here’s a crucial lesson I learned long ago.

In health care, what drives people most, what matters most to patients? They’re people, of course. What determines their responses to their treaters and treatment options? The answers matter deeply if you want to do good and efficient work with people, if you want to succeed, if you want to improve your results and your enjoyment at work.

As is, treaters generally overwhelmingly focus on illnesses and symptoms and tend to frame patient complaints in terms of symptoms. That’s how they’re educated and trained. Patients aren’t irritated, they’re irritable. Patients aren’t unsure if they can trust treaters they just met (very) briefly , they’re guarded or even paranoid. Patients don’t disagree with their treaters, they lack insight and judgment. Patients don’t struggle with difficult decisions given vague data and little time to work with, they’re ambivalent and indecisive. And on and on. So it goes every day in health care. Experiences I as a provider often see as completely normal routinely get framed and documented by others as symptoms, in effect as defective thinking, So it goes. Especially among mental health treaters, the entire industry is geared to blame the patient for everything that bothers treaters, everything that goes wrong, everything that differs from treater expectations and desires. Everything! So it goes.

Yet it has been well documented that patient dissatisfaction even in psychiatric settings generally has far less to do with patient diagnoses than most people imagine. No, peoples’ responses to care have far more to do with universal human needs, the stuff that makes us all human, that ties us all together and makes us all essentially the same. Psychiatric illness or not, these needs remain constant and centrally important, timeless. What factors most reliably lead to violence and restraints? Surprise, surprise: diagnoses are very poor predictors of violence, histrionic news stories to the contrary. Far more reliable predictors include unit temperature control, noise, waiting, (in)consistency of rules, perceived disrespect and so on, the kinds of issues that bother anyone. Regardless of illness. So it goes. 

When we learn how to address normal human needs more effectively, regardless of illness people appreciate it and treat us well in turn, or at the very least, better. It helps. It makes a difference, it makes all interactions, all people work better. Not perfect: I offer no fairy tales here. It’s impossible to control others like puppets and it’s wrong to try. I have no interest in manipulating or controlling others, for both ethical and practical reasons. I develop and teach ways to make it better, ways to  help patients and treaters get along better. Better is enough for me, because it’s real and it’s achievable, today, now.


Have no fear of perfection: you’ll never reach it.

– Artist Salvador Dali


Perfection sounds wonderful and it never actually happens. To the contrary, Better builds on itself step by step, upward and forward, never perfect, never finished, yet ever better. How far can we take such an upward, forward climb? Who knows? The only way to find out is to try it and experience it yourself. I’m not concerned with that end point: I live here and now, as we all do of course. Sadly, most of us mostly focus on the past and the future where we lack power. You can’t change the past at all, not even a little bit: it’s untouchable. You can change the future but you can’t touch it directly. NOW is where better happens, where EVERYTHING happens in fact, and by making things better, step by step, we can build a progressively better future as we go. That’s how better works!

So for the last twenty years I’ve explored and tested and refined ways to help patients and treaters get along better, work better together, get more done and have more fun together. It has made me a far happier and far more successful efficient clinician and patient.

That’s right, I play both sides of the clinical fence. Surprised? There are perhaps millions of us, the mental health fence straddlers. Mostly we hide in plain sight. Not me, though. I use transparency to fight stigma to help save lives.

But that’s for another time. Thanks for your attention, and I appreciate any feedback you might offer. I  live to learn from others.


  1. how would one feel to be betrayed by a psych professional . One who will write what the referring agency wanted. Demand that you go to counseling , based on future “predictions”. I think he is the lowest form of life and hate anything to do with psychology ! he is a money loving , nasty evil old man

    Liked by 1 person

    1. I hate to hear about such abuse, but it’s also important to know. I might well feel a deep distrust for all involved in the system, i imagine, just to play it safe, a sad outcome indeed. Yet like any other large group of humans, ethics and professionalism run the gamut. Perhaps you can play the field and find someone far better. Good luck and thanks for opening up on such an important topic.


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