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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Titles Presume Expertise but Should You Trust Them?

Allan N. Schwartz, LCSW, Ph.D. Updated: Jul 9th 2007

The general public tends to trust medical titles. Medical degrees, with their specialties, carry a lot of authority because of the expertise that it is presumed the carriers of the titles possess. Terms such as psychiatrist, internist, neurologist, brain-surgeon and so on, are believed to mean that the doctors holding these licenses have a very high level of training, knowledge and excellent judgment. However, is it not possible that there is less to a title than what we presume? Is it not in our best interest as consumers of medical and mental health services to look behind the titles and specialties? The answers are yes but most people tend to feel intimidated and trusting beyond what they should believe and think.

An article written by a medical doctor, Jerome Groopman, for the July 7th, 2007 issue of the New York Times brought home the problem of medical practice. The article is titled "Mental Malpractice." However, it does not relate to mental health or psychiatry but to the training of doctors. The connection to the field of psychology, according to Dr. Groopman, is that the medical establishment needs to use research from cognitive psychology to better train doctors to make correct decisions in crisis situations.

The particular field of cognitive psychology that Dr. Groopman is referring to deals with how human beings make decisions. He states that Doctors look at symptoms, make diagnoses and prescribe courses of treatment. The problem, according to Dr. Groopman, is that 15 to 20 percent of the time the doctors make the wrong choices or the incorrect diagnosis and treatment. His criticism is that most of these incorrect choices result from faulty thinking.

Why do these errors occur? The doctors are not trained in how to think. Instead, they make "snap judgments" based the first symptoms they see. Therefore, their decisions are biased towards what is most recent and most familiar to them. He refers to this as a "cognitive trap" in which the diagnosing doctor selects what is most familiar to him.

What is my point in emphasizing this issue here?

My point is that there is more to a practitioner than his title and this is as true in the fields of psychology and social work as in medicine.

As a society we tend to be hypnotized by titles and overvalue some professionals because they hold licenses and titles. Yet, we do not look further into the backgrounds of these people to know whether or not we are making the right choice.

Choice theory refers as much to the consumer of services as it does to the practitioners in health and mental health. A doctor may be a brain surgeon but what is his rate of success with patients? It is presumed that a psychiatrist is expert in all aspects of mental health because of his licensing and title. However, what is his track record with the treatment of patients? It is presumed that a clinical psychologist is expert in psychology and mental health. Many consumers make the assumption that psychiatrists know more and are more skillful than psychologists because they are medical doctors. Is this a correct assumption? What is the reputation and success rate of these psychologists? Finally, it is presumed that social workers are the most poorly trained and least qualified mental health practitioners. Is this a correct assumption? Do people consider whether or not these social workers have additional training beyond the social work masters degree?

The theme here is that it is important to think carefully about choices before we make them and not be guided by biases in our thinking which are often based less on facts and more on assumptions. The simple fact is that in all professions, both medical and mental health, there are excellent practitioners who are trained to think carefully about what they are doing and there are those who simply are not trained or think very little about what they are doing.

The buyer of medical and mental health services must beware. How to beware? Everyone has a right to learn about the training, licensing and reputation of a service provider before they submit themselves to treatment. Information about reputation is usually available in the neighborhood, among friends and among family members. All the professions have state regulatory agencies who keep information available to the public about any wrong doing on the part of medical doctors, psychologists or social workers.

Learn to make good or informed choices about everything from your chiropractor to your dentist, family doctor, mental health provider and even the hospital you may want to use. Do not make assumptions about titles.

Your comments are welcome and encouraged.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

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