Not too long ago, I had a new patient (let’s call him ‘Joe”) who immediately conveyed through his body language and emotions he was not happy to see me. I quickly intuited Joe was surveying me and my office and I was coming up deficit.  Before he began, he announced (when I asked what brings you here), he wanted to know my credentials. He seemed taken aback by my training; I sense he was disappointed I was NOT fulfilling his negative expectations I had gone to some hick school. But he quickly turned this around: if I was so well trained, why was I doing here (as an employee in a pokey little clinic rather in an academic setting). After a few more questions about my worth, I finally got in word-wise to ask him why all this mattered. Joe explained he was had moved and was having his treatment in a prestigous academic setting, by a psychiatrist I sensed I was supposed to recognize and be in awe.  When I replied honestly I didn’t know these fellows – nor have I published anything, this dropped the last penny: I knew in Joe’s eyes I was a nobody, and not qualified to treat him.

I did my usual initial evaluation, which is thorough and competent.  Although I was able to answer his ‘pounce questions’ I sensed he already knew the answers had asked them to test me.  At the end, he announced this was more an interview than a consultation; he didn’t think I was qualified enough help him.

Joe’s main psychiatric condition was he was a snob, but it did touch a nerve. He wasn’t wrong viz. I am a ‘nobody’ doctor.  I work as a “grease monkey” clinician, treating people in a clinic with little contact with other shrinks. I don’t publish papers, I don’t belong to University; I work in isolation so few if any physicians know of me, let along other psychiatrists.

The Other Doctor in the clinic, who used to be in private practice, knows every doctor in the Valley.  On his wall is the cover of the local magazine with the title “The Best Doctors of Phoenix’. He was voted as one of them*.

The other five doctors from my residency are all in academics, or part of presitigous practices or doing research. They are names.
I really am OK with my job and position in life. I am good at what I do; I am liked by my patients. They send me their friends, family or co-workers (a good sign indeed). Recently a new patient told me she came to see me as she had looked me up on line and decided to see me as my reviews were excellent**.


All the same, when patients like Joe remind me of my professional position, it stings a bit, to remember the roads not taken.



*Sometimes patients ask me why I am not ‘one of the best’. 

I like to explain I was eliminated in the swimsuit competition.


**I have never looked myself up on the internet, so this was news.