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Thursday, March 28, 2024

Skypiatrist's Dr. Sandip Buch Says Obsession with Data is Corrupting the Practice of Psychiatry

Last updated Friday, March 24, 2023 15:03 ET

Dr. Sandip Buch, founder of Skypiatrist, says that the misuse of data and patient ratings is damaging the psychiatric and medical professions, contributing to numerous adverse outcomes.

New York City, New York, 03/24/2023 / SubmitMyPR /

In today's economy, data is the new gold. Technology has made it easier to collect and analyze large amounts of data, and almost every business touchpoint is exploited as an opportunity to collect data. However, this prevailing fixation with data is also causing damage to the practice of psychiatry and medicine in general, in a way that systems are not taking into account, according to Dr. Sandip Buch, founder and CEO of telepsychiatry service provider, Skypiatrist.

Buch questions the assumption that more data is always better, and that more data necessarily improves medicine. He has observed that most online psychiatry providers ask patients to answer long checklists on their personal history before speaking to a professional, making the booking process cumbersome and distracting. This interrogative process leads patients to give inaccurate information because all they want to do is get past the questions, and to the appointment booking page. While site developers may be happy with the amount of data they are collecting, the data is flawed and patients end up losing out on immediate direct contact with a trained professional.

Says Buch, “The problem is that this obsession with data is taking over healthcare, often without the input of doctors. It’s being placed in the hands of people who have no clue how to treat a patient and have never treated a patient in their life. Silicon Valley investors and insurance companies are also very partial to so-called ‘data-rich’ practices. Every individual patient interaction is being boiled down to numbers, and I disagree with that. The collection of the data requires patients filling out forms and checklists, and now the doctor has to spend an already limited amount of time with the patient going over those forms and checklists, instead of having an interaction guided by their expertise and experience.

Dr. Buch maintains that professional practices commonly reduce a patient’s first session from one hour to 20 minutes, because they have already obtained a lot of data in the initial questionnaire, and so feel it unnecessary to spend any longer with the patient. They can then have more patient visits per hour, improving their bottom line, and boast that they have collected more data. Buch maintains that doctors being allowed to collect history directly from patients is important, because that time spent face to face creates rapport and trust, which are crucial to the doctor-patient relationship. Patients will be much more truthful when answering questions in-person with their doctor, as opposed to a computer screen. They also become less likely to react negatively if the doctor does not give them what they want, when attempting to make the best long-term medical decisions.

Buch states that practices should focus first and foremost on letting doctors speak directly to the patient as they have been trained to do, instead of having the process dictated by 3rd parties. “Consider a person who is going through some distress. One friend listens to them, provides support and understanding, and has a human interaction with them. Another friend makes them fill out a checklist about their distress before ever talking to them, boils down their distress to a score, then talks to them briefly about the items in the checklist, and then has them fill out another checklist at the end of their meeting. Who was a better friend? According to lawyers, administrators and insurers, it's the second individual, but any human would recognize the second friend’s behavior as absurd. Yet this is exactly what is going on in our healthcare system.”

According to Buch, Skypiatrist does not pressure any of its doctors to change their professional behavior in response to bad patient ratings, when a decision is made that is clearly in the patient’s own best interests. Says Buch, “I believe that doctors should make decisions on all aspects of patient care, with proper oversight. Data is important, but it can be misused. A doctor who sticks to science and to their principles might have lower ratings than one who just does whatever the patient wants. That’s why I encourage Skypiatrist’s doctors to practice in accordance with their expertise and to the standards of proper medicine.”

The effects of the doctor rating system have been documented, with studies showing that prospective patients are likely to develop their opinion of a consulting doctor based on positive and negative online reviews. Aside from making a bad first impression, having low ratings can affect a doctor’s referral rates, memberships on insurance lists, and search engine rankings. The fear of getting low patient ratings has led to doctors giving in to patients’ whims and overprescribing medications and treatments, even with controlled substances. According to Buch, this has contributed to the worsening of the opioid crisis, as well as the proliferation of antibiotic-resistant bacteria, due to the overly liberal prescription of powerful painkillers and antibiotics, respectively.

Says Buch, “Physicians have been pressured by the system to write these unethical prescriptions, otherwise their ratings would go down. Patient ratings have become some sort of holy grail on what makes a good doctor. This is all a consequence of patients being viewed, not as patients, but as customers – and the customer is always right. While I believe that ratings and patient satisfaction are important, there are huge caveats on relying solely on those. I believe that many doctors feel that they can’t rely on their own judgment anymore, and that spending less time in face-to-face conversations has a huge negative impact on the practice of psychiatry.”

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