On Tue, Jun 11, 2013 at 7:30 AM, Bob in Jersey <bob.in.jer...@juno.com>wrote:

> Inside a piece about his multi-show life in the NY 
> Times<http://www.nytimes.com/2013/06/09/fashion/dr-drew-pinsky-physician-and-media-star.html?pagewanted=all&_r=1&;>:
> When former clients e.g. Mindy McCready died, Laura Holson writes,
> "...people hold him accountable long after his on-air doctoring is done.
> 'They think I’m a millionaire and they think I am, like, rampaging or
> exploiting people to maintain that,' he said. 'And that could not be
> farther from the truth.'


He has a partial point here. It is not fair to hold a mental health
professional for the outcomes of a patient long after the treatment is
over. And when you work with high risk patients, you will almost inevitably
have more eventual bad outcomes. In my practice I work
almost exclusively with depressed patients. I have been lucky not to have
(yet) had a patient under my care kill themselves, but a lot of that is
just luck. And I am not famous, and my patients are not famous, so I really
have no idea if any of them have killed themselves years after terminating
treatment with me. The chances of someone I have treated killing themselves
is much higher than the chances that the average person would know somebody
who has killed themselves, just because I see people who, by definition,
want to kill themselves. The same is true for the kind of people Pinsky
sees.

But that misses the main point, which is that what he calls his "on-air
doctoring" is not really "doctoring" at all (if by that he really means
psychotherapy or treatment of their substance abuse problems). The only
real justification for what he does is not treatment benefit for the person
on his show (who might better be termed a cast-member than a patient) but
education of the public with possible preventative health value. But even
if there is real public health benefit for his show (something I am not
convinced of) that would have to be weighed against the potential harm done
to the person being exposed on air.

So, the real question is not whether Pinsky is responsible for what happens
to "patients" long after he terminates treatment with them. The real
question is whether appearing on his show harms the "patient" - either
directly (the powerful reinforcing attention of the public for their drug
behavior) or indirectly (e.g. being on a TV show about drug treatment
instead of actually being in real drug treatment).

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