In the digital age, we have been conditioned to trust the social proof of a high star rating. We see five stars on a retail site and immediately assume the product is excellent. But as a psychiatrist, I have learned that when it comes to medicine, that logic is fundamentally flawed. In fact, if you encounter a physician with 375 five-star reviews and not a single negative comment on social media, you should be wary.
We live in an era of manufactured satisfaction. Major retail outlets spend millions of dollars incentivizing glowing reviews for products provided for free, creating a feedback loop that often has no basis in reality. Unfortunately, hospital administrators and business managers have bought into this model. They now assess physicians primarily by the volume of their positive reviews, importing a transactional retail metric into a field that is, by definition, complex and deeply human.
In my practice, I frequently handle requests that fall far outside the bounds of ethical, evidence-based care. Patients may demand the immediate escalation of controlled medications, insist on prescriptions without the necessity of a medical visit, or ask me to bypass internal guidelines. My job is not to be a service provider who satisfies every customer demand; my job is to be a physician. Healing often requires the gentle confrontation of dysfunctional defense mechanisms and the courage to address conflict. Sometimes, it means saying no when saying yes would be medically inappropriate. This is the art of medicine, and it is fundamentally at odds with the “customer is always right” model.
When administrators prioritize survey scores over clinical rigor, they incentivize doctors to become people-pleasers rather than healers. It creates an environment where the easiest path to five stars is simply giving the patient whatever they want, regardless of the medical consequences. As a result, many of my most skilled and ethical colleagues are being labeled as difficult or possessing a poor bedside manner simply because they refuse to compromise their professional integrity.
When we reduce medicine to a popularity contest, we lose the nuance that makes this profession a calling. No one outside of our offices truly understands the weight of the decisions we make behind closed doors. We are not selling products; we are navigating human suffering. We must stop holding physicians hostage to these consumer-grade metrics. To keep the integrity of our field intact, we need leadership that understands that a difficult doctor is often just a principled one, and that the best patient outcomes rarely come from the path of least resistance.
Farid Sabet-Sharghi is a psychiatrist.
