From Dr. Larry

Dr. Larry Gelman is fiercely devoted to each client, with a deep and profound respect for their own self-agency and self-determination.

“...Recommendation for Your Consideration...”

My bias is clearly explicated and wholly unequivocal. Each and every single time I deign to venture, even slightly outside my scope of professionalism and licensure, I invoke a well-rehearsed refrain that “...off the record, as a lay person in X, Y or Z field, it is my recommendation for your consideration...”

In the real world of personal services consultation, in my opinion, it is generally preferable (either when the client directly engages the consultant in an explicit interrogatory or when it may be otherwise, appropriate), for the so-called expert to say that “...off the record, as a lay person in X, Y, or Z field, it is my recommendation for your consideration...”

There are several very good reasons for this specific formulaic qualifier which serves to provide a manifest clarion call both to immediately forewarn and, thereby, to consequently forearm its intended recipient.

The first reason for use of my verbal formula is for the professional, or “expert,” to acknowledge to his/her client, in clear and unambiguous terms, that there are always very real limitations to anyone’s professional education, training and experience.

Stated alternatively, the “expert” is advised to make known that, “...off the record, as a lay person in X, Y or Z field, it is my recommendation for your consideration...,” then to make said recommendation without said qualifier, if relevant, so that they may best serve those in their charge by overtly confessing their professional incompetence with respect to prefacing that they cannot possibly know everything about everything, inclusive of their own special area of professional competence.

I am reminded of Socrates’ exhortation that “the wisest of all men is he who knows he knows not.” When one genuinely accepts and trumpets one’s own level of professional incompetence, there is a greater likelihood, in my opinion, that true mastery and professionalism are probably extant...and, therefore, probably worth seriously considering.

Consequently, if I am queried about a question pertaining to psychoactive medication, I will, invariably, reply that “...off the record, as a lay person in medicine and pharmacology, it is my recommendation for your consideration that the questioner inquire directly of his/her prescribing physician or dispensing pharmacist for all appropriate information, which ought to be individualized for the individual, directly 'from the horse’s mouth.'”

The second reason for use of my verbal formula is that a bona fide professional must, in my opinion, always operate within the bounds of his/her professional licensure, certification or registration, including the location or actual site of where services are rendered because not to do so is, not only egregiously unprofessional but also opens the door to a potential and wholly unnecessary lawsuit.

Although there may emergency situations and other mitigating circumstances (e.g., acts of God, natural disasters, terrorism, etc.), let us conjure a helpful, caring and kindly health care professional who is visiting old friends and is introduced to a new acquaintance who, upon learning of the health care professional’s occupation, inquires in a casual, yet sincere, manner about still another person’s health status... a person who is not present at the gathering.

For the sake of example, the question goes something to the effect: “...since you are a doctor of clinical psychology, what should my friend do for her cutting behaviors, post-partum depression and suicidal ideation?”

If ANY professional advice is provided at this gathering of old and new friends, it is advice inappropriately offered by a health care professional, who has NOT rendered proper due diligence of individualized services in the privacy of an office consultation room, health clinic or hospital.

Additionally, should the advice be disseminated to the intended recipient of benefit and that individual injures or kills herself, the good-intentioned provider of professional advice will likely be the eventual target of civil and possibly criminal liability because no individualized and private diagnostic interview was thoroughly performed in an appropriate health care facility or location.

The third reason for use of my verbal formula is that personal services consultants often wield enormous power and influence over those seeking their guidance because the supplicants may be in great need or are, otherwise, anxious, vulnerable, desperate, overwhelmed, confused or, quite simply, out of their element.

While there are certainly times, places and circumstances where explicit directives from an “expert” are absolutely crucial to one’s health, welfare and safety it is more-often the case that each sentient person must learn to be responsible and accountable for how he or she thinks, judges and acts in virtually every area of life.

Hence, each one of us, barring an incapacity to think, judge and act on our own behalf, must reconcile ourselves with being personally responsible and personally accountable for each one of our thoughts, judgements and actions no matter how convinced we are that someone else knows better than us.

So when I am asked a direct question, in an appropriate setting, I may answer directly if it is within the scope of my professional practice.

However, when the interrogatory is clearly outside the scope of my education, training, experience or professional licensure, do not be surprised if you hear me reply, “...off the record, as a lay person in X, Y or Z field, it is my recommendation for your consideration...”

It is in this slightly cumbersome formulaic verbalization that I, most humbly, aspire to “do no harm.”

Author Note: Dr. Larry B. Gelman is a Clinical Psychologist and a Personal Mentor


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