How often do you receive a good psychiatric report?

It is easier to write a good psychiatric report about psychotic patients than neurotic ones. A psychiatrist is inhibited by fears that patients might read "their" notes and be overwhelmed by clinical descriptions, that the referring doctor will believe his or her patient is being slandered, of going against patients' wishes that information, often most important, should not be told to his or her referring physician, and that the referring doctor will use the information to bustle his or her patient prematurely into making life changes. Suggestions for writing a good report are given, although discussion by telephone may sometimes be the best resolution of the difficulties discussed.