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  • Writer's pictureRachel Rubin

Someone gave us a 1-star review.

No explanation. Just 1 star.

The same week I had a patient tell me her first visit gave her so much hope. Another patient said his pelvic pain and erection issues were completely resolved; he shared how grateful he was since he had seen many doctors before us. I even had a urologist call me about his personal medical problems, and I had novel ideas about how best to help him.

We had a patient send a testimonial about how great Dr. Klos is to work with, and another patient so grateful that Dawn, our physician assistant, saw her so quickly to help with an urgent urinary tract infection. We had a patient drive 8 hours to see our current training fellow Dr. Vaccaro, and she was thrilled at the number of ideas we had about helping her menopausal symptoms—even after she had been seen at a prestigious Ivy League institution.

Still. We got a 1-star review.

Now, we know most of our patients don’t leave Google reviews. It’s hard to do so

anonymously (though this person figured out a way), and many of our patients see us

with very personal issues.

I get it, though: 1-star reviews happen. There are people who have given 1 star to

Apple, Disney, Oprah, and Dolly Parton. So of course there will be times when someone

gives us a bad rating.

The hardest part of this 1-star review is that it’s hard to learn from it. There’s no

feedback. No reason why. So how can our team improve our care?

Part of what I love about the field of sexual medicine is that we have so much to learn,

and we must be committed to getting better. I also know that I have so much to learn

about business, private practice, and how to help people to the best of our ability.

So I’ve been thinking.

There are a few reasons why we may have gotten a 1-star review.

Problem: The person giving us 1 star is suffering, and we didn’t cure them quickly enough.

Many of our patients are suffering. Many are in pain. Many are devastated by a

condition that has been minimized or, worse, ignored by other medical

professionals. We deal with complex medical issues that affect people and their

loved ones deeply.

We are not magicians. While we follow the data closely, and even conduct our

own research, we have a long way to go to expand our toolbox. While we can’t

“cure” everyone with one magic pill or in one visit, we pride ourselves on being

insanely curious and cutting edge, and we use the tools that we do have as much

as possible.

Treating complex problems also often requires a team approach. It takes the

help of pelvic floor physical therapists, mental health professionals, pain

management doctors, spine surgeons, allergists, and anyone else we need to get

involved. Think of us like the lead consultant to help guide you.

We aim to validate your experience, empathize, hypothesize, and advocate with

you. Our goal will always be to give you hope and not give up.

Problem: We are out of network with your insurance.

It’s true: We don’t negotiate our rates with insurance companies. Though we always

provide you with transparent prices prior to your visit and a superbill to submit for

out-of-network reimbursement.

The American medical system is deeply broken. Most doctors only spend 10 minutes with you and get the same low reimbursement whether they help you or not. Often you are left with surprising costs...sometimes months after your appointment, due to high deductibles.

The current medical system does not care about your orgasm, libido or pelvic

pain. Nor does it care about working collaboratively with a multidisciplinary team

to help you.

But we care deeply, and you and your loved ones do too. We are also committed

to hiring a knowledgeable team that DEEPLY cares, one that makes you feel

seen and heard when you call us or send messages through the portal. And all of

this costs money.

I had a patient explain to me once why she was so thrilled to pay $600 for a vial

of pelvic floor botox (the true cost of the medication). She said to me “Dr. Rubin:

How much does divorce cost? You helped me not only have penetration with my

partner but I enjoy it again. You saved my marriage.”

Problem: I can’t get a new appointment quickly.

It’s true: We are quite busy. Dr. Klos and I take a lot of time with each patient which means we don’t have unlimited availability. We refuse to cram people into 10-minute slots or double book.

We also both have small children who we enjoy spending time with.

This is why we are committed to training physicians who are devoted to practicing sexual medicine at the highest level. Dr. Vaccaro, our first clinical fellow, came to us with years of experience as a urogynecologist, but wanted to gain expertise in sexual medicine.

I dream of having more clinical and research trainees moving forward and finding

ways to expand access while delivering high quality care.

When seeing us is not possible, we encourage patients to check out the ISSWSH

or SMSNA websites to find clinicians near you. We are also constantly teaching,

lecturing at conferences, providing free content on social media, and advocating for

a better future.

To the person who gave us 1 star: I am sorry for your experience. We can’t improve if

we don’t know the details. Please reach out to us directly. You deserve time, expertise, compassion, and a medical team committed to optimizing your sexual health and quality of life.

To our patients, if you ever want to send us helpful feedback we are here to learn and listen. Please email us or through the patient portal.

If you ever want to leave us a kind review, click here or email a testimonial to for us to post anonymously on our webpage for you.

We aim to help you feel cliterally the best!

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