When is it time to break up with your doctor?

That is a question some people may ponder in the fall, typically a time when employers offer employees a chance to change health insurance plans.

UC Riverside psychologist Robin DiMatteo says that a patient's decision to switch doctors is never easy. But after 30 years of studying patient satisfaction with medical care and communication between physicians and patients, she says, there are times when it's in a patient's best interests to make a change.

"A doctor who is not supportive or who blames, ignores or criticizes the patient does not support healing," says DiMatteo, distinguished professor of psychology. Years of study have demonstrated that "patients do better when doctors are encouraging and supportive."

DiMatteo, who has analyzed audio- and videotaped medical visits, says there are huge differences in physicians' communication skills. If a person with good communication skills has a couple of off days, "they may deserve some feedback. If someone is consistently bad, you should go with your gut instinct and go with another doctor."

If the physician is a nice person but had one bad day, it makes sense to give the doctor another chance and give them feedback, she says. "But if someone is mean, or discounts your feelings, or treats you badly, you should leave."

Some doctors don't respond well to patient feedback, however, and become defensive, she says.

"If you really are with a doctor who makes you feel badly about yourself, if you're in pain and the doctor says you should be better and you're not, and you feel blamed, that is not promoting healing. I think that is a circumstance when a patient should leave," DiMatteo says.

"There are a lot of smart doctors out there. Get one who's also nice."