I agree, it really depends on the pdoc, and I think it also depends on the patient. I think I got really lucky with my pdoc. He was recommended by my T, and my T contacted him first to tell him about me. When I met with him, he really seemed to understand my concerns, and he's never dismissed anything I say about how any meds affect me. He accepts what I consider "unacceptable" side effects, and we work to minimize those. But, I think it's also the patient's responsibility to be willing to communicate clearly with the pdoc and acknowledge that the pdoc does have experience and knowledge on their side. I think that just like with any other doctor, the only way things can work well is if both doctor and patient have open, honest, and respectful communication. I know lots of doctors that seem to have a power thing going on with patients, and they are derogatory, cold, disrespectful, and dismissive...I won't work with someone like that and simply find another provider.