I get the surgery without anesthesia analogy but I think it is the client who is the surgeon, not the therapist. At best the therapist is the person wiping off the brow of the surgeon/client and sometimes handing the client the right tool, at worst, the therapist tries to sew the client back up but leave sponges and stuff behind, drops the needle and so forth.
I would never let the therapist be the surgeon.

I don't see a psychiatrist or even an md of generality - I don't think everyone sees a psychiatrist.