I can see where things go wrong both ways. I have an old time Internet friend who doesn't self DX but has some kind of nutty drug pusher as a doc. Friend can walk in and ask for anything and I mean anything and get it. Currently on 21 different meds (at the same time).

I had a doc that was quite the opposite, getting a med change was like sucking blood from a rock. The only meds she wanted to give me were new "cool" ones to try n me. It took me years for me to put my foot down and ask and actually get a med that had good reviews for my issue and should been tried long before offlabel stuffs. She was just the type that knew it all and the patient can't know anything. I finally got the med I wanted and got so much better! She was simply unwilling to help I have realized.

After her I had a med mastermind, he could almost just look at you and understand your issues and get you the right med! But those are so rare.