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- Sep 18, 2006
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As part of my training in residency we work a 6 month community mental health rotation. For the most part I enjoy this, typically it is patients who are on medicaid or another susidy program that thay have here and they tend to be people who genuinely want and need help.
However, as of lately I have been feeling some deep issues of countertransferrance and generalized frustration with a number of my patients. I understand the economy is not the best it has been, jobs are not in abundance and people are having a difficult time getting by. But, I am appalled at the number of otherwise healthy patients who come in here seeking disability from their first or second visit. I can understand they have depression, I can understand they likely have sxs of borderline or antisocial personality disorder and they do play a role in them having a difficult time seeking employment but where do we as psychiatrists and as society draw the line in what disability is? And since when are psychiatrists the ones to essentially tell people "ok, you shouldn't do anyhting, you should sit on your butt at home and collect a monthly check" instead of "I have multiple treatment options we can explore and we can eventually work towards getting you back into the workforce"
When I try to do the latter I suffer some form of repurcussion whether it be a formal complaint against me or a request for a change in provider or the patient just stops coming in to see me. Or I even have social workers who will contact me and send me on a guilt trip about how hard the patients life is.
Like I said, I understand there are those who need disability but I also think metaphorically speaking that we shouldn't feed the bears. If you go to the national parks and you feed a bear you will be given a citation, reason being that the bears give up on learning how to hunt and forage. Is disability in theory feeding the bears?
Those of you in residency are you often required to fill out these forms?
However, as of lately I have been feeling some deep issues of countertransferrance and generalized frustration with a number of my patients. I understand the economy is not the best it has been, jobs are not in abundance and people are having a difficult time getting by. But, I am appalled at the number of otherwise healthy patients who come in here seeking disability from their first or second visit. I can understand they have depression, I can understand they likely have sxs of borderline or antisocial personality disorder and they do play a role in them having a difficult time seeking employment but where do we as psychiatrists and as society draw the line in what disability is? And since when are psychiatrists the ones to essentially tell people "ok, you shouldn't do anyhting, you should sit on your butt at home and collect a monthly check" instead of "I have multiple treatment options we can explore and we can eventually work towards getting you back into the workforce"
When I try to do the latter I suffer some form of repurcussion whether it be a formal complaint against me or a request for a change in provider or the patient just stops coming in to see me. Or I even have social workers who will contact me and send me on a guilt trip about how hard the patients life is.
Like I said, I understand there are those who need disability but I also think metaphorically speaking that we shouldn't feed the bears. If you go to the national parks and you feed a bear you will be given a citation, reason being that the bears give up on learning how to hunt and forage. Is disability in theory feeding the bears?
Those of you in residency are you often required to fill out these forms?