- Joined
- Aug 19, 2011
- Messages
- 500
- Reaction score
- 321
I used to agonize a lot about my psychiatry practice and the field of psychiatry in general. Then a few months ago I had a medical event. I recovered, but it did for me much more than years of therapy and medication had done. I realized life is too short and there are better things to spend mental energy on than obscure worries about unlikely medical outcomes, whether patients like me or not, or being sued or reported to the board. Of course, being sued or reported or having bad medical outcomes are still important to avoid as best you can, but they don't need to be all-consuming concerns.
Suddenly, my notes are getting done faster, I am barely ever late unless there's a really hairy clinical situation or other emergency, and my patient rating, for what that's worth, has no dropped but actually improved. As long as I know I am providing standard of care (which is actually quite a large ballpark, as I'm learning), I can make a decision, communicate clearly, and move on. I am also better at not taking on too much perceived responsibility. Patient does not like my boundaries? They can see someone else. Patient not following the treatment plan? Well, I guess they are not going to get better. Patient did not do what they needed to do to maintain access to their meds (usually this is cessation of various substances). Well, that is on them.
I even negotiated a later start to my day and a later end time, and that helps because I have always had a delayed sleep cycle and I decided I no longer wanted to keep fighting it to remain a productive member of society. Not being quite so tired helps a lot too.
Some of the above may also be because I know my patient load a better now, and know what to expect from many of my patients, even as they have developed more trust for me.
Are things perfect? No. There are still patients I don't look forward to seeing. I still spend more time than I'd like to on notes, but at least more of them are done by the end of a normal clinic day. I am still frustrated that medications don't work as well as we hope a lot of the time, and time and other systemic constraints prevent us from engaging in enough therapy. But it's ok, for the time being, and I'm ok, doing the best I can with the tools I have.
Suddenly, my notes are getting done faster, I am barely ever late unless there's a really hairy clinical situation or other emergency, and my patient rating, for what that's worth, has no dropped but actually improved. As long as I know I am providing standard of care (which is actually quite a large ballpark, as I'm learning), I can make a decision, communicate clearly, and move on. I am also better at not taking on too much perceived responsibility. Patient does not like my boundaries? They can see someone else. Patient not following the treatment plan? Well, I guess they are not going to get better. Patient did not do what they needed to do to maintain access to their meds (usually this is cessation of various substances). Well, that is on them.
I even negotiated a later start to my day and a later end time, and that helps because I have always had a delayed sleep cycle and I decided I no longer wanted to keep fighting it to remain a productive member of society. Not being quite so tired helps a lot too.
Some of the above may also be because I know my patient load a better now, and know what to expect from many of my patients, even as they have developed more trust for me.
Are things perfect? No. There are still patients I don't look forward to seeing. I still spend more time than I'd like to on notes, but at least more of them are done by the end of a normal clinic day. I am still frustrated that medications don't work as well as we hope a lot of the time, and time and other systemic constraints prevent us from engaging in enough therapy. But it's ok, for the time being, and I'm ok, doing the best I can with the tools I have.