Are you energized or drained by psychiatry?

[albertwhatjob]

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This is a vast generalization but supposedly, most psychiatrists are introverted types, which means having to talk to people and being social is more draining than energizing for them (i.e. it takes work and doesn't come naturally). Of course, talking one on one with a patient is more meaningful and so may be in that sense it is more fun and fulfulling.

For you guys, how much of your time do you spend working with things and information as opposed to working with people? How much of your time is spent analyzing stuff and working by yourself? Do you feel drained or do you feel pretty skippy at the end of the day? I'm just not sure if I can handle talking to people, even if it is one on one, 8 hours a day! Any insight would be appreciated. Thanks!

 

[vmc303]

This is a vast generalization but supposedly, most psychiatrists are introverted types, which means having to talk to people and being social is more draining than energizing for them (i.e. it takes work and doesn't come naturally). Of course, talking one on one with a patient is more meaningful and so may be in that sense it is more fun and fulfulling.

For you guys, how much of your time do you spend working with things and information as opposed to working with people? How much of your time is spent analyzing stuff and working by yourself? Do you feel drained or do you feel pretty skippy at the end of the day? I'm just not sure if I can handle talking to people, even if it is one on one, 8 hours a day! Any insight would be appreciated. Thanks!

This is the one thing that's made me a bit reluctant to go into psychiatry. It's a fascinating field, and I like just about everything about it, except the, well... the "seeing patients" part of it. This doesn't sound like much fun for me. I always thought psychiatrists were introverts too. Having to continually meet and talk with strangers doesn't seem to be too compatible an assignment.

 

[PsychFuture]

This is the one thing that's made me a bit reluctant to go into psychiatry. It's a fascinating field, and I like just about everything about it, except the, well... the "seeing patients" part of it. This doesn't sound like much fun for me. I always thought psychiatrists were introverts too. Having to continually meet and talk with strangers doesn't seem to be too compatible an assignment.

I am a complete introvert, I get very energized dealing with patients one on one. I hate to talk about myself but could spend hours talking to someone else about their experiences. Don't go into Psych if you don't like dealing with patients, duh. Go into Path or something similar, no shame in knowing who you are just pick a field where you know you will thrive.

From my experience with Psych, which is a number of rotations in med school, you would see many patients during the day. One of the reasons I am going into Psych is the focus on the patient.

 

[OldPsychDoc]

This is a vast generalization but supposedly, most psychiatrists are introverted types, which means having to talk to people and being social is more draining than energizing for them (i.e. it takes work and doesn't come naturally). Of course, talking one on one with a patient is more meaningful and so may be in that sense it is more fun and fulfulling.

For you guys, how much of your time do you spend working with things and information as opposed to working with people? How much of your time is spent analyzing stuff and working by yourself? Do you feel drained or do you feel pretty skippy at the end of the day? I'm just not sure if I can handle talking to people, even if it is one on one, 8 hours a day! Any insight would be appreciated. Thanks!

Being with patients is different than "being social". I'm an introvert socially, but find that I rely on my "white coat role" with patients--that is, I have a job to do and the expertise to perform that job. There are times though, when a patient is so demanding or needy in an Axis II way, or their situation so overwhelming in an Axis IV way that I really do feel drained after dealing with it. (And on those days, it doesn't exactly help that I have "high maintenance" kids at home, either!) You've got to find ways to cope, but overall, I really found psych to be a good match for my style and interests.

 

[MDgonnabe]

i agree with those who say that there's a big difference between being extroverted in social situations vs being extroverted in clinical encounters. clinical encounters are a lot more "scripted" and they also revolve around the patient. personally speaking, my extroversion-introversion varies greatly depending on whom i'm around. if i'm around very extroverted people, i tend to quiet down and listen in, ie become much more observant. if i'm around very introverted people, i naturally become the conversation starter. sure, i have days when i never want to be around others. other days i crave the company of good friends. i think my desire for solitude slightly outweighs my desire for company as i've never been a big party person; and i definitely prefer one-on-one time with very close friends. so i'm probably introverted over all. as such i'm sure that dealing with certain patients will be draining for me. but at the same time, i also think that there'll be some patients whom extroverts find very hard to deal with. one of the reasons why i started considering psych was because about halfway through my 3rd year i noticed how i was enjoying my interactions with certain patients whom i found out, in retrospect, apparently had psych issues. so i think you could also think back to how you felt around patients with psych problems in all the other clinical settings you've been in.

 

[OldPsychDoc]

Energized or drained?

I cover inpatient beds in the morning, and outpatient clinic in the afternoon. It's a pretty varied life. As I posted earlier this week, it's not always a bed of roses. (Thanks BTW to those of you who offered support and sympathy.)
This morning was, well, nuts. I spent 45 minutes on the phone trying to get an out of state insurer to cover two prescriptions for a patient who had had the misfortune of decompensating while travelling out of her coverage area. Two more patients should be going home today but "just don't feel ready." I spent the better part of another hour trying to coordinate discharge planning for another difficult patient. On top of that (for comic relief) a psychotic & manic patient threatened to fire my social worker because we wouldn't give him a pass to go out an smoke! (If she goes, I go!!) I was EXHAUSTED when I got to clinic. (Late, of course. No time for lunch, either.)

So my first patient is a very pleasant cooperative young adult who started an antidepressant with her primary MD, has a nice life, but just wants to feel a little happier, more like herself. We increased her dose, set a follow up plan, and she left with a smile. My final patient is a middle aged woman, former inpatient, very depressed and badly alcoholic. We practically bludgeoned her into a residential 90 day program before we would agree to discharge her. It was not pleasant, and she was pretty pissed at us before it was all over.
Today she was 2 days post discharge from the 90 days. I was a little nervous about this one. Well, to make a long story a little shorter, she basically thanked me for saving her life 92 days ago. She had nothing but nice things to say about the staff of our hospital, and thanked us profusely for "applying your foot to the small of my back" and sending her to the program. (Of course we were lucky that she had good insurance--it's not always that easy...)

So there you have it...a day in the life of an introverted junior attending.
Glad to be home. Glad to not be on call. Glad to have a 3-day weekend.
Enjoying a beer (in moderation, always.) Did my job, saved a life. That's about as great as it gets.

 

[marie337]

Well, I'm years away from being a psychiatrist, but as introverted as I am, the aspect of medicine that draws me in is the one-on-one interaction with patients. I love listening to people and trying to help them sort out their problems. But, my weekly visit with my psychologist is extemely draining. I imagine that having patient after patient with sucicidal ideations and "life is pointless" conversations could be depressing. But, I seriously doubt that is a typical day.

Those of you who do private practice, what is your typical day like? What are the most common issues and is there anything that you get tired of? Just curious. I'm thinking more and more of psychiatry, but I still have plenty of time to change my mind.

 

[willow212]

One thing the OP asked was - how much time do you spend with your patients vs. doing other things? As a resident, one of the things I really like about psychiatry is that you get to spend more time (still not enough time) with your patients than you do on other services, because the interview is your data gathering tool. There aren't as many other things you need to do (like interpreting radiologic images or lab tests or calling consultants) like other medical specialties.

To answer the main question, I would agree with some of the previous posters, who said that some patients energize you and some drain you. The ones who tend to drain me are the ones I feel I can't help, because they are at a stage where they aren't accepting of treatment recommendations; though in some cases, they can be energizing since they are challenging.

I'm definitely more on the introverted end of the spectrum, but agree with others who note that this is not a hindrance in the structured setting and one-and-one nature of the interview. Being able to listen and pick up on subtle cues is just as important as coming up with something helpful to say, so it's good to have strengths in both.

Overall, my interest in the field and the support I get from the other people I work with, along with my curiosity about each patient, makes it all worthwhile.

 

[PsychMD]

Personally, I tend think that the "drain" parameter is pretty much directly correlated in a very straightforward manner with the VOLUME (number) of patients one sees per day. I am aware that certain systems of care (read bureaucratics/logistics/administrative settings) may make a larger volume seem more palatable in some settings vs. others, and that also the severity/acuity/complexity factors may influence the drain factor too, but all these are secondary "corrective" factors. Volume is still no. 1!

I can actually probably envision a mathematical formula for this! 🙂

Something like: DRAIN= VOLUME * (kp/sa), where

k= acuity and complexity (like inpt. settings vs. out pt.);
p= local managed care market penetration (here one could include other external factors too, e.g. funding problems, local liability climate, whatever);
s= solo (autonomy, not necessarily the "exact" type of practice, could also mean protection from some bureaucracy/paperwork in some settings);
a= "academic" interests (not necessarily the setting, though! here one could also include some subjective factors related to the personality of the psychiatrist too, curiosity, optimism, superior defenses, support system, etc.).

The problem with my "formula" is that the "protective" factors, the "s" and "a", are more abstract in nature, not easily quantifyable, and highly subjective in nature. But I tried! I am no mathematical whiz, so I appreciate any corrections!