Burnout

[PublicHealth]

Is burnout an issue in psychiatry? I have heard of several psychiatrists who have left the field to pursue other specialties -- some have gone on to occupational medicine, anesthesiology, and family practice, citing difficult, hard-to-treat patients, 5-minute med checks, loss of physical diagnosis skills, and "not feeling like a real doctor" as the primary reasons for their leaving the field. Anyone feel similarly or know of people who have left the field?

 

[Anasazi23]

On the other hand, psychiatry is the most commonly "switched-into" field in medicine. Physicians often leave their practices and enter psychiatry residencies citing similar difficulties in medicine, family practice, pediatrics, etc. They complain of repetitiveness and noncompliance of cellulitis and metabolic syndrome patients, etc.

If you've lost physical diagnosis skills and "don't feel like a doctor," you have not been practicing proper psychiatry. To separate medicine from psychiatry is dangerous and is a lower-level of care for the patients. Modern psychiatry uses many different medications "off label" as well as for approved purposes. Prescribing a Ca channel blocker is for some psychiatrists more than just for essential htn. I admit that some revolving door patients can press on your nerves, and that if you've set up your practice such as you've described, ennui may set in. But I also assert that if you're bored, you're not reading and up-to-date. Psychiatry research is arguably one of the fastest growing fields in medicine. There's more than enought to stay cutting-edge and interested for many lifetimes.

 

[purpledoc]

Is burnout an issue in psychiatry? I have heard of several psychiatrists who have left the field to pursue other specialties -- some have gone on to occupational medicine, anesthesiology, and family practice, citing difficult, hard-to-treat patients, 5-minute med checks, loss of physical diagnosis skills, and "not feeling like a real doctor" as the primary reasons for their leaving the field. Anyone feel similarly or know of people who have left the field?

Well, I admit to being somewhat skeptical about your motivations for asking, given your strong support for psychologist prescribing. However, taking your question at face value, I would say that psychiatrists are actually happier in many ways than other physicians. Often, we get emergency calls after hours less frequently; have medications that work for 80% of patients (say, with depression) instead of about 50% (say, with diabetes or heart disease); can see patients for 45-50 minutes at a time, if we choose; are in high demand in most areas of the country; get sued less often; and can even hospitalize patients who have decompensated, instead of PCPs who must stand by and watch as their non-compliant diabetics lose a toe, then a foot, then a leg... Plus, psychiatrists can choose to be fee-for-service in many areas and still make a living. There aren't many other doctors who can say that, except perhaps plastic surgeons and fertility specialists.

All in all, Anasazi is right -- more doctors switch into psychiatry than out of it. Personally, I know of at least 5 -- and probably closer to 10 -- people who switched into it. My own childhood pediatrician went back into a residency at age 50 to retrain in psychiatry, which had been her dream for years since psychiatry wasn't very welcoming to women at the time she trained. 🙂 I've actually never heard of a psychiatrist "burning out" and retraining in another medical specialty.


Peace,
Purpledoc