feeling less disillusioned

[randomdoc1]

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hi all, I've continued to lurk the forum but am happy to say I'm feeling less and less disillusioned.

1) I've found as my practice has grown, that I was able to fill my practice with plenty of motivated patients who want to follow the evidence based route. As a matter of fact, many patients when I sat down to explain to them my rationale, were quite appreciative that there are providers who are interested in gathering a good history so we have a good idea of what we are actually treating before proceeding forth with treatment. As a matter of fact, many patients when you explain the evidence based model, were quite excited about it and many were not aware that this is how many physicians are trained. They felt reassured and less disillusioned themselves after learning that there is a method to the madness. In addition, many patients are very understanding that nothing will ever replace lifestyle changes and express interest in pursuing that route. Lifestyle changes are not always the easiest to follow through with, but many patients do own up to it. This is not to say there aren't equally as many patients who want a fix, I still encounter many of those and if we are not a match, eh, not the end of the world, they can come back when they are ready if they reach that point...and over time, some have.

2) The NPs versus MDs debate. There is no doubt that NPs get far less training than an MD would. And I'm quite sure my ability to practice medicine would be atrocious if I went the NP route so I obviously don't blame the NPs as people...although there certainly are some with huge chips on their shoulders but likewise with some MDs. As I said, there are decent NPs out there. But I have had some patients seek care with me after they were unsatisfied with their NP and many have expressed interest in the level of training their provider has had. This is also not just specific to psychiatry. More and more patients have expressed to me how appalled they are at how bare some of the NP training is and are now more proactive about finding a provider that they don't just get "good vibes" from, but they want a well informed and well trained provider. That was quite good a hear.

Just wanted to share some brighter moments I've had now that I've been a little over 2 years out of residency!

 

[dl2dp2]

hi all, I've continued to lurk the forum but am happy to say I'm feeling less and less disillusioned.

1) I've found as my practice has grown, that I was able to fill my practice with plenty of motivated patients who want to follow the evidence based route. As a matter of fact, many patients when I sat down to explain to them my rationale, were quite appreciative that there are providers who are interested in gathering a good history so we have a good idea of what we are actually treating before proceeding forth with treatment. As a matter of fact, many patients when you explain the evidence based model, were quite excited about it and many were not aware that this is how many physicians are trained. They felt reassured and less disillusioned themselves after learning that there is a method to the madness. In addition, many patients are very understanding that nothing will ever replace lifestyle changes and express interest in pursuing that route. Lifestyle changes are not always the easiest to follow through with, but many patients do own up to it. This is not to say there aren't equally as many patients who want a fix, I still encounter many of those and if we are not a match, eh, not the end of the world, they can come back when they are ready if they reach that point...and over time, some have.

I endorse this as well. In general, psychiatrists make PLENTY of big differences in life for people who are motivated to change but lack the tools and need meds re-evaled and streamlined. People's motivation change in time, and you can't win every battle, but when there's a win, especially over time, it's extremely rewarding and not easily comparable to any other field of medicine for chronic conditions.

2) The NPs versus MDs debate. There is no doubt that NPs get far less training than an MD would. And I'm quite sure my ability to practice medicine would be atrocious if I went the NP route so I obviously don't blame the NPs as people...although there certainly are some with huge chips on their shoulders but likewise with some MDs. As I said, there are decent NPs out there. But I have had some patients seek care with me after they were unsatisfied with their NP and many have expressed interest in the level of training their provider has had. This is also not just specific to psychiatry. More and more patients have expressed to me how appalled they are at how bare some of the NP training is and are now more proactive about finding a provider that they don't just get "good vibes" from, but they want a well informed and well trained provider. That was quite good a hear. Just wanted to share some brighter moments I've had now that I've been a little over 2 years out of residency!

I think the issue with NP or even other allied professionals in mental health is that the quality is so uneven. Some are very good, but the bad ones are extraordinarily bad, and it's hard to tell them apart at first glance. One big picture to start from a well-trained MD is that we generally get a bigger picture management style, typically as the MD training starts and ends with very sick people (in all kinds of ways). MDs generally don't stress over detracting details as much as others do. This character provides real value IMHO even for people who are less sick in routine practice.

 

[Bartelby]

A great reminder that attending practice can be very different from residency, both in terms of the patient population and your own level of control over your working conditions.