Non clinical options

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sunlioness said:
No, they figure that with a no show rate averaging 25% that it works out in the end. Some days it does. Some days it really doesn't.

And yes, I'd certainly consider that. I'd also be interested in being a consultant type to primary care docs. I did a bit of that at my last job.


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This job sounds like a grind. Part of the problem with shortage of psychiatrist is when they get their hands on one, they work them to death. No one wants to work at the pace they want psychiatrists to in community mental health. Meanwhile the case managers are actually enjoying themselves and getting to know the patients, building therapeutic relationships. The case managers will often stay on for years even at relatively low pay while the psychiatrists are churned and burned. Not only that, they don't want your opinion either, just write the script and shut the heck up about everything else. Yeah, I would want out too! I was only treated about half as bad as the psychiatrists I have seen in CMH and I still got out as fast as I could. Too many social workers and administrative types running the show and making decisions not based on best practices or any type of research.
 
peppy said:
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Has anyone actually seen a psychiatrist get fired over something relatively minor such as not getting their flu shot documentation to occupational health before the deadline or being lazy about finishing their charting in time? (The organization I work for did threaten to fire us if we didn't get our flu shot paperwork to them, and I would not actually dare them to do it, but I wonder how likely it actually is)
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Based on an actual case observation, the bureaucratic violations might be used as the final, objective justification for ridding an organization of someone who was an a$$---- in multiple other significant interpersonal ways. But for "normal" people--most places wouldn't shoot themselves in the foot that badly. Well. maybe excepting governmental entities....
 
Does anyone know anything about the Kaiser Family Foundation? Their research is more on health disparities, not specific to psychiatry at all, but if I were to ever bail on clinical practice, I'd be interested in them. I'd probably need more schooling, though, in public health or statistics.
 
dropoutclub.org
nonclinicaljobs.com
 
So I've started meditating. Like they tell all the burned out docs to do. I've started meditating. And I'm crap at it. But I think I've figured some things out.

Psychiatry really isn't the problem. I truly am not the most passionate psychiatrist in the world. And that's okay. But I do think I'm better than average at it. And when I'm not doing it forty hours a week, I even kinda like it sometimes.

My old job wasn't the problem. My current job isn't the problem either. The field isn't the problem.

I think if I worked closer to thirty hours per week (either by working six hour days or four days/week), it'd be totally workable. I'd enjoy life again. I'd have balance.

It's a crappy thing to realize now though because this was totally doable in my old job. I could even increase my productivity because now I know I can do fifteen minute checks. Someone coming in stable for years on their ADD meds that their PCP isn't comfortable prescribing doesn't need a half hour.

Here? I'm sure they'd have no objection to my cutting my hours. It's just not terribly feasible because the salary is already fairly low. And the way things are set up, it would have repercussions on my benefits that weren't the case where I was before. And the cost of living is much higher.

So the upshot is . . . I feel dumb.


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I could totally swing it here even in the low salary high cost of living northeast if it weren't for the loans.


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Obviously it's easy for me to say without knowing you, OP, but I say decrease to 30 hours weekly and figure out the benefit situation, even if you lose the benefits. Is burning out and working so much just to keep the benefits worth your sanity and mental health?
 
sunlioness said:
I think if I worked closer to thirty hours per week (either by working six hour days or four days/week), it'd be totally workable. I'd enjoy life again. I'd have balance.
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Have you looked into part-time employment with benefits?

If you're so inclined, some county jobs give full-time benefits for employment of 24 hours or more (with pro-rated retirement). Many of these qualify for loan reimbursement as well. Some private employers also offer full benefits for part-time work.

If working 30 hours/week would give you professional satisfaction and a good life, it seems that this would be preferable to switching careers. There aren't many careers you can switch to with a medical degree that would give you any comparable salary with a decent lifestyle (which seems to be a priority). good luck...
 
Much preferable to switching careers. And totally workable at the place I just left. And I'm sure it'd be okay here too . . . But the salary is so much lower anyway with a cost of living that is about 75% higher and the six figure loans that aren't going anywhere. It's much less practical. And yeah, lifestyle is important. I just don't want to be a doctor and not be able to have some nice things and do some fun things every now and then. I used to feel badly about that. I don't anymore.

I don't think I burned any bridges, so I could look into going back. But I'm not sure it's the best option all things considered. It would have to be looked at carefully. And other options considered too.


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I ditched my part-time benefits because they sucked. Now I'm dealing with the healthcare exchange which also sucks. Bottom line is it all sucks so go ahead and cut your hours.
 
Yeah. My brother and several friends are dealing with the healthcare exchange. It sucks uniformly. My brother is probably going to opt out and pay the penalty. It's cheaper that way and it's not like his insurance actually covered much useful.

I'll look into it in the New Year. Or if that wouldn't work maybe there is ten hours of non-clinical something I could do.

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Going to a 30 hour week sounds pretty nice. Honestly working a stacked clinical schedule for 40 hours a week (especially if each day 30-90 minutes of extra work spills outside of business hours) sounds draining. I think to make it into the 40-50 hour range burnout-free there would need to be some variation, for example spending a day each week doing emergency psychiatry instead of outpatient.

I also think in terms of paying loans / cost effectiveness dropping to a thirty hour a week schedule and pursuing other interests in all of that free time makes more sense than retraining for another career (which may end up paying lower than the thirty hour a week psych job anyhow).
 
sunlioness said:
Much preferable to switching careers. And totally workable at the place I just left. And I'm sure it'd be okay here too . . . But the salary is so much lower anyway with a cost of living that is about 75% higher and the six figure loans that aren't going anywhere. It's much less practical. And yeah, lifestyle is important. I just don't want to be a doctor and not be able to have some nice things and do some fun things every now and then. I used to feel badly about that. I don't anymore.

I don't think I burned any bridges, so I could look into going back. But I'm not sure it's the best option all things considered. It would have to be looked at carefully. And other options considered too.


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You're an adult who's worked hard, and you deserve some nice things. About loans, is there any chance you would qualify for the Repaye program? At least that caps your loan payments at 10% of your income, which isn't small but still ...

When I had my brief stint of doing multiple different jobs, I realized that one weekend of hospital call was close to one week day of pay, so I could work 4 days a week + one weekend and wind up about where I'd be working 5 days a week with no call. Weekend call sucks, but having it mixed with 3 weeks of of 3 day weekends could be nice.

Regarding benefits, you qualify for benefits at 20 hours/week at most of the places I've talked to out here. I had benefits at my 20 hour/week community MH job.
 
I think I would like a job doing outpatient. It could be 15 minute med checks. It could be therapy. It could be whatever. But outpatient or IOP. Or maybe even a bit of inpatient. But not a lot. But no more than 32 hours/week tops. Very minimal, if any, call (ideally make it optional and well-paid), and a salary of at least $200K with full benefits.

Do those exist? How do you find them?

A former colleague had the thought of dropping to part time where I am now (I don't think I could swing it on it's own here), but picking up some per diem work doing chart reviews or something. That might be worth looking into.
 
sunlioness said:
I think I would like a job doing outpatient. It could be 15 minute med checks. It could be therapy. It could be whatever. But outpatient or IOP. Or maybe even a bit of inpatient. But not a lot. But no more than 32 hours/week tops. Very minimal, if any, call (ideally make it optional and well-paid), and a salary of at least $200K with full benefits.

Do those exist? How do you find them?

A former colleague had the thought of dropping to part time where I am now (I don't think I could swing it on it's own here), but picking up some per diem work doing chart reviews or something. That might be worth looking into.
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I was able to get 150k. 30 hrs with full time benefits. 200k is a bit of a stretch in my area for the number of hours. Nice having a four-day weekend though!

Right now I am at 20 hours no benefits. Even better. Can't wait to retire!
 
there are MBA programs specific for physician, its expensive but i believe it may lead you to a CMO position or other executive positions
 
sunlioness said:
I think I would like a job doing outpatient. It could be 15 minute med checks. It could be therapy. It could be whatever. But outpatient or IOP. Or maybe even a bit of inpatient. But not a lot. But no more than 32 hours/week tops. Very minimal, if any, call (ideally make it optional and well-paid), and a salary of at least $200K with full benefits.

Do those exist? How do you find them?

A former colleague had the thought of dropping to part time where I am now (I don't think I could swing it on it's own here), but picking up some per diem work doing chart reviews or something. That might be worth looking into.
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We would probably be able to offer something like that to a psychiatrist here, especially if you could work with kids, but you would have to want to live in a pretty small town in the middle of nowhere. 🙁
 
Hmmm. I'd be leery of moving to a small town in the middle of nowhere where I didn't know anyone just because I'd be worried about social isolation. I'm unmarried, so it'd be just me. And the dog I'm going to get. And I'm not sure that would be all that terribly brilliant.

But that's really cool. Thanks. 🙂


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sunlioness said:
Hmmm. I'd be leery of moving to a small town in the middle of nowhere where I didn't know anyone just because I'd be worried about social isolation. I'm unmarried, so it'd be just me. And the dog I'm going to get. And I'm not sure that would be all that terribly brilliant.

But that's really cool. Thanks. 🙂


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You are correct that it would probably not be a good idea. We have had various providers move here without family and it usually doesn't work out well.
 
This is a great thread. Sunlioness I hope you will keep us posted about your plans. There are a LOT of things you can do with an MD that have nothing to do with clinical care. For example you could work for the CDC, or the UN, or the WHO - and you don't have to specialize in mental health unless you want to. You can go into business consulting or finance, like other posters have mentioned, or medical or science journalism.

I'm starting a new residency in July. I won't say what field it's in because I don't want to be identified. But I am super excited. If my new plans shave even one day off my life listening to people complain about restless legs, insomnia, low energy, "mood swings" and all the other vague complaints I have spent the l last six years listening to, it will be worth it.

Splik's list is excellent, and I would add to it that psychiatry is not a good field for people who think analytically or like to see things quantified or explained logically, or who want variety that includes doing procedures, not just listening and prescribing meds all day.
 
Thanks! And good luck to you! I think I'm going to see if I can figure out how to reduce my hours first. And then see if that's enough. It might be. I know when I started here, I kinda liked it. But then I realized I kinda liked it because I'd just had a few months off. It didn't last long. Now I'm reading Pam Wible and shaking my fist a lot.

I gotta run. Gotta evaluate a patient who scheduled with me because the last doc told them she wouldn't prescribe a stimulant without testing or documentation of previously done testing. So unreasonable!The nerve of her! (Can't there be rules to prevent this sort of thing? I mean I'm going to spend an hour just to tell this person the same thing. And it'll probably be an argument. And I just don't feel like it.)


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sunlioness said:
Thanks! And good luck to you! I think I'm going to see if I can figure out how to reduce my hours first. And then see if that's enough. It might be. I know when I started here, I kinda liked it. But then I realized I kinda liked it because I'd just had a few months off. It didn't last long. Now I'm reading Pam Wible and shaking my fist a lot.

I gotta run. Gotta evaluate a patient who scheduled with me because the last doc told them she wouldn't prescribe a stimulant without testing or documentation of previously done testing. So unreasonable!The nerve of her! (Can't there be rules to prevent this sort of thing? I mean I'm going to spend an hour just to tell this person the same thing. And it'll probably be an argument. And I just don't feel like it.)


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Reducing your hours could help a lot. I did that recently, and couldn't be happier. Before my current job, I had been working for a corrupt state hospital. The pay was great but the conditions were very disturbing. I decided I needed to get out quickly, and I took the first job I could find. I'm doing med checks at a rural clinic, and they let me work exclusively by telemedicine. I set it up so I work 4 days a week. All the same stuff about psychiatry still bugs me, but it is so much more tolerable. The pay isn't the best but for now it's ok, especially since I'm just biding my time until July. My personal life has improved too because I have more flexibility in terms of location and I am not as stressed out.
 
Yeah. That's what I'm thinking. I'm never going to enjoy getting worked over for adderall. But if I had more time for a personal life and wasn't constantly getting worked over for adderall, I could tolerate getting worked over so much better. That's the hope anyway. I really don't want to train for a whole new career. I really don't.

Jeopardy didn't work out. But I sent in an application for 500 Questions. So there's always the game show angle to explore.

The last eval went much as expected

I have ADD

What symptoms are you having?

I don't know. You're the doctor. You have to ask me questions.

Okay. Do you start projects you don't finish? Do you misplace things? Do you procrastinate? Do you fart when you eat noodles?

YES YES YES. All of that!! So much!!!!

Well, that's not verbatim. But kinda.

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sunlioness said:
Yeah. That's what I'm thinking. I'm never going to enjoy getting worked over for adderall. But if I had more time for a personal life and wasn't constantly getting worked over for adderall, I could tolerate getting worked over so much better. That's the hope anyway. I really don't want to train for a whole new career. I really don't.

Jeopardy didn't work out. But I sent in an application for 500 Questions. So there's always the game show angle to explore.

The last eval went much as expected

I have ADD

What symptoms are you having?

I don't know. You're the doctor. You have to ask me questions.

Okay. Do you start projects you don't finish? Do you misplace things? Do you procrastinate? Do you fart when you eat noodles?

YES YES YES. All of that!! So much!!!!

Well, that's not verbatim. But kinda.

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The pharmaceutical companies are pretty good at pushing their product and they blame the docs for any problems. Why let the mexican drug cartels get rich off the stimulants when companies like Shire pharmaceuticals can do so much better and they are "helping patients"
Now targeting adults, Shire and two patient advocacy groups have recruited celebrities like the Maroon 5 musician Adam Levine for their marketing campaign,“It’s Your A.D.H.D. – Own It.” Online quizzes sponsored by drug companies are designed to encourage people to pursue treatment. A medical education video sponsored by Shire portrays a physician making a diagnosis of the disorder in an adult in a six-minute conversation, after which the doctor recommends medication.
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from NY Times article http://www.nytimes.com/2013/12/15/h...ion-deficit-disorder.html?pagewanted=all&_r=0
 
I am starting to dislike fake ADHD even more than fake bipolar disorder. The town I'm working in is plagued with prescription drug abuse and bad unemployment. Selling Adderall on the street is a part time job for many of our patients. The clinic has had a hard time recruiting doctors and NPs and apparently, for many years they were stuck with this one doctor who literally gave everyone Adderall. Who knew it could be used for "racing thoughts" and "anxiety?" Who knew I was "required" to get the patient's "consent" before decreasing or stopping it? But the patients expect that. I've had patients who have done time in jail for selling Adderall come in and shamelessly try to get me to continue it. I've had entire families where all the members will make appointments with me and try to harass me into giving it to them. Luckily our administration is supportive of me when I say no.
 
sunlioness said:
I gotta run. Gotta evaluate a patient who scheduled with me because the last doc told them she wouldn't prescribe a stimulant without testing or documentation of previously done testing. So unreasonable!The nerve of her! (Can't there be rules to prevent this sort of thing? I mean I'm going to spend an hour just to tell this person the same thing. And it'll probably be an argument. And I just don't feel like it.)
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The only way I would ever work in outpatient again would be if I could work in a setting where I could have my receptionist/scheduler tell everyone upfront that the doc has a policy of not prescribing medications with a high risk of addiction to hopefully screen out most of these types of patients. Since psychiatrists are in short supply, I feel like it is a horrendous waste of resources when we psychiatrists waste our time arguing with drug seekers when that time could be used to see people who actually want help and can't get in to see a psychiatrist for months.
I definitely think that one reason why psychiatrists are considered a relatively happy bunch is because part time work IS a realistic option in our specialty, moreso than in some other specialties. Right now I am doing full time work at a job that is somewhat busy by Psych standards, but only because I want to be rid of the loan debt. It's definitely not how I want to spend my entire career.
 
peppy said:
The only way I would ever work in outpatient again would be if I could work in a setting where I could have my receptionist/scheduler tell everyone upfront that the doc has a policy of not prescribing medications with a high risk of addiction to hopefully screen out most of these types of patients. Since psychiatrists are in short supply, I feel like it is a horrendous waste of resources when we psychiatrists waste our time arguing with drug seekers when that time could be used to see people who actually want help and can't get in to see a psychiatrist for months.
I definitely think that one reason why psychiatrists are considered a relatively happy bunch is because part time work IS a realistic option in our specialty, moreso than in some other specialties. Right now I am doing full time work at a job that is somewhat busy by Psych standards, but only because I want to be rid of the loan debt. It's definitely not how I want to spend my entire career.
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It's really that much easier. If they come in asking for Xanax or whatever their drug of choice is, you explain that their symptoms are not justified in giving out a controlled substance rather taking on alternative therapy. If they agree to hear it out and disagree, you just agree to disagree and treat the session as a consultation only and provide a list of other psychiatrists in the area. Bill it at a 99204 and you move on and close their case to the clinic so no further appointments can be made.
 
Shikima said:
It's really that much easier. If they come in asking for Xanax or whatever their drug of choice is, you explain that their symptoms are not justified in giving out a controlled substance rather taking on alternative therapy. If they agree to hear it out and disagree, you just agree to disagree and treat the session as a consultation only and provide a list of other psychiatrists in the area. Bill it at a 99204 and you move on and close their case to the clinic so no further appointments can be made.
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Except in a capitated system, where they keep coming back to argue their case....


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Or they jump to hear the same thing from another doc in the same group. There should be a rule that you can't just keep running through everybody hoping to get the drug you want. It is a huge waste of a valuable and limited resource. And if I were waiting months to get in to see somebody and knew how much time was taken up by that, I'd be pissed.


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Shikima said:
It's really that much easier. If they come in asking for Xanax or whatever their drug of choice is, you explain that their symptoms are not justified in giving out a controlled substance rather taking on alternative therapy. If they agree to hear it out and disagree, you just agree to disagree and treat the session as a consultation only and provide a list of other psychiatrists in the area. Bill it at a 99204 and you move on and close their case to the clinic so no further appointments can be made.
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In Alanon they talk about letting go and detachment. This sounds like a good example of that. The addict wants an argument, that is a pattern of interacting they are comfortable with. The less you engage in it the better. It can be hard because they are so good at sucking us in and we tend to be nice and want to be helpful. Reminds me of a line about not mistaking kindness for weakness. The kindest thing is to tell an addict no but that takes strength. Nevertheless, I usually get one or two a week who get under my skin a bit and I don't even have access to the pills. They are just coming to me because the person who does have access to the pills told them they had to come. They usually get pretty angry when I explain addiction, tolerance, effective treatment and realize they don't really want that. Some do recover though and those are the bright spots who I get to watch recover and its important for me to hold on to that. Of course, they also begin getting off of many of the medications and having less and less need to change them because "they aren't working anymore" so the psychiatrist doesn't always get to see the recovery process as much as I do.
 
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So I answered a recruiter's email. He'd written dangling jobs in a region of the country that I'm fond of, have lived in before, and have family. I told him I wasn't actively looking, but could be tempted by the right offer. Outpatient only. No call. 30 hour week. $200K salary. I figured he'd say nope.

He didn't blink. Told me he'd check the database and get back to me. And he did with four opportunities. They aren't in a big city. But they're close to big cities. Not the middle of nowhere. Not specifically where I know anybody.

And I'm thinking . . . How do I find the time to investigate these things? I work forty hours. It'd be "unprofessional" (Splik, you are like my favorite SDNer now) to take days off with less than a few months notice to vet these places. How do you check them out? How do you interview and get a feel for the people, the place, the patients when you have no time to do it?

I got a bit weepy at a BW3 last night thinking about it. Then I went home and went to bed ungodly early.

And today I'm thinking locum might be the best short term option. I'd set my own schedule. Negotiate my own rate. Probably make more than I'm making now and have the time to check places out as thoroughly as I feel I need to at this point. Maybe even work a few places and see if I like them.

Problem is I could only do it in two states or the VA right now. Should I start picking up licensure in states I think I might want to live in? Do people do that?



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sunlioness said:
So I answered a recruiter's email. He'd written dangling jobs in a region of the country that I'm fond of, have lived in before, and have family. I told him I wasn't actively looking, but could be tempted by the right offer. Outpatient only. No call. 30 hour week. $200K salary. I figured he'd say nope.

He didn't blink. Told me he'd check the database and get back to me. And he did with four opportunities. They aren't in a big city. But they're close to big cities. Not the middle of nowhere. Not specifically where I know anybody.

And I'm thinking . . . How do I find the time to investigate these things? I work forty hours. It'd be "unprofessional" (Splik, you are like my favorite SDNer now) to take days off with less than a few months notice to vet these places. How do you check them out? How do you interview and get a feel for the people, the place, the patients when you have no time to do it?

I got a bit weepy at a BW3 last night thinking about it. Then I went home and went to bed ungodly early.

And today I'm thinking locum might be the best short term option. I'd set my own schedule. Negotiate my own rate. Probably make more than I'm making now and have the time to check places out as thoroughly as I feel I need to at this point. Maybe even work a few places and see if I like them.

Problem is I could only do it in two states or the VA right now. Should I start picking up licensure in states I think I might want to live in? Do people do that?



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My understanding is that locums places help you get licenses often quickly. Come work where I'm working. 🙂 We just picked up a new locums person a few months but will need someone after that. The hospital is closing supposedly in November, so I don't think it's likely anyone will sign on permanently. Of course it doesn't actually fit what you want otherwise, but it's not a bad gig, so some locums stuff out there has to be OK.

I can join you in the unprofessional in that I quit a job with less a one month notice just a few months after starting. I also cancelled a residency interview with less than two weeks notice. I'm waiting for the medical board to revoke my license.
 
I need to figure some crap out and talk to the boss. It's scary. Quitting a sure thing to do locum feels like blindly jumping into an abyss on faith. I've never done anything remotely like that before. I'll give myself time to consider. There may be things I can yet do to fix it.



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Worrying about locums in a large city seems like wasted energy. It seems like there are always locums jobs coming up.
 
Seems like I got to this thread a little late.

Splik's list is a careful distillation of the situations that expose our human conflicts in performing our jobs.

But, they are not the conflict itself.

As you have figured out, having the conflicts is not the problem. Psychiatry, institutions, etc. are not the problem. The problem is understanding the conflicts and yourself and being in charge of your level of engagement in them. Since they are human conflicts, they will exist everywhere you go. Being a sideline reporter sounds like a lot of fun, and you may be really good at it, but the second some prettier girl (I'm assuming from your username) comes along and jumps you on the ladder with none of the hard work, how are you going to cope with that?
 
If you want to get a flavor, arrange to have a phone chat with them in the evening. You've got your feet up, no pressure because you're not committing to anything. Ask questions and get a feel for the work environment and what would be expected of you. If one of the places strikes a chord, let them fly you out for a peek. --- you do need vacation days anyways!
 
sunlioness said:
I need to figure some crap out and talk to the boss. It's scary. Quitting a sure thing to do locum feels like blindly jumping into an abyss on faith. I've never done anything remotely like that before. I'll give myself time to consider. There may be things I can yet do to fix it.



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No such thing as sure thing. Safety and insanity cross paths.
 
sunlioness said:
I need to figure some crap out and talk to the boss. It's scary. Quitting a sure thing to do locum feels like blindly jumping into an abyss on faith. I've never done anything remotely like that before. I'll give myself time to consider. There may be things I can yet do to fix it.
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it is also exciting and liberating!
 
nancysinatra said:
Splik's list is excellent, and I would add to it that psychiatry is not a good field for people who think analytically or like to see things quantified or explained logically, or who want variety that includes doing procedures, not just listening and prescribing meds all day.
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I completely disagree. I'm an analytical and logic-loving and feel that psychiatry is perfect for me. Sure, there's a lot of holes in our evidence and lots of ambiguity, but to me, that makes good thinking even more important. If we had clear cut studies and answers, then the job would be automated, without much thinking required. But to put together what our studies actually show and confront the ambiguities takes some real thinking power. As someone said once before, psychiatry is easy to practice poorly. To do it well takes hard work.
 
Seriously, psychiatry is the most natural fit for analytic thinking. There's a reason people with the training are called psychoanalysts. What it is not a good fit for is people who require concrete and readily measurable and visible parameters, and for people who require a reductionist viewpoint to make decisions. Don't get me wrong, many of those people are brilliant and help a ton of people. They're called neurologists.
 
hamstergang said:
I completely disagree. I'm an analytical and logic-loving and feel that psychiatry is perfect for me. Sure, there's a lot of holes in our evidence and lots of ambiguity, but to me, that makes good thinking even more important. If we had clear cut studies and answers, then the job would be automated, without much thinking required. But to put together what our studies actually show and confront the ambiguities takes some real thinking power. As someone said once before, psychiatry is easy to practice poorly. To do it well takes hard work.
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Fair enough. I agree that there's plenty of room for analysis and logic in psychiatry - in its ideal form. But the reality of the job market and my own residency program didn't really encourage that kind of work. I don't think I'm a bad or lazy psychiatrist either - I'd just like to do something else.
 
sunlioness said:
I need to figure some crap out and talk to the boss. It's scary. Quitting a sure thing to do locum feels like blindly jumping into an abyss on faith. I've never done anything remotely like that before. I'll give myself time to consider. There may be things I can yet do to fix it.



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If you are reluctant to make a change because it seems like jumping into an abyss, then it might be just the right thing to do. It's a chance to learn how to negotiate a good deal and handle uncertainty. You always have a solid backup plan since you are very employable. Job hopping is probably not a great strategy super-long-term, but it teaches you some good things!
 
thoffen said:
Seriously, psychiatry is the most natural fit for analytic thinking. There's a reason people with the training are called psychoanalysts. What it is not a good fit for is people who require concrete and readily measurable and visible parameters, and for people who require a reductionist viewpoint to make decisions. Don't get me wrong, many of those people are brilliant and help a ton of people. They're called neurologists.
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What do you mean when you refer to "people who require concrete and readily measurable and visible parameters... who require a reductionist viewpoint to make decisions?" Maybe some people want to see readily measurable and visible parameters. Maybe some people want to "reduce" a myriad of possible explanations for a problem down to one that makes the most sense. (I thought a version of this was called Occam's Razor in medicine. People who reject that principle tend to be the ones whose "Assessments" have ten diagnoses per outpatient visit, one of which is ALWAYS PTSD. Nurse practitioners seem the most guilty of this in my experience. Thank you very much but I think I will stick with being a "reductionist.")

Personally, I like to think that having "readily measurable and visible parameters" is an important tool in fending off pseudoscience and quackery. If you are not aware that pseudoscience has, from time to time, affected the practice of psychiatry, then you need to read the following famous article from the 1970s called "On Being Sane in Insane Places":

http://psychrights.org/articles/rosenham.htm

I do agree that the job of psychoanalyst would require logic and analysis. However there are no jobs for psychoanalysts. And I can't even get my patients to go to short-term CBT let alone psychoanalysis.
 
nancysinatra said:
And I can't even get my patients to go to short-term CBT let alone psychoanalysis.
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Why spend so much longitudinal cash and time to try to "fix" a problem that a tablet of Xanax could immediately solve at less than $0.15 a pop?
 
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