From my own experience, its going to highly vary depending on the type of office its in.
For example, one office I was in was in an inner city setting in Atlantic City--in one of the poor areas. Most of the patients who were just discharged from the hospital were referred there. Most of them didn't show up for their first outpatient office visit. I spent several hours doing nothing there, and used it for time to study for USMLE III. Several of these were frequent flyers who never followed up after discharge.
Another office was in a middle class area of NJ, and my patients showed up over 90% of the time.
In general however, all outpatient offices will deal with patients of lesser severity evidenced by higher GAF scores. The range dealt with patients who on their medications are stable and show no DSM symptoms of their mental illness whatsoever to manageable symptoms that don't warrant outpatient (error-meant to write "inpatient") treatment.
Another aspect with outpatient is you can deal with patients who may need a bit more on the psychotherapeutic side. The place I was at, well they didn't want the psychiatrist doing psychotherapy, but heck, I tried to do some once in awhile by strategically placing the patients at the right time. The office also had a psychotherapist the patient could work with, and the psychiatrists would meet with the psychotherapist to make sure they were on the same page.
Another aspect was that several outpatient offices I've seen were not well equiped should they get a decompensating patient. If they had such as patient, only thing the office did was call the cops and the cops might not show up for 15-20 minutes. Such an incident of course was extremely rare, though I have seen it happen, and when it does happen-you don't have much at your disposal to deal with the patient. During my 4 year stint as a resident, I've seen this thing happen 3 times. 2x I was present, a third time it happened to one of my friends.
For that reason, IMHO, outpatient offices should have some type of alert system such as perhaps panic buttons. That being said though, I have not seen any outpatient office have such as system, and have seen some psychiatrists who have practiced for decades claim that they have never had this type of problem ever.
A typical day is you seeing patients. There is a longer period of time between the last time you see them and the present time. That can make some aspects for difficult. E.g. if your patient has panic disorder, you may never see them with the actual symptoms of that disorder. In inpatient, usually by day 3, someone has gathered enough data to make a reasonably accurate diagnosis. You can have a situation where you never see the symptoms ever because the patient will never show it in the office and/or they are managed enough.
Things that can help with this is have the patients write their symptoms down, or keep track of their symptoms using a scale. So when they next see their psychiatrist, that can aid the doctor to see what was going on.
In this situation its also more important to make sure your patients asking for meds that may be abused.
