Private Practice Psychiatry

[YES123]

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Hi Everyone,
I am potentially interested in going into Psychiatry and am trying to learn more about the field. Specifically, I would be interested in knowing what is the typical weekend/evening like for a private practice psychiatrist who runs and owns his own practice (either adult or child/adolescent) and treats depression/anxiety/maybe a bit of bipolar and the likes (and only minimally deals with the more wild areas of Psychiatry [like Schizophrenia, Insanity...]). Would such a person expect to be called multiple times in the evening or during the weekend with real emergencies? Would he/she have to frequently interrupt weekend plans to be in the emergency room with a patient? Or is it more like he/she would be able to live a normal life outside of his/her practice with only occasional emergencies [say 3-5 calls a week, and only actually going in for an emergency once a month or so]?
Thanks!

 

[whopper]

A lot of this will depend on what type of practice you'd like to have. In private practice, at least from what I've seen, you're going to have patients of a better GAF than other areas of practice. These people need to be well enough and motivated to want to go to treatment on their own.

Like any area of practice there are pros and cons. You have to worry about the money-side of things, dealing with pre-authorizations, problematic patients, and insurance compaines can be a pain in the butt. Unless you're working with other psychiatrists, if you want to take time off, it'll be difficult.

I rarely have to deal with emergencies but they happen. About once every 3 months I need to have staff members call 9-1-1, and sometimes people call the office freaking out. Thankfully I don't have to deal with the latter because a psychologist does that for me.

You'll be able to live a normal life. If not you can tailor your patient load. If, for example, I get a patient that is too much to handle (e.g. they need a case manager, I don't have one in private practice) I'll tell the patient that I cannot handle this case and refer them elsewhere.

The first several months of private practice will be tougher because every patient you see for the first time will likely be sicker. Having one sick patient after another is time-consuming and wears on your morale. After a few months many of them get better, and then it's just a matter of refilling their meds.

Another thing that makes the first few months tough is you got to figure out how the local players play. E.g. one hospital would refer patients to us that clearly were to0 sick for private practice and even still suicidal. I was placed in a difficult position where I pretty much had to send them back to the hospital even though they told me the psychiatrist there was terrible and openly insulted them. I had the office staff refuse patients from this hospital after several attempts were made to make a relationship with them. They didn't seem to give a damn even after we told their social workers that because we didn't have case management we couldn't deal with people with a GAF < 50.

 

[nitemagi]

It depends on how you want to set up your practice. Some give out a set phone # that they can be reached in an emergency. Others have an answering service with a set algorithm leading to few calls, if ever. Others form a cooperative with other solo providers and rotate who covers for times like weekends.

I have a PP only 2 days a week right now. I get calls very rarely (maybe once every other week), and it's at best urgent, not emergent.

 

[YES123]

Hi,
OK, thanks for responses (it is really quite kind of you to take the time to answer my question). If anyone else has experience with this, I would appreciate your responses too, so that I can get as broad of a picture as possible.
Thanks 🙂