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To those who love their outpatient job, what type of environment do you work in? Is it your own private practice? A well run, psychiatrist-owned private practice? A cash practice that serves the worried well?
In residency, our main outpatient clinic was comprised of only 20% controlled substance seekers, who usually went elsewhere for goodies after a few visits. Otherwise, there was a lot of therapy involved, and I enjoyed the interactions with almost all my patients, who were actively trying to improve themselves. Some people described this clinic as a boutique practice. I've never worked in a boutique practice, but I imagine that is what it would be like.
In the "real world", my outpatient gigs are in Big Box shops for The Man. There is very little therapy because many patients just want a pill, a controlled substance, a disability letter, etc. Many are interested in what I can get or do for them, instead of what they can do for themselves. I feel my therapy skills atrophy. And every 2-3 months, I lose a patient to suicide, homicide, alcohol, opioids, or disease. It is draining, and not enjoyable at all. It is so draining that I lack energy to start my own private practice, even though I work part time. I also had a former colleague commit suicide. Though I can't say for sure, I wouldn't be surprised if it had something to do with their work at a similar Big Box shop, and frankly I was not shocked.
My former co-residents who do outpatient at Big Box shops feel kind of the same, though they seem to have experienced less severe pathology. Those who work at private practices find it not quite as bleak, but do feel it is all about grinding through 2-3 controlled substance patients per hour. So, I'm wondering if this a small sample set, or if this is the way it is, or if others who love outpatient have just found some niche of their own.
In residency, our main outpatient clinic was comprised of only 20% controlled substance seekers, who usually went elsewhere for goodies after a few visits. Otherwise, there was a lot of therapy involved, and I enjoyed the interactions with almost all my patients, who were actively trying to improve themselves. Some people described this clinic as a boutique practice. I've never worked in a boutique practice, but I imagine that is what it would be like.
In the "real world", my outpatient gigs are in Big Box shops for The Man. There is very little therapy because many patients just want a pill, a controlled substance, a disability letter, etc. Many are interested in what I can get or do for them, instead of what they can do for themselves. I feel my therapy skills atrophy. And every 2-3 months, I lose a patient to suicide, homicide, alcohol, opioids, or disease. It is draining, and not enjoyable at all. It is so draining that I lack energy to start my own private practice, even though I work part time. I also had a former colleague commit suicide. Though I can't say for sure, I wouldn't be surprised if it had something to do with their work at a similar Big Box shop, and frankly I was not shocked.
My former co-residents who do outpatient at Big Box shops feel kind of the same, though they seem to have experienced less severe pathology. Those who work at private practices find it not quite as bleak, but do feel it is all about grinding through 2-3 controlled substance patients per hour. So, I'm wondering if this a small sample set, or if this is the way it is, or if others who love outpatient have just found some niche of their own.