What are some of the most challenging things of being a psychiatrist?

[Prime2000]

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What are the most challenging aspects of being a psychiatrist vs. most other specialties? Pretty broad question, I know, but I'm pretty new to learning about psych. Thanks.

 

[sunlioness]

Right now the most challenging thing to me as a psychiatrist is convincing insurance companies that I deserve to get paid.

Which makes it fun when I continue to get monthly bills from one of these companies for my OWN health insurance. I am so tempted to send those bills back saying I deducted the cost of my own policy from what they owe me. "Dear Insurance Company- You now owe me this much. It is due now. Thank you for your prompt attention."

 

[whopper]

There was a thread where this question was asked a few months before...

 

[RGMSU]

Right now the most challenging thing to me as a psychiatrist is convincing insurance companies that I deserve to get paid.

Which makes it fun when I continue to get monthly bills from one of these companies for my OWN health insurance. I am so tempted to send those bills back saying I deducted the cost of my own policy from what they owe me. "Dear Insurance Company- You now owe me this much. It is due now. Thank you for your prompt attention."

Hah, that is by no means unique to psychiatry. I would think that the patience required in dealing with people who are often intractable or even downright belligerent would be a significant challenge. Of course, you will see intractable and belligerent people in other specialties as well, maybe just not as many of them?

 

[kugel]

Hah, that is by no means unique to psychiatry. I would think that the patience required in dealing with people who are often intractable or even downright belligerent would be a significant challenge. Of course, you will see intractable and belligerent people in other specialties as well, maybe just not as many of them?

In psychiatry, we are expected (permitted) to deal with the belligerence, personality, intractable patients directly - rather than ignore it or react in kind.
"It's all grist for the mill."

 

[ronin12]

dealing with belligerent,intractable pts is part of our job. dealing with Belligerent, intractable, labile,intrusive coworker was an unwelcomed surprise.
It is a challenging experience, which everyone faces in field of medicine, probably more so in psychiatry.

 

[RGMSU]

Now, for the positive - tremendously interesting subject matter? mystery of the mind? window into the soul/human condition? etc? etc?

 

[sunlioness]

So a patient came to me about a month ago. Patient did not disclose at the time that she was still seeing another psychiatrist and therapist who had recommended referral to IOP. I did not find this out until patient showed up in my office one day distraught over something the therapist had said in the session they had just had. I'm like, "Wait. What?" So I get release to talk to therapist and find this long h/o acting out, dangerous behavior, all this stuff and that the referral had been made to IOP. Have a discussion with patient about the importance of honesty, my limits as a solo practitioner, blah blah. Patient says this is all fine. Within the week, patient continues to act out all over the place and demand after hours access. Responds to my redirection by telling me I should never have gone into mental health because I obviously don't care about people. Leaves some really interesting messages on my office voicemail. So I talk to patient about this and tell patient that a higher level of care is definitely required and support the referral to IOP/partial. Tell patient that barring this, I cannot continue on the case. Patient refuses referral. I get told within the space of minutes both that I am the worst person who ever lived and also that I was the only person who ever seemed to really understand. Doesn't seem to get that what I am really saying is that patient needs more support for their own health and well-being, that it's not a personal condemnation. Called my emergency number this evening with the same stuff and some vague suicidal threats.

Yes, being a shrink is fun . . .

 

[OldPsychDoc]

So a patient came to me about a month ago. Patient did not disclose at the time that she was still seeing another psychiatrist and therapist who had recommended referral to IOP. I did not find this out until patient showed up in my office one day distraught over something the therapist had said in the session they had just had. I'm like, "Wait. What?" So I get release to talk to therapist and find this long h/o acting out, dangerous behavior, all this stuff and that the referral had been made to IOP. Have a discussion with patient about the importance of honesty, my limits as a solo practitioner, blah blah. Patient says this is all fine. Within the week, patient continues to act out all over the place and demand after hours access. Responds to my redirection by telling me I should never have gone into mental health because I obviously don't care about people. Leaves some really interesting messages on my office voicemail. So I talk to patient about this and tell patient that a higher level of care is definitely required and support the referral to IOP/partial. Tell patient that barring this, I cannot continue on the case. Patient refuses referral. I get told within the space of minutes both that I am the worst person who ever lived and also that I was the only person who ever seemed to really understand. Doesn't seem to get that what I am really saying is that patient needs more support for their own health and well-being, that it's not a personal condemnation. Called my emergency number this evening with the same stuff and some vague suicidal threats.

Yes, being a shrink is fun . . .

Sounds like a real diagnostic challenge at least... 🙄
😀

 

[stn2006]

Scientologists

 

[sunlioness]

Sounds like a real diagnostic challenge at least... 🙄
😀

Indeed. 🙂

 

[RGMSU]

Indeed. 🙂

Heh, heh - so forget about the positives.

 

[hallam]

Scientologists

LMAO

 

[HMSPSYCH]

What are the most challenging aspects of being a psychiatrist vs. most other specialties? Pretty broad question, I know, but I'm pretty new to learning about psych. Thanks.

For me mental exhaustion from having to treat diseases no other medical services can manage.

 

[hkusp]

Indeed. 🙂

Oh, I don't think there is much of a diagnostic challenge there! I think we can all see that one coming a mile away. It is over by the exchange between Cluster B street and the Axis II highway.

 

[sunlioness]

You must have missed the heavily dripping sarcasm in our exchange. 😉

Yes, the patient has borderline pd. And some stuff on Axis I, but definitely borderline.

 

[AG22]

You must have missed the heavily dripping sarcasm in our exchange. 😉

Yes, the patient has borderline pd. And some stuff on Axis I, but definitely borderline.

Eeep! Hey, how do you guys and gals, deal with burnout? I'm seriously considering psychiatry (lowly premed here! 😳) but I've been thinking more and more about this lately.

How does it feel dealing with patients day in and day out, and helping to nurse them back to some "normal" level of functioning? How do you deal with being too involved with a patient, or not being involved enough? Does it at any point feel like one's being suffocated by all these problems of the patient?

I suppose one has to be truly "present" in order to help the other person without taking on their problems as one's own, and without it seeming as a chore.

I think it's good that I'm soul-searching all this right now. And I truly believe that it takes an exceptionally strong and motivated person to enter this profession and help others while not being affected on a personal level. Hat's off to you 👍

 

[sunlioness]

Honestly what is being driven home to me again and again is the importance of balance and having a fulfilling life outside of work. If your life is just work, it will crush you. But if you have balance, then it all just stays in proportion.