psychiatry
Reflections
Sat, November 3, 2007 at 06:59AM 
Three days ago I clicked enter to save my entry and something went wrong.
Somehow every word was deleted and lost forever. I wrote it off as an exercise in patience and tolerance since there have been times in the past when such an occurrence would have resulted in great anguish and frustration for me. I'll be more careful with today's' effort. It's hard to believe it will be a new year in less than two months. 2007 thus far has been a period that has been an endurance test for me personally. A female aquaintance recently described her impression of me as being miserable. Being quite fond of this person caused me to feel a bit troubled by such a perception for I know that is not who I am as a person. My suggestion to her was to reserve judgment a while longer. My personality traits consist of unusually high degrees of thinking, feeling, and intuition. This translates to a tendency to often react intensely to acute threats of change or actual change in circumstances. The past couple of years for me have been filled with such threats and changes.
As seen in my writing, I tend to often deal with adversity and controversy through cynicism or sarcasm. Some people refer to it as dry humor. I don't mind occasionally playing the role of devil's advocate just for the sake of argument. Some people don't seem to get this. Others are totally down with the program. To survive in my particular line of work it is essential to have effective ways of venting and maintaining some sort of personal mental balance. Daily reality for me involves facing issues of unexpected deaths from overdose, child sexual abuse, unfixable patients, managing risk to minimize the risk of being sued (lawsuits and threats of lawsuits are inevitable), trying to stay caught up on paperwork, staying in compliance with guidelines of the DEA, Medicaid/Medicare, and the IRS, Continuing Medical Education requirements, credententialing and licensing requirements, medical billing requirements, keeping staff content... There really just isn't time for personal issues.
I'm having to ask myself if this private practice life is worth it. Sometimes the stress is just too great and the compensation much too low. I've discovered several opportunities with salaried positions that would eliminate much of the hassle. On the other hand I love having autonomy which a salaried position does not offer. I've thought hard and heavy about these things over the past weeks and have concluded that for the most part I really enjoy patient care exactly the way I do it now. More importantly, most of my patients are appreciative of the care they receive. The real problem in my opinion are the insurance companies and their need to control. If they were easier to deal with all the other problems could be handled eventually. At the risk of sounding paranoid, I must admit feeling that third party payers intend to run me out of business, mainly because I refuse to run my practice as a prescription writing factory. I believe that psychotherapy is equally as important as the use of medications. Studies have proven this to be true. I plan to fight to continue to practicing psychiatry in the manner I see fit. I realize I may lose the battle but I believe the Lord will make a way, as always.
Reader Comments (4)
Working in a competitive job market is hell for most people, in my opinion. I used to be able to do it. Then my illness and environment took a turn for the worst. I even tried to commit suicide my job, in 2000. I was under so much pressure and felt so alone that my hands just started popping pills. I did not have a real psychiatrist at the time, as I found out later, just a prescribing nurse. Things had to get worse before they got better. But in general, I sympathize with your position. Is it any wonder that there is a shortage of people in your job category?
I, too, have watched my carefully crafted words disappear into computer hell. To prevent that, I now compose offline in a word processor, and copy and paste into my blog. Perhaps that could work for you, too.
i just wanted to comment that seeing a psychiatrist who also does psychotherapy is absolutely the best way of dealing with mental illness. there are fewer appointments to manage (and keep!), less gets lost in communication; when my psychiatrist/ologist sees that I'm headed downhill, she doesn't need to wait 6 or 8 weeks before my medication can be changed by my psychiatrist. it makes a huge difference to feel like i am top of my medication and an active part of keeping it on target, and seeing a doctor who knows my day to day life and struggles is a huge part of that.
you are absolutely right that insurance companies don't favor what is clearly best for the patient, and that is a shame. i really admire you for trying to work with medicare/insurance/etc. my dr is wonderful, but i will be in debt by the time i finish seeing her. :) it sounds like you recognize the sacrifices your patients are making, and despite all the struggles you have, i think it's really wonderful that you're providing the care that you do.
������� ������. ����� ���������� � ����������:
http://newsaboutforex.com
newsaboutforex.com