Friday, August 10, 2007

Things I Like About Psych

  • Consult-Liaison is kind of fun. It's a lot of work, but I like being the integrative force for a patient. So often, 5 or 6 different teams of 8-9 people each are coming by to see a patient on any given day, each with their own plans for the patient. What ends up happening is that the overall plan will be lost on the patient, who is confused and feeling alone. When we are consulted, I take the time to read the chart and know all the plans (as best I can) in order to a) determine how it impacts OUR plan and b) know what to say to the patient in case they ask me what's going on.
  • I like the lifestyle. I really don't care what the money is going to be like (the average doctor is making a decent living, regardless of specialty), but I like knowing that I can be flexible in my schedule. It's important to me that my family know me, and I think I have a better chance of making a good schedule on psych.
  • I like the discussions. They don't feel as inhumane as the endless differential diagnosis conversations in internal medicine, in part because we consider the whole person. We talk about their medical problems, their psych problems, social issues, substance abuse, and anything else that seems applicable.
  • I like the people. They're not as malignant and gossippy as some of the OB/Gyn's I worked with; they're not as snotty and self-loving as the surgeons; they're not as full of their own intelligence as the internists; they have better senses of humor than the pediatricians; and they don't have inferiority complexes as large as the family docs. Obviously, these are generalizations, and I'm sure there are psychiatrists I will not like. Overall, though, I get along with the psychiatrists, and that's important to me.
  • I like that the field is evolving so rapidly. I'm sure many of our current diagnoses will be totally re-written within 20 or 30 years as we understand more about the brain and the genetics of disease. By the end of my career, I'm sure much of what we do now will be seen as primitive and misguided, and that's fine with me. As long as we do our best and treat patients with kindness and current knowledge, we'll ride the waves.

Basically, I'm a little confused (and ashamed) that I put off not liking psych. I thought of it as not being real medicine, as being too soft, as "beneath me" if I may put it that way. I'll confess to not being entirely past those thoughts; part of me feels regret for all the other parts of medicine I'll leave behind. I can't have it all, though, and I rejected those other parts of medicine for good reasons. I just have to remind myself of them from time to time.


The MSILF said...

Whoa. I don't read your blog for a few months, and then come back and it's a totally different person! I'm catching up now, and this is an interesting twist!

Also, interesting comment on family docs being more lowly than psych. I am still being torn between family and neuro (status).

Tiny Shrink said...

Do what you want, and screw the status. We need good people in all fields, and I think in family more than most. Good luck with the decision!