Friday, September 18, 2009

Why Psychiatry is a Wonderful Medical Specialty

Dear Medical Student:
This is why you should become a psychiatrist. It's a wonderful career with lots of flexibility and you can pursue a broad range of interests. You love people and their stories? You love feeling helpful in their lives in an integral way? Then psychiatry's for you. What better then being there when a seriously depressed person feels better and gets their life back? You hate people, can't stand complainers, and would like to isolate yourself? Ah, psychiatry has so many unanswered questions and can let you flow in so many different directions: find a lab and isolate genes or look at brain scans or receptors....there's lots of room in the field for basic researchers. You're something in between? Psychiatrists have medication practices, or psychotherapy practices (most have a little of both), they teach, they are administrators (some never go near a patient) they can work with inpatients or outpatients or in residential settings. They can work in jails or with the courts. They write, they have blogs! They work for themselves (I never fight with my boss) or as part of large academic or government institutions. They work with patients with medical illnesses (on transplant teams, in oncology and HIV centers, as consult-liason docs in the general hospital). You can find a job where all you do are evaluations and you never see the same person twice or you can be a psychoanalyst and see one person five times a week.
It's as medical or non-medical, researchy or non-researchy, and people-centered as you want it to be. And you can do pieces of a variety of different things. What could be better?

No big bucks-- sorry.


Anonymous said...

um...have to disagree with the no big bucks. or maybe you're just on a different scale then the rest of us plebians.
$200 for 45 minutes, back to back sessions, full time as my psychiatrist does? And her still completing her psychoanalytic training, with no other special training, 3 years out of residency....don't even want to know what could be charged once she has actual experience. Yeah. Don't know what scale you're living off of, but in my little upper-middle-class world, that's big bucks.

April said...

Yep, same here. My shrink charged over $200/hr for 50 min. That's big money to me!

Anonymous said...

I would hope that anyone who "hates people and can't stand complainers" would stay clear from medicine entirely, but would especially stay clear of psychiatry. Even if you are not working directly with patients, I think that this attitude would inform the way you approach research...and I personally don't want people who think that psychiatric patients are "complainers" to be the people who are doing research into these conditions.

And as for "big bucks"...I am also not really sure why psychiatry doesn't involve "big bucks". Compared to surgery, maybe this is true, but compared to most other professions psychiatrists DO make good money. I'm not sure what you consider to be "big bucks"!

DrivingMissMolly said...

I know my psychiatrist doesn't make a lot of $$$.

I went to see an orthopedist and let's just say that I know he lives in a half a million dollar house and my much older, experienced shrink who also has fancy titles at a local medical school lives in a much more modest home price-wise.

You can check home value on county tax sites.


itsjustme said...

I think she means big bucks in comparison to other fields of medicine not compared to a receptionist.

Dinah, it sounds like you really love your job. That's so cool! I'm envious. I really wish I felt that way about my career. I wonder if my pdoc feels that way you do. I hope so. I have a feeling she might.

Dinah said...

Relative: psychiatrists and pediatricians are the lowest paid specialists. We just don't have the incomes of the cosmetic or orthopedic surgeons.

Young psychiatrists make the same thing old psychiatrists make. Some of my supervisees are charging much more per session then I charge.
Someday I'll get up the nerve to write a post on this.

Young psychiatrists may have bigger debt-- some are coming out of med school $250,000 in debt from educational loans.

It wasn't to complain, but I wrote the post as "dear Medical Student" so yes, compared to surgeons, radiologists....

Pleochroia said...

Do you think managed care is going to change that, in terms of the breadth of work environments for psychiatrists, e.g. whether they still do psychotherapy? Do many younger docs do that?

Perhaps this is a state-specific question. I'm just asking because I've heard that young(er) psychiatrists mostly do med management. Especially if they work at HMOs.

chartreuse said...

Thanks for this post! I'm a fourth year medical student, and read the post while taking a break during an elective in emergency psych. I've been waffling between family and psych for some time, and after doing electives in both, I've finally settled on psych as what I really want to do.

I just ordered the full version of Kaplan and Saddock from Amazon! I figure the fact that I'm so excited for it to come is a good confirmation that psych is for me. :)

The disappointing thing is that my family members are all trying to convince me not to do psych. It's sad that there's still such stigma about choosing to do psychiatry over other medical specialties.

Matt said...

Hey! Thanks for a med-student related post. I'm a 3rd year that's also going into psychiatry- but I haven't done my psych rotation yet so I guess I'm still "open minded". Like Chartreuse, I've experienced some resistance from family. My parents haven't said anything but I can tell they aren't super excited. A small point on the money aspect-- psychiatrists make less per year than many other docs, but when you work it out per hour it stacks up a little better. 40 hrs/wk for psych VS 70 hrs/wk for a general surgeon. I'll take a salary cut if means I get to love my job. Great bogging, by the way... excellent site.

Anonymous said...

Why do people hate people who hate people? Even in these forward-looking times there's such a stigma.

As a closeted people hater, I can say it's usually nothing personal, and also no ill will towards the human race, I just know what I like and what I like doing and it ain't people. That came out wrong.

As far as it hindering my ability to isolate genes or read brain scans, that's a big, sweeping assumption about a big, sweeping class of activities. Get over yourself. People don't have to feel a particular way about you to do things that benefit you.

People create drama where there doesn't need to be any, like about this. Even healthy people are guilty of the complaining I'm thinking of, which I think is different than what you took it to mean. Either way it's more that we just don't want to listen to it, not that we think people with depression need the ol' bootstrap approach.

Plus, there are lots of reasons people go into medicine, and I'd be more worried about the ones who do it for ego and adulation than the lab rats who work quietly and keep their own company.

Anyways -

Everyone stop picking on the misanthropes! Don't hate us just because we hate you! ...Pfft, just forget it, I hate you all ya big meanies!

Medical Aesthetics Careers said...

I think psychiatry is a beautiful field of work, and many of the most influential minds in history were psychiatrists. Even the "Father" of mind manipulation and Nero-linguistic Programming, Edward Bernays. This field is being studied to its true potential today and is proving the theories and suspicions of Sigmund Freud to be true. Perception Without Awareness and Subliminal Messages have interested me immensely, and I think Psychiatry is a powerful skill to have.

LASIK Eye Surgery said...

Dont they all charge around that much? My is like $200 an hour, man I'm in the wrong business.

Ginekologijos Klinika said...

I agree, that 200 for an hour is quite a big money.
Anonymous, do you earn more?

tablet pc said...

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Anonymous said...

Reply to the posts about psych income:
Yes, MDs are on a different scale from you plebeians. It takes 13 years of training to become an attending psychiatrist. That's 4 years of undergrad, during which a would-be MD must get outstanding grades while taking a challenging science course load in order to even have a chance of getting to med school. After undergrad, med school is 4 years. 25% of med students now graduate with over $250k worth of debt. After med school, a psych residency is 5 years, during which time a student can expect to make around 40000 per year while working 80 hour weeks.
When that is all done, a psychiatrist can expect to earn under 200k per year. That 200 you shell out for an hour visit goes to pay for overhead AND salary. A psychiatrist just pay for office space and staff in addition to other costs.
In contrast, an established attending orthopaedic doc STARTS at 500k per year after residency, and some earn over 1 million per year.
When your job takes 13 years of training, you can complain about greedy doctors. Until then, don't.