Psychiatry is a field of medicine that tends to be more fluid. For example, setting a broken bone is pretty straightforward. Treating a social anxiety is anything but. Moreover, standards and best practices in psychiatry tend to change more frequently than most other medical disciplines. To say that there is constant change in psychiatry is to state the obvious.
With that in mind, consider a Psychiatric Times piece written by Allen Francis, M.D. The piece was published on October 2019. In it, Dr. Francis passes on 50 things he has learned over his 50 years of practice. This post will not address all 50, but it will touch on five of the most poignant points made by Francis. These points represent things about psychiatry jobs that never change, regardless of how the specialty evolves.
1. Meetings with Patients Are Never Routine
First on the list is something that is learned with experience: meetings with patients are never routine to them. They may become routine to a psychiatrist who feels like he is making very little progress, but the patient sees things very differently.
Mental illness, by its very nature, leads to thoughts and emotions that exist outside of socially acceptable norms. A person suffering from depression does not see the world the same way everyone else does. What might be a minor inconvenience to you or I could seem devastating to someone with depression. Likewise, what may seem like a routine meeting to the psychiatrist could be overwhelming to the patient.
2. Patients Require Validation and Expectations
Regardless of how diagnoses evolve over time, psychiatric patients need two basic things: validation and expectations. As Dr. Francis explains, it is important that psychiatrists validate patient efforts to do their best. Yet those same patients also need future expectations that motivate them to continually to try to be better.
3. Patients Take Precedent over Supervisors and Books
If there is one field of medicine in which the patient takes precedent over all else, it is psychiatry. Supervisors may want a psychiatrist to do things one way, but the doctor knows that would not be good for the patient. There are also times when what is best for a patient does not agree with what the psychiatrist learned from her books. What is she to do? Francis says she should follow the patient rather than her supervisor or her books.
4. Taking Your Time is Important
Rare is the patient who sees the doctor just a few times before being declared ‘cured’. Mental illness often takes years to treat successfully. As such, one of the most important aspects of psychiatry is patience. The best psychiatrist knows how to take his or her time to do things right. He or she knows that moving too fast can lead to critical mistakes with far-reaching consequences. Dr. Francis exhorts new psychiatrists to take their time and be careful.
5. The Bandwagon Isn’t the Place to Be
Finally, Dr. Francis warns new psychiatrists not to jump on the diagnosis bandwagon. Psychiatry has a tendency to come up with diagnoses you could almost consider the ‘flavor of the month’. That doesn’t make such diagnoses viable or even real. Instead of jumping on the bandwagon, doctors should stick to getting to know their patients and working through each case on an individual basis.
Whether you’re an established psychiatrist, starting your search for a psychiatry job, or a med student preparing for residency, keep in mind these five unchanging aspects of psychiatry. Along with the other 45 tips offered by Dr. Francis, they will help you make the most of your career.
