As Dr. Jody Schindelheim taught us in residency training: "Don't just do something, sit there!"
Great advice for psychiatrists, but no help to our colleagues in primary care unfortunately. Yet as you point out, our field catches the blame either way. I think if PCPs felt more empowered in their roles as healers (not prescribers, not providers, etc) then they may realize that simply lending a listening and supportive ear is often much more powerful than any SSRI.
Great formulation and discussion of the problem that I believe applies to far more than prescribing psychotropic medications.
Not sure how best to handle the situation, but I’ll share feedback I received decades ago from a mentor. On a long ride home from DC to NJ, I was complaining about the volume of day to day administrative, clinical, teaching, and offsite community projects I was involved in, and that I couldn’t get any creative work accomplished. His feedback was immediate: “I’m not surprised you’re not getting anything done during the day. Get used to it. And understand only very few are given precious time without distractions for that. That kind of work gets done in the off hours. So find the time!” I stopped complaining and eventually created that time.
To some degree the same applies to clinical practice when one deals with the issue you appropriately call the “Do Something Imperative”.
Dealing with clinical issues can often require a creative, personalized approach, especially when considering an issue that we think has to be dealt with right away.
Why not set one or two thirty minute sessions twice a week after hours to deal with issues like that. Have the patient come back for a discussion. It may work if it’s kept simple and directed and a plan is agreed upon. Certainly at the initial visit this option would relieve the pressure right away.
One of the big issues is the routine use by doctors of the drug company created phq9 and gad7 doing what they were designed to do, expand market share.
What psychiatric expertise? it's just an opinion based on a check list with waffle thrown in.
As Dr. Jody Schindelheim taught us in residency training: "Don't just do something, sit there!"
Great advice for psychiatrists, but no help to our colleagues in primary care unfortunately. Yet as you point out, our field catches the blame either way. I think if PCPs felt more empowered in their roles as healers (not prescribers, not providers, etc) then they may realize that simply lending a listening and supportive ear is often much more powerful than any SSRI.
Hi Randy,
Great formulation and discussion of the problem that I believe applies to far more than prescribing psychotropic medications.
Not sure how best to handle the situation, but I’ll share feedback I received decades ago from a mentor. On a long ride home from DC to NJ, I was complaining about the volume of day to day administrative, clinical, teaching, and offsite community projects I was involved in, and that I couldn’t get any creative work accomplished. His feedback was immediate: “I’m not surprised you’re not getting anything done during the day. Get used to it. And understand only very few are given precious time without distractions for that. That kind of work gets done in the off hours. So find the time!” I stopped complaining and eventually created that time.
To some degree the same applies to clinical practice when one deals with the issue you appropriately call the “Do Something Imperative”.
Dealing with clinical issues can often require a creative, personalized approach, especially when considering an issue that we think has to be dealt with right away.
Why not set one or two thirty minute sessions twice a week after hours to deal with issues like that. Have the patient come back for a discussion. It may work if it’s kept simple and directed and a plan is agreed upon. Certainly at the initial visit this option would relieve the pressure right away.
One of the big issues is the routine use by doctors of the drug company created phq9 and gad7 doing what they were designed to do, expand market share.