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Career Story: Psychiatrist In Private Practice

Psychiatrist In Private Practice

Job Title: Psychiatrist

Type of Company: I am self employed.

Education: BA in European Intellectual History, Yale •• MD Harvard Medical School, Medical Internship at Beth Israel Hospital, Boston •• Psychiatry Residency at Cambridge Hospital •• Psychoanalytic training at the Boston Psychoanalytic Society and Institute.

Previous Experience: I did psychiatric research a a number of different universities over the summers in college.

Job Tasks: As a full time psychiatrist in private practice, I spend most of my time taking care of patients. Because my goal was to do long term psychotherapy and psychoanalysis with adults, I set up my own practice so that I could have the maximum amount of freedom to treat patients in the ways that I felt would be most helpful to them in the long term. The majority of my time is spent in my own office, which is just a short bike ride from my home. I see patients anywhere from one to five times a week. Each session is 50 minutes long, and we spend the time talking about my patients' lives and their problems.

I see patients with all kinds of difficulties. Some of them have very serious mental illnesses, such as schizophrenia (a disease in which people can hear voices or become paranoid and have trouble telling what is real from what is only in there own mind). Others have more common diseases which can also dramatically affect their lives, such as depression, eating disorders, or serious anxiety. Some people are dealing with terrible events in their lives, such as childhood abuse, divorce, or substance abuse. Others have had repeated problems in relationships or at work, and they realize that they may be doing something to cause their own problems, but they need help to change. I spend most of my time doing psychotherapy with patients, using understanding to help them see ways that they can change, and also using the therapeutic relationship we develop to understand what is causing their problems. Some of my patients also use medications such as antidepressants and antianxiety medications to help them.

In addition to working in my own practice, I also spend a couple of hours a week working in a group practice, treating similar patients. In the group practice I have a different role. I am a consultant to the therapists who are working more closely with patients, and I also evaluate patients to decide whether medications could be helpful to them. If they need medications, I prescribe them, and then I meet with the patients about once a month for a briefer (20 minute) session to see how the medications are helping them. My work at the group practice is a nice change from the more intense psychotherapy in my own practice.

I also spend a lot of time teaching. Right now that is mostly at a special psychoanalytic institute, a place where psychiatrists, psychologists, and social workers come to get advanced training in how to do psychotherapy and a special kind of psychotherapy called psychoanalysis. I find the teaching very rewarding. My work is very hard and complicated, and it helps a lot to have a community of other professionals to talk to about how therapy works. I have also found that by teaching students, I learn a lot. Not only do I have to prepare for the class, which takes a lot of preparation (I really have to understand the material well in order to teach it), but the students often ask really interesting and challenging questions, and it makes me think a lot about the work that I do. Sometimes I also see other professionals for supervision. In supervision, another psychiatrist or psychologist will come to my office and talk about a patient of theirs, and we will think together about how best to help the patient.

Best and Worst Parts of the Job: The best part of the job is that it is always interesting. People are all different and have interesting lives, and I get to hear about them and help them.

The worst part of the job is that I have to sit in the same chair all day long, and sometimes my back gets tired, or I want to be outside in the sunshine!

Job Tips:
1. I studied at a liberal arts college and got to take all kinds of courses, not just pre-medical or psychology courses. As a psychiatrist, I think it is really worthwhile to know about all different parts of life. It helps in relating to so many different kinds of people.

2. Take a statistics course. Nothing else is as helpful in really understanding research, some of which is really good, and some of which is really bad. If you don't understand the statistics, it can be hard to tell the difference.

3. Make sure you have lots of interests and things you enjoy besides work.

Additional Thoughts: Being a good psychiatrist is challenging, because you have to be a really good listener, be able to really understand what is going on in someone else's experience, and also be able to help people who are having really intense feelings. For some people that can be uncomfortable. You have to always want to know about both your patients and yourself.

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