Sunday, May 21, 2006

"I don't know why I spend my time writing songs I can't believe, with words that tear and strain to rhyme"

The thought to re-tool in a different medical specialty comes to me now and then. Something that makes more use of what I learned in medical school. Something more technical or more tangible. Something where the results are more noticeable.

At times I'm not sure I have the ego strength to continue in psychiatry, or at least this particular flavor of it. I was just lying in bed doing a rough calculation of how many of our patients really get better, how many of those improvements can realistically be traced, even in part, to my efforts, and how many of those can appreciate what's happened. I estimated about 2%. By the way, the fellow I mentioned a couple weeks back, who said he was about to be be discharged and thanked me for my help, was not actually leaving, nor much improved. He's still upstairs, back to refusing medications and threatening people.

The other night I chit-chatted with another MD of about my age at a dinner party, a specialist in a surgical field. He told of a patient who he had treated emergently after an unfortunate accident, who turned out to have a slip in the same marina as the doc's boat. Ever since, out of gratitude, the patient has informally looked after the doc's boat when the latter wasn't around. Jus an unspoken thank-you. That sort of thing doesn't happen in my world. On the contrary, I sometimes awaken at night to a noise in the TurboPalace and wonder if it might be one of the several very paranoid people who have "promised" to do one thing or another to me after they get out of Green Acres.

Besides these intangibles, I later learned that the specialist owns a home actually worthy of the title Palace, as well as two big boats (one sail, one power), three luxury vehicles, and two ski homes (one in Smallish State, one out west). Not that I want, or could even keep track of, all those things. But it does say something about the relative societal value of our work, and that, I'm afraid, I do care something about.

I also discovered this week that I could probably make about twice as much per hour as a courtroom "expert witness" in psychiatric lawsuits as I can actually practicing psychiatry. Not to mention that while practicing psychiatry you constantly run the risk of winding up the defendant in such a lawsuit; simply being a witness would be much preferable. Which all is starting to make me wonder if the entire purpose of psychiatry is the generation of lawsuits to support the legal and insurance industries.

Today's cynicism session ends here. I'm going out to plant impatiens and morning glories.

P.S. Lest you think ill of the specialist-- much of our conversation centered around his assertion that the wealthy don't pay enough taxes, and a proposal he had that out-of-state vacation-home owners should pay double the property taxes of local residents.


Anonymous Turbomom said...

You see more progress and actual cures with outpatient work--depression, anxiety, ADHD and people with bipolar illness who actually want to take their meds. You will have grateful patients who can get on with their lives. Of course, those who have or finally get jobs often have to be seen at night. But that would leave days free for sailing, biking, gardening, etc. There is also the big hassle of insurance forms, and trying to get paid. Stick with one good HMO and take Medicare patients with good Medigap insurance, people with indemnity plans and those with private resources (like your surgeon acquaintance). One of my patients just graduated after 12 years during which she raised three great kids and has developed a successful career. But you won't make anywhere near as much as you make now. Better than 6 years of surgical residency though.

5/21/06, 10:56 AM  
Anonymous gt said...

listen to your mother.

5/22/06, 9:13 AM  
Blogger girl MD said...

do what ever it is you think would make you happy. if we can get through my internship (6 more weeks!), we can get through anything.

5/24/06, 1:11 AM  
Blogger The MSILF said...

It seems like your shrink related blogging sort of disappeared when you went over to private practice, and I keep wanting to hear more about how that is going.

3/14/08, 4:11 PM  

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