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What makes a competent psychiatrist

Posted by Corinne on October 21, 2009

I have worked with psychiatrists for about 10 years, both in an inpatient and outpatient setting.  About 60% of my clients are on a psychotropic medication  and therefore need to be followed by a psychiatrist. They typically see that person about once every 1-3 months for about 15 minutes .However, that depends upon the medication  and how long the client has been on medication. I have spoken with clients about their experiences – the good, the bad, and the questionable.  I have learned that, for sure, the client’s ultimate prognosis can be greatly helped or hindered by the medication and treatment from a psychiatrist. I have had the pleasure of working with one psychiatrist that was so trusted and appreciated that he was invited for Thanksgiving Dinner by clients.  On the flip side I have had a client come to see me in tears because her psychiatrist told her “just be a better wife.”

The role of psychiatrists have changed in the last 20 years. Therapists like myself know them as the “go-to guy” for managing medications and hospitalization of clients.  Many of them in practice today have had just basic counseling experience, especially if trained after 1990. Most of them, they have chosen to serve as managing medications and referring to LCSWs and LPCs /MFTs for counseling.

If a client is on medication and actually needs a MD to manage it, the first criteria in selecting a psychiatrist is how she or he is willing to collaborate with your therapist. I strongly believe good mental health care takes a team approach: the client, the family, the therapist and the psychiatrist.  I have worked with some psychiatrists that have done wonderful jobs on assessing clients, and some that basically ask me to get the psychosocial  info and make their own judgement on how to treat them.  Typically a competent psychiatrist focus on gathering info, suggest psychotherapy and a treatment regimen of medications.  He or she should always review options of medications and side effects just as any other MD would be expected to do.  Clients need to trust their gut when it comes to any MD, especially one that needs to know more than your vital signs and medical history.  If you feel that a psychiatrist is asking a lot of questions and seems genuinely interested- great!  If he or she rushes you out with a sample of meds without explaining the meds or giving you a diagnosis… find another one.

Another thing to consider as a client is who your internal medicine MD or other MD refer to.  They may have worked with a certain psychiatrist that they felt managed patients effectively.  Of course their experience is not as a patient but they have seen the kind of time this person has invested in his or her patients and sometimes that is even better.


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