As a psychiatrist, time dictates my day in the office. My schedule is divided into 20-minute increments for patient follow-up visits and 40-minute blocks for new patient evaluations. I try my best to stay within the specific time limits, but sometimes patients require a bit more time in order to effectively convey & discuss the diagnosis and treatment plan. If a few minutes overtime are needed, I allow it, however, it’s also necessary for a psychiatrist to set boundaries on time because it can take away from each successive patient’s appointment time. Even though some patients may take up more time than allowed, it’s my job as a psychiatrist to direct the interview and complete the entire session within a reasonable timeframe.
Sometimes patients are so anxious about disclosing information that they wait until the last minute when the session is almost over. A psychiatrist should acknowledge the patient’s disclosure and triage/judge whether or not the issue is emergent and must be addressed, or if the issue can wait until the next appointment. I’ve had to remain in the office after hours several times, mostly when a patient is an imminent risk and needs to be assessed for possible hospitalization.
If you don’t feel like you get enough time with your doctor, then you’re not alone. Most doctors wish they could spend more time with their patients, but the pressures to see a patient within a short amount of time exists. Over the past four years that I’ve been in practice, I’ve developed my own therapeutic style that allows me to to efficiently ask necessary questions while maintaining a connection with my patients (hint: such techniques involve direct eye contact, spending the first few minutes allowing the patient to talk uninterrupted, acknowledging factors in their lives other than solely discussing meds, etc). In a 20-minute session, I probably average spending 25% of the time discussing medications. A psychiatrist’s job isn’t easy — I may be a physician, but I’m also a human being and can’t help but be impacted by my patient’s heartbreaking issues. Therefore, prioritizing time for self-care is absolutely necessary.
I utilize my weekends doing non-psychiatry activities (with the exception of blogging & social media). I used to be on-call at my previous job, but realized I needed weekends off to maintain my sanity. I admire anybody who takes call on weekends, but for me there was nothing worse than getting paged at 2 am and driving to the hospital half asleep.
Having made career decisions that doesn’t compromise on providing the best quality of care I can nor the people and activities that are important to me, I feel much more balanced with my current part-time schedule. I used to feel extremely constrained by time (I still feel that way, but not nearly as much), but these days I am far more in control of how I choose to spend it.