Vikram Kumar Rohra, a senior medical student who has own his blog site, Psihub, as for my comments on an article ( “Addressing the Escalating Psychiatrist Shortage” by Stacy Weiner, posted February 13, 2018, AAMC News) about the shrinking psychiatric work force. Part of the challenge is, as Vikram points out, is the graying out phenomenon. About 60% of us past the age of 55 (including me) are planning to retire soon.
I’m not sure what to do about that cohort effect, except to say that it’s probably past time for some older psychiatrists to retire at last (including me?). At the risk of sounding like I’m beating a dead horse, I can tell you one reason why I and other psychiatrists and physicians from other specialties are retiring and that’s the regulatory hassles, especially Maintenance of Certification (MOC).
Vikram may never have to deal with that scheme by certification boards for scamming money from hard-working doctors–if coming to American is not the plan. However, American physicians have been either putting up with this or protesting MOC for many years. Just type “MOC” in the search box to see what I’ve written on the subject.
I’ve chosen to drop any pretense of complying with MOC and continue to believe psychiatrists, internal medicine specialists, and surgeons can learn what they need to do on their own without expensive recertification examinations and other nonsense lacking any relevance to our practice. Take a look at the Clinical Problems in Consultation Psychiatry (CPCP) on this blog site if you want an idea of what lifelong learning can be. A quick link is on the left column of my blog home page.
You can also head over to Dr. George Dawson’s blog, Real Psychiatry, to get an idea about the ravages of managed care ruining the idealism of doctors, young and old.
That’s only part of the reality, though. After all, I don’t want to discourage Vikram. There are efforts to recruit psychiatrists and one of them is the exposure to medical students of what is admirable, enjoyable, and intellectually stimulating about medicine and psychiatry. I gather the University of Nebraska Medical Center is doing a great job with that, according to the article under discussion.
They also create a strong culture of mentoring, which I think is critically important. I’ve not been a great or consistent mentor in my career although one medicine resident recently called me a mentor. I will always be grateful for his gratitude. And I’ll always wonder what I actually did to deserve it.
One statement caught my attention in the article: “…access to more varied client populations can decrease burnout and thereby increase workforce retention.” There are a couple of things going on there. I’ve been in private practice settings very briefly, and it can get a bit dull and frustrating waiting for no-shows in clinics. I’ve also had to cope with burnout, which led to my taking up mindfulness meditation.
This reminds me to plug Consultation-Liaison Psychiatry. It’s difficult to imagine a more varied work and patient access experience than C-L Psychiatry. You can view short videos of C-L Psychiatrists describing what they do and why they love it at the Academy of Consultation-Liaison Psychiatry website. Although it’s hard work, I’ve enjoyed it.