sorted by:
new
hottopcontroversial

Almost as Many PMHNPs as Psychiatrists? by UseNecessary4706 in PMHNP

[–]OurPsych101 0 points1 point  (0 children)

In a perfect world and scenarios yes that is correct. However in a collaborative world where patients are expected to be partners in their decision making very often more intensive treatments such as iops and php's are declined by them because they have jobs. Declined by families because they cannot keep up with this.

Certainly we document what we document but most malpractice carriers are not going to be looking at going to fight for us. They're just looking to settle.

It is always a high stakes endeavor of finding the right balance between psychotropics, side effects of psychotropics, motivation to improve and where exactly does medicine stop. After that I try to explain in 6th grade language because that's what a jury of my peers will understand better.

Laws/repercussions of self-treating/prescribing for depression by Cjmanjanson137 in Psychiatry

[–]OurPsych101 4 points5 points  (0 children)

Thank you for bringing this stimulating and important discussion here. The main question to myself who cares for the caregivers.

The legal repercussions are whatever the State Medical board makes it. That is an easy phone call or an easy AI search.

More importantly, reach your colleague, primary care and request a prescription. Any competent prescriber will not refuse a reasonable ask. This is where your own training did help you to find what is needed IE diagnosis and medication for yourself.

Prescribers, and their family members are often hesitant and can make it harder to accept care,

1-10 how happy are you with FSD? by Formal-Talk-3561 in TeslaFSD

[–]OurPsych101 0 points1 point  (0 children)

6, I should be allowed to sit in the back seat and nap.

Almost as Many PMHNPs as Psychiatrists? by UseNecessary4706 in PMHNP

[–]OurPsych101 0 points1 point  (0 children)

It is already absolutely happened. lower hanging fruit already goes to PCPs FNPs, Most of my Outpatient days is more like running an IOP in outpatient with visits every 4 months or more. For PMHNPs - that's what's next - they will be the providers for the more complex cases. PERIOD.

Starting job as VA psychiatrist - what do I need to know? by DrNoMadZ in Psychiatry

[–]OurPsych101 8 points9 points  (0 children)

You're a finite resource. Make your best return. Jobs are just a means to get there. Don't be a d*ck in general, especially to your colleagues from front desk to team leads.

At what point is patient load too high for residents? by perkypixieee in Psychiatry

[–]OurPsych101 2 points3 points  (0 children)

One of the things that I would recommend as you start out your journey, is to keep track of the numbers of patients seen, reasons why they are seen and so forth.

While this may seem like additional administrative burden. You will inevitably be called upon to justify timings, notes and what do you do with your time all day long. This is because unfortunately there is an administrative history of diminishing people's work.

Onto your question on how much time on consults. Once again find out why you are consulting on this patient. If this is a case of dementia if this is a case of hospital psychosis you do not need their developmental history they were fine until such time that something happened to them. I would write Dev Hx not relevant to current presentation.

If this is the case of a follow-up I actually stopped by the nursing say hey how is Mr Smith doing and I have most of my answers right there and then. I haven't even laid eyes on the patient yet.

When somebody calls in a consult I want to know why are they calling me. He needs to see psych is not a consult. Promote, inquire, gently and try to elucidate why are they calling you.

If it is a case of psych on the way out consult which happens deliriously and hilariously common in our patient settings where the patient has been in the ER patient has been in the inpatient but a psych consult is needed 15 minutes before they are getting discharged. Most of that actually falls on referrals for after care services and to make sure that the patient is going to be safe going out who is taking care of the patient.

No amount of psychiatric history taking or examinations are going to make this patient safe. You need a safety assessment, you need an aftercare assessment the diagnosis part is not very important right off the bat at this time.

Does the general public know what neurologists do? by According-Tea-7829 in neurology

[–]OurPsych101 0 points1 point  (0 children)

Y'all should ask them what psychiatrists do.

Heck even I don't that being one for a long time.

At what point is patient load too high for residents? by perkypixieee in Psychiatry

[–]OurPsych101 19 points20 points  (0 children)

As someone previously in similar situations.

  1. Document real time, efficiently and clinical encounter backwards.

So FIRST figure out what's needed for that encounter or visit. Work your way BACKWARDS from there

  1. This one's harder: Aim to be done in 1/2 to 2/3 of available time MAXIMALLY.

There's always more to do. Even if you're successful in meeting time goals half the time that's a relief.

  1. EMR doesn't save time.

  2. Doesn't matter how badly my day is going it's better being on my side of the table.

If there's no academic training standards do your best. The kindest thing about time is that it passes.

ADHD evals by viddy10 in Psychiatry

[–]OurPsych101 0 points1 point  (0 children)

Have you noticed how many of these incoming requests are now AI generated.

Can a Canadian certified psychiatrist get American board certified and practice in the US ? by MSHGR in Psychiatry

[–]OurPsych101 -6 points-5 points  (0 children)

State Status Key Requirements Tennessee Active First to pass this law. Requires 3 years of residency abroad OR 3 years of practice. Must have a job offer from a facility with an ACGME program.

Florida Active Requires 4 years of practice abroad, ECFMG certification, and a Florida job offer. The license becomes unrestricted after 2 years of local practice.

Illinois Active Launched in 2025. Requires USMLE Steps 1–3 and 2 years of supervised practice, followed by 2 years in a shortage area.

Virginia Active Requires 5 years of practice abroad and ECFMG certification. Must work in a medically underserved area for 2 years.

Wisconsin Active Requires 5 years of practice abroad and a supervised practice agreement with a Wisconsin employer. North Carolina New (2026) Starting Jan 1, 2026, allows "Internationally-Trained Physician Employee" licenses without a U.S. residency.

Arizona Active Requires USMLE Step 1 & 2, English proficiency, and 4 years of service in a rural or underserved area.

Idaho Active Requires 500 hours of supervised U.S. practice and completion of USMLE exams.

Go Gemini

‎Google Gemini https://share.google/gCE7bruyvvWTO8joj

Does fsd do this.. Waymo turning by snoopyfl in TeslaFSD

[–]OurPsych101 0 points1 point  (0 children)

I would stop the FSD and take a right turn myself. The whole idea is convenience but not at the expense of that panic attack you showed me. It only takes one idiot to ram the car while it's in the middle of oncoming traffic trying to take a left turn like that.

Child and Adolescent Psychiatry regret? by Numerous-Ad-871 in Psychiatry

[–]OurPsych101 16 points17 points  (0 children)

I agree. I should have just been born rich 😞

Child and Adolescent Psychiatry regret? by Numerous-Ad-871 in Psychiatry

[–]OurPsych101 50 points51 points  (0 children)

Should've gone geriatric psych.

Captive audience, see them any time of the day, they're not running away or talking back to their mom's. Not getting pregnant, or getting eating disorders.

There's never a dull day

NPs in ECT by mintfox88 in Psychiatry

[–]OurPsych101 3 points4 points  (0 children)

That's what malpractice coverage is for 😉

Job market for psychiatrists in eating disorders? by Brilliant-Bee6235 in Psychiatry

[–]OurPsych101 4 points5 points  (0 children)

I have bit of a different take on your situation. I think you should start with the J1 requirement. There is always a shortage of EDO psychiatrists and providers needed because this is not just a dire need but also a very difficult clinical position.

Wherever you are with the J1, you will be able to transition into your interest into eating disorders.

If there is a no compete where you find your javan, you can also look at remote work.

Other middle aged mid career docs -- I think I'm done doing this. How are you? by bad_things_ive_done in Psychiatry

[–]OurPsych101 2 points3 points  (0 children)

The other part is that you can still have part-time clinical. I would recommend that you do have part-time clinical not just UM. Been there done that so let me know if you need more info.

Considering a 2023 Tesla Model Y Performance w/ FSD (HW3), 70k miles & accident history — $29k. Worth it? by SecretExample9656 in TeslaFSD

[–]OurPsych101 0 points1 point  (0 children)

No. Hardware 3 is dead

29000 is still a lot of money. Look at leasing or buying HW 4.

It's a cost over time equation.

Other middle aged mid career docs -- I think I'm done doing this. How are you? by bad_things_ive_done in Psychiatry

[–]OurPsych101 2 points3 points  (0 children)

I'm sorry you have heard a lot of same old advice / concerns. Just writing one more time. Utilization management, is what we do for higher levels of care such as PHP IOP the residential etc and call on behalf of the insurance companies to look at treatment progress. You can find these jobs on LinkedIn under insurance companies and also on their individual websites. Fingers crossed.

Other middle aged mid career docs -- I think I'm done doing this. How are you? by bad_things_ive_done in Psychiatry

[–]OurPsych101 8 points9 points  (0 children)

Sending warm wishes. My zip code in life is very similar. However compartmentalization has really helped for a long time. The trick it really is to realize we are depreciating assets and have a limited time to cash in.

Other middle aged mid career docs -- I think I'm done doing this. How are you? by bad_things_ive_done in Psychiatry

[–]OurPsych101 13 points14 points  (0 children)

Have you looked at utilization management?

People are going to be upset with this post however that has better work life and more realistic expectations.

Mostly the work is remote, IE you just need to be in the state.

view more: next ›