u/Impressive_Arm_9197

I'm in a clinic attached to inpatient hospital for over a year now and I'm struggling with my patient panel. I don't know if it's a me issue, a work issue, or mix of both.

I estimate at least 20% are challenging (at least to me) whether it's due to being high risk, severity of symptoms and illness, difficult circumstances/high social needs. The clinic I work at does not have any case management, RNs, or social work support so it often feels like just me myself and I managing these patients. I get frequent messages for same day appointment requests, severe symptoms arising, paperwork requests, family concerns etc. we have to handle all messages outside of scheduling.

Are most outpatient positions like this, with that mix of acuity and what feels like little support?

Hi all, early career psychiatrist here. I've been feeling a bit stressed and burned out by work and thinking about establishing with a therapist. I also wonder if this could be useful to improve my own therapy skills. My only reservation is I would prefer someone that goes beyond "talk therapy".

Any recommendations on how to find a good therapist perhaps one with psychodynamic or psychoanalytic proficiency? I imagine a psyD or PhD would be my best bet?

Edit: thank you all for the input!

I am early career and I wonder if I spend too much time in evaluations. I see primarily young to middle age adults in outpatient setting with varying degrees of acuity level.

I tend to use a full 60 minutes with patients, which doesn't include chart review or completion of note. I do talk as a type. I generally use 10-15 minutes outside of interview time on the note.

Any advice on speeding things up or is this something that just takes time and experience?

I don't feel like I'm much faster since residency.

Edit : thanks to everyone for giving their perspectives !

Hello all. Looking to start a small private practice on the side focusing on 30 follow ups + some therapy (90833), not intending to replace the therapist however.

I'm inticipating running into patients who prefer a quick 5 minute med mgmt visit, so I'm wondering if it's a good idea to explain in the initial visit that these are going to be longer visits with therapy and deeper discussions in mind? And if that model is not a good fit for them I offer to refer them out?  

Main concern with this is being too upfront may turn people away prematurely, but I'm not sure.

Would like to hear some suggestions on best way to set this expectation up or any general tips, especially from those who do a model like this. I know it's a pretty popular practice right now.