Why Psychiatry?

Trying to figure out what kind of doctor you should become? Wondering what specialty you should choose? Then SheMD's Why Specialty Series is perfect for you! We're bringing you female physicians sharing WHY they chose their specialty. Today's post is on why Dr. Grayson chose the field of psychiatry and why child and adolescent psychiatry is a great field.



“Sometimes people need to take the wrong path in order to lead them to the right one”

-Nashoda Rose

This was definitely the case for me. I completed 3 years of neurology residency before switching my specialty, and entering into psychiatry. A few months later, I decided to do a fellowship in child and adolescent psychiatry (child psychiatry). I discovered after changing my career path that this was a common path for many psychiatrists. Many have switched from residency in other fields to psychiatry. Now I absolutely love going to work every day and I can’t imagine doing anything else. I definitely could not say this a few years ago as a neurology resident.


Why didn’t I pick psychiatry in medical school?


“Psychiatry is a pseudoscience”


“Is it even medicine?”


“Listening to people complain all day will cause burn out”


“Your talents will be wasted on psychiatry”


Psychiatry is a field that carries a lot of preconceived notions and stigmas. During medical school I let statements like these influence my specialty choice and rank list, despite knowing deep down that psychiatry was where I belonged.


Why did I change to psychiatry?


Not long after starting neurology residency I knew it definitely wasn’t for me. I was just not happy. I found myself wanting to spend more time sitting and talking to patients about how their illnesses impacted them and their lives. I remember sitting with one patient who was labeled “non-compliant, a problem patient, frequent flyer” and asking her about her life and how she was doing and coping. She broke down crying and told me about how hard it had been to get out of bed and care for herself and her child. I spent forty five minutes with her, referred her to therapy, and started an antidepressant. Six months later she came back for a follow up and was a completely different person. A year later she was taking her medications and had stayed out of the hospital for eight months. This was the turning point where I realized psychiatry was what I was meant to do and made the decision to switch.


Switching to psychiatry was one of the best decisions I have ever made. My days no longer seem like work. Once I switched there was no question that I wanted to fast track to child and adolescent psychiatry. My passion since I was young was working with children, and this passion resurfaced. I think child psychiatry is an amazing, fun, and rewarding field- and one that we are not exposed to enough in medical training.




10 Reasons Why You Should Consider Child and Adolescent Psychiatry


1. Psychiatry is Both an Art and a Science


Psychiatry is a combination of science and art. In psychiatry we follow algorithms and choose treatments based on evidence-based research, but at the same time we realize that every patient is different. There is room for creativity. Prescribing an antidepressant is rarely successful without taking the time to fully understand a patient and their situation. Rather, the best treatment plans in psychiatry are as complex as the patients themselves, involving therapy, medications, and often social interventions and behavior changes.


2. Work-Life Balance


Since changing to psychiatry my work-life balance has improved greatly. As a fellow I still take home call, but rarely do I get called in. Overall I have found most people in the field to be happier and have a more balanced life. Per Medscape's psychiatrist lifestyle report in 2018, psychiatrists rank among the top five happiest physicians at work. (1)


3. Diversity of Job Settings and Opportunities


Within psychiatry you can practice in many areas. Over the past few years I have had the ability to work in hospitals, emergency departments, outpatient clinics, integrative primary care clinics, crisis centers, prisons, school system, family counseling centers, and with Child Protective Services. 


4. High Demand, Low Supply


There is a need for child psychiatrists all over the United States. There are 15 million children in the United States who need a child psychiatrist. According to an article in 2017 there are only 8,300 practicing child psychiatrists in the country. (2)


5. Long Lasting Bonds with Your Patients and Families


As a psychiatrist you build a unique, intimate connection with your patients. They trust you with their deepest feelings and thoughts. You are a constant and non-judgmental support for them. Families and patients often continue to check in with their psychiatrist even after “graduating” from their care.


6. Central Role in All of Medicine


Psychiatric illness can affect a patient's overall health and compliance with other medical treatments. Mental illness is prevalent in every specialty. You have the opportunity to help these specialists understand how their patient's psychological and social well-being affects their illness.


7. Advocate For Those Who Cannot


Whether your patients are non-verbal or just not yet able to express their feelings, you help them find ways to communicate. Sometimes children act out because they are not able to express themselves. It is very rewarding to be able to understand children’s feelings and needs based on non-verbal and verbal cues and to subsequently help them address/express these feelings.


8. Patients Get Better


Children are resilient and you have the chance to make a big difference in their lives. It is very rewarding to see them improve and do well. Addressing problems, especially in children with genetic and social loading, at an earlier age gives them a chance to improve problems that may impact their self-esteem, schooling, social interactions, and quality of life. You have the ability to change the trajectory of a child’s life and watch them thrive.


9. You Have the Ability to See Adults and Children


Becoming a child psychiatrist gives you the ability to see patients of ALL ages. Some outpatient child psychiatrists choose to see just children, but others opt to see adults and children.


10. I Get to Play with Children All Day!


Part of my job as a child psychiatrist involves building a rapport with children to get them to open up, and creating a safe, fun environment so that they want to come back week after week. A lot of that can be done by playing with them! As part of my fellowship we get a toy fund to help fill our offices with fun supplies for the children. My office is filled with games, toys, books, and art supplies. Most of my visits include some play time!



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References:


1. Medscape Psychiatrist Lifestyle Report 2018: Personal Happiness vs Work Burnout Sarah Grisham | January 24, 2018 | Contributor


2. Cama, S., Malowney, M., Smith, A. J. B., Spottswood, M., Cheng, E., Ostrowsky, L., ... & Boyd, J. W. (2017). Availability of Outpatient Mental Health Care by Pediatricians and Child Psychiatrists in Five US Cities. International Journal of Health Services, 0020731417707492.