How Do You Find a Good Psychiatrist?

By Marvin Ross

Home on the Hill
From left to right Jude Mersereau, Dr David Dawson, Lindsay Thompson, Kathy Mochnacki (chair) Along with a police officer from the York Regional Police Force who often come to learn about mental illness

And that is a rhetorical question as I have no idea. It was a question raised the other evening at a presentation I was at with fellow blogger Dr Dawson. The presentation was put on by the group Home on the Hill Supportive Housing in Richmond Hill Ontario as part of their ongoing Robert Veltheer Lecture Series.

At this presentation, two women with schizophrenia talked about their experiences with the disease and how they coped. Dr Dawson answered questions about the nature of schizophrenia and the video will be available soon which I will post. Both women received standing ovations from the audience when they finished describing their struggles and their successes. I have to admit that I was very moved.

The question of a good shrink was raised and people struggled to answer it so I would be most interested in how the readers of this blog might answer that question.

Dr Dawson, if I remember correctly, talked about the need for all doctors to focus on their patients. Evidence based plus Electronic Medical Records (EMR) allows for the efficient input of great quantities of data gleaned from a q and a with the patient. But, while inputting, so much if not all of the appointment is spent with the doctor staring at the monitor or back and forth between patient and monitor. This strict adherence to evidence based medicine is unsatisfying for the sufferer and thus probably a reason more and more, in this era of science and information, are turning to acupuncture, naturopathy, chiropractors all of whom provide some comforting magic and the promises we all want to hear.

Another important component of psychiatric support is ongoing support for the patient at fairly frequent and regular intervals. This can actually be done (and is often done in good programs) by case managers. The case manager will meet with the patient and discuss successes, failures and activities. If there are problems, then the psychiatrist can be brought in.

Most of the time, we do not get to chose the psychiatrist but have one assigned to us by the hospital or agency based on who is available. There is little room for choice given the shortage of those in this specialty. If I get referred to a cardiologist by my family doc and I do not like that person, I can always go back to the family doc and request a referral to someone else. This is not a luxury open to psychiatric patients.

Another problem, in Ontario at least, is that if you are hospitalized, the treating outpatient psychiatrist is replaced by whichever psychiatrist is responsible for that unit. Most of the time, the in patient doc will consult the chart and talk to the regular psychiatrist and caseworker but not always. I’ve seen that happen with disastrous results. And, like a crap shoot, you may actually get an exceptional psychiatrist which, thankfully, I’ve also experienced.

So from my perspective, a good psychiatrist is one who understands the disease and its treatment, listens to the patient and interacts with them, the family and provides regular and frequent support from a qualified and empathetic case worker.

I’d love to hear what you think.

4 thoughts on “How Do You Find a Good Psychiatrist?

  1. Hi Marvin,

    You asked: What makes for a good psychiatrist?

    The best psychiatrist I had was one who respected my decision not to start treatment (for my newly-diagnosed bipolar disorder), even while scheduling weekly follow-up appointments during which he educated me in a collegial, non-patronizing, non-sexist way about why I was experiencing certain symptoms of hypomania, etc. When depression set in, I decided of my own accord to relent and start treatment. This was the first in a long series of steps I took to reach eventual acceptance of my disorder. My sincere thanks to “Dr. Y” (he has humbly asked to remain anonymous), at the Jewish General Hospital in Montreal.

    Cheers, Merryl Merryl Hammond, PhD 6 Sunny Acres Baie-D’Urfé, QC, Canada H9X 3B6 Tel: 514-457-4347

    Mad Like Me: Travels in Bipolar Country A memoir merrylhammond.com

    >

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    1. Sometimes one can wait to start treatment, but sometimes a lifeline has to be extended forcefully. A good psychiatrist usually has lots of experience , patience , empathy and above all knowledge What to do, when to do and what not to do!

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      1. For me I have found a great psychiatrist. I live in Ontario Canada. Finding a psychiatrist elsewhere could be different. My psychiatrist is very much into empowering his patients.We can talk about absolutely anything. I am extremely comfortable with him. We talk about any new medication or medication changes. We make all decisions together. I wish you all the best in finding a psychiatrist.

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  2. I was once had a medical consultation with an English internist. (Sorry, being English just added to the pomposity of his posture). He looked down his royal nose and said, “Psychiatrists–they are still physicians, I suppose, are they not?” To which I replied, “Internists–they are still healers, I suppose, are they not?” His nose went even higher in the air.

    A healer listens to the patient (the second rule of medicine) and thereby offers a therapeutic relationship, something that I think accounts for much of the placebo effect–even in a medical prescriber. It is the relationship–the offering of attention–not the manualized questionnaire that brings healing.

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