I work in an private practice doctors’ office with three psychiatrists and a nurse. I answer phones, set up appointments, deal with drug reps, file medical records, send medical records, request medical records. . . etc.
I see everything from extreme personality disorders to neurotic socialites to catatonic schizophrenics every single day. It’s an interesting job, and I’m constantly thinking that it’s probably nothing like people imagine. Any questions?
Do you feel that drug reps pressure doctors into prescribing their products the way so often displayed in TV dramas?
Best lunatic story?
Ever had a patient who was afraid to talk to you?
How long is the wait for a new patient to get an appointment? Does your doctor do talk therapy along with med management or just the meds?
I’m guessing you have occasional direct contact with patient (at least on the phone making appointments), so:
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Have you ever felt afraid or threatened by a patient?
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What’s the funniest thing you’ve ever seen or heard of (obviously that you can mention w/o risking HIPAA violation or patient confidentiality).
How often are people visibly distraught in the waiting area?
I think drug reps do everything within their power to get their drugs prescribed. Every pen, tissue box, lotion dispenser, clock, clipboard, notepad, etc. has a different medication advertised. The purpose of them is to get the name of the medicine in as many places as possible so that the doctor thinks of it first when writing a prescription. I see at least ten drug reps per week, each one bearing candy, cookies, lunches, dinner invitations, office supplies, or just plain old ass-kissing. In the old days, drug reps gave out vacations, cruises, and golf trips. Nowadays, their bribery is limited to meals and office accessories. The gifts have changed, but the goal has not. They are shameless vultures who will hang around the office forever in the hopes of catching one of the doctors long enough to give them a pamphlet or booklet. It gets so bad sometimes that we’ve actually had to tell drug reps that they have to get out and come back another time.
I’ll really have to think about that one. There are so many. We’ve had a suicide threat that ended with the person firing a bb gun into the fat of their abdomin, a woman who called to tell us that Osama Bin Laden and George W. Bush were having a meeting right then on her roof, and should she call the media, a patient who used to call the staff “nazi bitches” and goose-step in front of the office. Let me think on that some more before I answer.
No, but we have a few patients here who are deathly afraid to talk on the phone, and will only do it with the help of another person to talk through.
Usually no more than a week. There are three doctors who work out of our office, and two of them will do talk therapy as well as med management, but one is strictly meds.
Does it appear to you that the patients are actually getting better?
What seems to be the big diagnosis in the practice?
I have contact with patients every day. I check them in and out, and sometimes I do their vital signs. I don’t often feel threatened by patients. Most of them are just regular people who have a problem with depression or anxiety. Sometimes though, there are people who have problems with rage. Those are the people that frighten me sometimes. We’ve had a few outbursts at the office, but they’ve been few and far between.
As for funny things, there are so many!!! I have kind of a sick sense of humor, but one that cracked me up was a patient who had fallen asleep in our waiting room. The doctor came out to tell him it was time for his appointment and tapped the guy on the shoulder. The guy snapped awake, jumped to his feet and screamed, “Don’t ever wake me up like that again! I swear to God if you ever do that again, I’ll come to your house and rape and kill you and your family!” He then stormed out of the office. A few hours later, he called back and apologized, stating that he wasn’t really a morning person.
Probably every day. Some people are nervous, some are embarrassed, some are just out of touch with what’s happening. Some of our patients are elderly people with severe dementia, and every visit is like their first one.
It depends on what’s wrong with them. Some people have a specific problem, see the doctor for awhile, and then stop coming forever. Other people, specifically personality disorders, see the doctor monthly (sometimes weekly!) for decades and decades with no hope or sign of ever changing at all. It can be very discouraging to deal with people like that.
You know, we’re not really that kind of practice. There’s another psychiatrist in the area who seems to label everyone as bipolar, but we don’t really seem to have that problem. One of our psychiatrists is a little quick to diagnose someone as having adult adhd, but other than that, there aren’t a lot of pet diagnoses.
I’m sorry Alias but your time is up for this thread. We’ll see you next week. Take care.
The catatonic patients…I assume someone drives them there and wheels them in?
Does the doctor who does just meds work closely with just a few therapists or do his patients come from a lot of sources. Or, is there a therapist in the practice as well?
Really? (Yes, that’s a question.)
My ex had to talk to her shrink for a 15 minute session every time she got a scrip refill for her ADD meds. He wouldn’t simply give it to her. They could talk about anything, the subject didn’t matter. They could talk about the weather for all he cared.
I’m not sure if that was the law or just his own office rules.
Very good, my friend. Very good. golf clap
I guess I was thinking about crying. (The last time I was in a psychiatrist’s office I was visibly, audibly, and viscerally distraught.)
How often, if ever, do people in the office discuss their own emotional problems? Is it like having a friend who is a mechanic? (Hey, could you look at my Id for me? It’s been making a weird noise.)
How many of your patients post here?
Yeah. Usually family or caregivers. 
We have patients from all over. We refer out to a small number of therapists, but we get referrals from all over. There is no therapist in the practice.
Yes, really. Although there are times when it might be longer to get in. The doctors primarily do med management, but 2 will do talk therapy as well. As for seeing the doctor for every refill of ADD meds, most doctors do not like to give ritalin or ritalin-like medications with numerous refills. They are very easy to abuse, and have a high street value. Most doctors want to make sure their patients are taking them correctly. Just a few abusers can screw it up for everyone.