Having seen a half dozen psychiatrists in town, I can appreciate the differences in bedside manners, communication styles, and psychiatric strategies.
I also know what makes a person a good psychiatrist, a mediocre one, and one that should have been held back in medical school, without a license to dole out antipsychotics and other powerful drugs to vulnerable patients.
Here are a few things I look for in a doctor, qualities that set them apart from your average psychiatrist.
1. Possesses some humility.
Nothing is more dangerous than a doctor who thinks he holds the secret to your mental health, who is convinced he is in possession of every bit of information available in the field of psychiatry, or who doesn’t think medicine has changed in 20 years. Although I have many doctor friends who are humble, beautiful people, I don’t think humility is a trait encouraged in med school. Therefore, when I find one that actually says out loud, “I really don’t know … I’ll look into it,” I know that I’ve hit gold. Why? Because a conversation is possible. When a doctor believes he might learn something from the person who sits across the room, collaboration and partnership are possible, which always harvests more success than does a magician and his observer.
2. Prescribes judiciously.
A mediocre or bad psychiatrist will listen to a person’s symptoms, look up to the ceiling for a second, and then jot down a prescription for a medicine that he ironically has samples of in his closet. Personally, I think any offer of samples is a red flag. You’re in trouble if your doctor’s best friend is his pharmaceutical rep because, on some level, he is being persuaded on what he prescribes to his patients. All the information that enters into that decision should come from his research, not from his free lunches.
3. Addresses underlying or accompanying conditions.
A good psychiatrist might order a bunch of lab work on a patient before deciding on a treatment plan. He investigates if there are contributing factors like Vitamin D deficiency, or hypothyroidism, that play into a patient’s depression and inquires about all complaints or symptoms mentioned by the patient, even if they don’t fall under the umbrella of psychiatry. He doesn’t stop asking, “What else could this be?”
4. Refers to other doctors.
Not only is an effective psychiatrist good at identifying symptoms of contributing illnesses, she has done her homework on which physicians are at the top of their field in other specialties so that she can confidently refer her patients to them. She has done considerable research on psychotherapists, compiling a list of excellent marriage and family therapists, personal (supportive) and cognitive-behavioral therapists, therapists for children, and group therapy resources.
5. Thinks holistically.
As part of any evaluation, a good psychiatrist asks her patients about sleep patterns, diet, exercise, and particular stressors. She inquires about key relationships and support systems. Part of the session covers non-pharmaceutical methods of relieving depression and anxiety, such as yoga, light therapy, or counseling. This doctor is aware of each patient’s key strengths and will suggest a recovery program based on those strengths.
6. Consults other physicians.
Effective professionals of any kind are connected to colleagues with whom they exchange ideas, strategies, and practices. A good psychiatrist regularly consults with others in her industry about what’s working well, and what’s not. She may get a second or third or fourth pair of eyes on a difficult case, or be directed to a body of research that could clarify a problem she’s faced in her practice. Ideally the psychiatrist is associated with a teaching institution and can benefit from the emerging research there, as well as the wealth of knowledge and experience available.
7. Is Accessible.
Maybe I’m just spoiled, but I am befuddled when a friend says he had to leave an urgent message with his psychiatrist’s office administrator, or leave it on the voicemail of the main office number. A good psychiatrist will give you her cell number, and return calls in a timely matter. I can even email mine questions or concerns and she almost always returns the email within the day.
8. Keeps good records.
I have worked with psychiatrists in the past that don’t write anything down during our appointment. The next time I come in, they want me to fill them in on where we left off—reviewing which meds I’m on and how many milligrams. Imagine if I am so depressed I can’t remember where I parked my car (very typical for me). You think I have a reliable record on the history of drugs taken and symptoms exhibited in the past? Being a good note taker is one of the critical qualifications that every efficient psychiatrist should have.
9. Gives Hope.
Good psychiatrists are in the business of delivering hope. That is, after all, their most important job, because the helpless person won’t be motivated enough pick up the prescription from the drug store or keep a follow-up appointment. Effective doctors don’t make unrealistic promises (“You will be well by next month”), but will emphasize a patient’s steady progress and serve as a much-needed cheerleader alongside the patient’s recovery.