I'm currently training under the field of psychiatry. The place I intend to practice in the future as a specialist is somewhere that needs the service the most. Only few people get to practice this field because of its peculiarities.
At first I was excited about being the only person in a province that will end up practicing my specialty. But then, I'd better home more people do after realizing:
First, there's a lot of people that live with mental health problems and cases can go under reported because some live in far flung areas. To make services available on these underserved areas is a noble thing to do but it also means seeing more patients than what you could reasonably handle. Even in cities where there are more practitioners in the same field get more workload.
Second, psychiatry has more subspecialties like geriatric, pediatrics, substances, and forensic psychiatry to name a few. A patient can come in that requires a subspecialist consult and still not get the optimal management they needed. The nearest specialist who could do is miles away and patient's are less incentivized to go.
Third, I'd be lying if getting paid for my services wasn't a factor but anyone who wants to play higher ground can forfeit their pay if they want, fine by me. It's a lucrative specialty because there's less people willing to do it but it's demanding to do. Eventually, the money isn't worth the trouble but trouble still finds you because you're the only one in the place to do it.
One of the realities in being a physician with a good reputation and practice is how hard work doesn't equate to better quality of life. The reward for doing well in practice is having more patients and therefore one has to expend more time in practice and less time allocated for other things that also matter.
In some way, it's like delayed gratification only instead of not having the money, I don't have the time or energy to do something else. I'd likely be guilt tripped for just asking a vacation.
This is the reason why doctors with rare subspecialties in practice tend to price their fees higher. It better be worth the trouble. While it's counterintuitive because this deprives most of the people that need the care the most but can't afford, it definitely helps with regulating the mental health of the professional doing the work.
I have job satisfaction in what I do but there are days when the volume of people that comes in for consult is no longer worth the compensation I think I'm getting.
So in the event that I do practice where I originally thought I'd want to be, I'd like choose the option where there's low commitment and responsibility.
Thanks for your time.
