Professional boundaries between mental health providers

[ronin12]

This is open to opinions from everyone, so please feel free to share

.How do you feel once non physician supervisors(psychologists) of mental health departments are appointing non physicians instead of a medical director to ensure physicians are complying with jacko requirements and evidence based practice of psychopharmacology.

. Rrequests for CME are declined by non physician supervisors as they do no think it is necessary to attend a bilogical themed seminars as non biological workshop of related topic is happening in the town.

.there are several other examples but i just posted few .

I would appreciate if others share their experiences working under non physician supervisors.

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[whopper]

I don't mind a non-physician supervisor checking into things so long as they are qualified to do so.

While having the rank of a physician certainly is something anyone with such can deservedly can pat themselves on the back for, IMHO it being so hard to attain and it being so socially elevating can cause its problems.

I've seen a number of cases where the nurse suggests something and that nurse is right, and the doctor is wrong, but the doctor has an attitude that he/she will never be corrected by an underling.

Its the old Vietnam-Platoon Master Sergeant who knows 100x more than the ROTC Lieutenant fresh from college. A good officer in time will eventually know more than his/her staff & enlisted soldiers, but must always be humble enough to listen to them, especially the good ones that tend to be right most of the time.

In the hospital I'm working at, I certainly trust several non-physicians much more than several of the physicians.

And I certainly have no problems with non-physicians checking up on me, & catching me for forgetting to fill out certain billing forms & other bureacratic forms that I often times forget to do-or couldn't because at the time a patient might have been agitated. It saves me the time & effort to have to go through all of my records myself.

In regards to JACHO (and that's what I believe you meant), its quite simple and something a doctor doesn't necessarily have to do. For example if someone is on a medication, a supposed JACHO requirement is for the doctor to write down what benefits or side effects its having with the patient. You don't have to go to medical school to see if the doctor is or isn't documenting that. And I'll be quite frank, several doctors don't document this and if they aren't that's a damn shame.

I would though have a problem with a non-physician trying to argue with me on my justification for doing something, and throwing a straw which could break the camel's back, arguing with me for doing something that was evidenced based, while they may object to it, but they do not have the training or knowledge to do so. I have had that on a few occasions at my work so far, but it was never something the institution tolerated. Whenever it happened it was something where the person doing so, did so breaking protocol, and I only allowed it to go because I was trying to be a nice guy.

 

[ronin12]

I don't mind a non-physician supervisor checking into things so long as they are qualified to do so.

While having the rank of a physician certainly is something anyone with such can deservedly can pat themselves on the back for, IMHO it being so hard to attain and it being so socially elevating can cause its problems.

I've seen a number of cases where the nurse suggests something and that nurse is right, and the doctor is wrong, but the doctor has an attitude that he/she will never be corrected by an underling.

Its the old Vietnam-Platoon Master Sergeant who knows 100x more than the ROTC Lieutenant fresh from college. A good officer in time will eventually know more than his/her staff & enlisted soldiers, but must always be humble enough to listen to them, especially the good ones that tend to be right most of the time.

In the hospital I'm working at, I certainly trust several non-physicians much more than several of the physicians.

And I certainly have no problems with non-physicians checking up on me, & catching me for forgetting to fill out certain billing forms & other bureacratic forms that I often times forget to do-or couldn't because at the time a patient might have been agitated. It saves me the time & effort to have to go through all of my records myself.

In regards to JACHO (and that's what I believe you meant), its quite simple and something a doctor doesn't necessarily have to do. For example if someone is on a medication, a supposed JACHO requirement is for the doctor to write down what benefits or side effects its having with the patient. You don't have to go to medical school to see if the doctor is or isn't documenting that. And I'll be quite frank, several doctors don't document this and if they aren't that's a damn shame.

I would though have a problem with a non-physician trying to argue with me on my justification for doing something, and throwing a straw which could break the camel's back, arguing with me for doing something that was evidenced based, while they may object to it, but they do not have the training or knowledge to do so. I have had that on a few occasions at my work so far, but it was never something the institution tolerated. Whenever it happened it was something where the person doing so, did so breaking protocol, and I only allowed it to go because I was trying to be a nice guy.

I do agree with you that non physicians do catch us with our mistakes or other bureaucratic processes.i sure do not mind there reminders i.e pharmacists or people from quality improvement. it seems these things vary from hosp to hosp . some hosp are likely to have better way of following protocol. in my situation it is intentional undermining of certain profession i.e psychiatrists as we constitute a small portion of a big bureaucratic place, which is unfortunate.

 

[whopper]

in my situation it is intentional undermining of certain profession i.e psychiatrists as we constitute a small portion of a big bureaucratic place, which is unfortunate.

Care to specify a little more? That's not to question you, but an attempt to understand you better.

 

[ronin12]

Care to specify a little more? That's not to question you, but an attempt to understand you better.

well... it is non academic govt hosp with strong bureaucratic traditions, as it has always been in shortage for psychiatrist. they have most of supervisory level posts to non psychiatrists. I took several initiatives after joining to improve pt access, ACA and redesigning the system, alongwith efforts to improve provision of psychiatric services. now out of blue non psychiatrists are appointed as head of those commitees which I lead before, with out me knowing. those individuals have minimal contribution what so ever in these efforts. so this is one example and there are some other instances in which psychiatrists are sidelined in favour of other non psychiatrists. medical director is practically a paper post, he has limited role in most matters.

Actually these are petty things , but they caught my attention as I found them as a trend and somewhat unprofessional. so that's why i was intrested in knowing experiences from others.
thansk for listening

 

[whopper]

Bureacracy. Sucks. Sorry to hear your situation.

 

[ronin12]

well it seems it's time to move on and look for other opportunities, once visa obligations are fulfilled.