for a 9-5 job that pays OK and there is essentially NOTHING expected of you.
This is a gross mischaracterization of the field. Nothing is expected of you? Ever deal with a patient that you've already given Haldol 100, Ativan 4 mg, Zyprexa 30 mg, and they're still running into a wall headfirst at every available opportunity?
Psychiatry certainly is not as stressful in some ways that most doctors encounter. E.g. you're hardly ever going to be dealing with a patient that is medically coding, but you can be in situations that are still very stressful such as violent patients due to psychosis or mania, being pressured to discharge a patient that you believe could be suicidal but you're not certain (they could be denying suicidal ideation simply so they could be discharged and complete the act in an unstructred setting where they could otherwise be stopped), or dealing with treatment-resistant patients who now need dosages of medications that aren't medically safe without careful monitoring (e.g. large amounts of Clozaril, Lithium might be the only medication that prevents the person from attacking others but the person has chronic kidney disease, etc.).
You also got to deal with a lot of needy people that are willing to back their demands with threats. When I was a resident I'd would've rather been doing surgery on a patient that couldn't talk back to me than a guy telling me that unless I give him Ativan he's going to cut his throat with a razor the second he's discharged.
You admit a patient against their will without due cause, you're opening yourself to a possible malpractice suit. Accountability zero? Yeah, in your dreams. If you request an involuntary hospitalization for a patient in most states, you could be subpeonaed to explain your actions. In the overwhelming majority of cases with involuntary hosptilization, at least one mental health professional will be. ER docs usually don't have to worry about this because the psychiatrist who takes the case after the request is made usually takes this up. In many cases, you got a grey area situation where you're not certain if the patient is dangerous and this is stressful because you could be potentially letting someone dangerous into the community.
If you discharge a patient that does something dangerous within about a month you could be targetted in a malpractice suit for not detecting the potential for danger when you had them. If found guilty, you could be held liable for any damage done by the patient. Even if you are not sued, the hospital you're in would likely do some type of internal investigation and M&M concerning this matter.
titrate depression/ psychosis/ ADHD meds and no one is expected to really get better.
Nope. Tell me the source of your data doctor that FDA approved meds for these disorders don't get these people any better? Most insurance companies expect you to get them better within 4 days of hospitalization evidenced by them often demanding you discharge the patient even when that patient is dangerous. Scientific data shows that antidepressants do work, not well, but do on an order around 60-70% at high dosages and take a few weeks to work. Antipsychotics can work within the same day. Treatment resistant patients can be given ECT or other more invasive treatments such as Clozaril and most of those patients do get better but we psychiatrists try to avoid the more invasive options.
And if patients dont' get better and they're in the hospital insurance companies, mental health boards, consumer advocate groups, the patient's friends and family among several others will rightfully question your treatment decisions.
There are advantages in psychiatry that could make it potentially less stressful vs. other areas of medicine. E.g. less need for call, you could limit your hours more, but the situations you bring up aren't true. As for call, most places still need psychiatrists on call, just that the need isn't on the order as other fields, so you got a better chance of getting a job not requiring it.
As for psychiatry as a field in general, most medical doctors I know had no background in the behavioral sciences prior to medical school and didn't understand much about human nature in general. Most residents I knew in other fields of medicine told me they didn't understand the field and didn't think they had the knack for it. I personally find the field interesting but I was a psychology major before medical school, not the typical biochem, biology, chemistry, or engineering major you'd typically see.
To get back to the original question, the best field of medicine you want is the one that you're most passionate about balanced with the lifestyle it can offer you. I personally loved surgery, but I didn't want to be frequently woken up in the middle of the night.
More specialties need joke acronyms like this.
