The Experience Trade-Off

What do surgery residents hate about taking call every other night? They miss half of the cases.

 

Experience plays a critical role in psychiatry as in the rest of medicine, but some inconvenient truths can get in the way:

  • There is always a first time using every treatment.

  • The more time a psychiatrist spends with each patient, the fewer patients in the practice, and the slower experience will accumulate.

 

Other truths may compensate:

  • The psychiatrist can benefit from the experience of colleagues.

  • The psychiatrist can benefit from education.

 

Still others are mixed:

  • The greater the psychiatrist's willingness to try a new drug or other treatment on a patient (use them as guinea pigs?) the more subsequent patients benefit from that experience.

  • The more often the psychiatrist makes a particular diagnosis, the more experience she will gain with its treatment.

 

How does a psychiatrist achieve the right balance? How much should a psychiatrist tell the patient about their experience (or lack thereof) with a proposed treatment? How does a patient find a psychiatrist whose handling of these realities fits his own values?

 

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