Although psychiatrists are generally suffering much less from the economic
crisis than many of their patients, it is nonetheless affecting them both
psychologically and financially (see Economic Crisis Taking Toll on Americans' Mental Health).
Some of the evidence that this is the case comes from a survey that APA
conducted of its members in April about the impact of the current economic
crisis on their patients, themselves, and their practices. Eight
hundred-and-five members responded.
Said one: "I thought as a doctor I'd never have to worry about money.
Wrong! Half of my retirement funds are gone. I have worked very intensely my
whole career and was looking forward to a great retirement fairly
Said a second: "I am losing money on seeing patients in the office.
If it were not for a clinical trials practice and some speaking engagements, I
would have gone bankrupt a while ago.... In addition, I have given up the
thought of retirement."
A third reported: "My patients are more stressed, sicker, and
crankier. That increases my stress and also my receptionists'
And a fourth noted: "I am still extremely busy—working harder
for less income. Yet I feel lucky to be working nonetheless. If this
continues, however, there will be a point of diminishing returns in which my
practice will fail."
Interviews that Psychiatric News conducted with members likewise
illustrate how the economic crisis is impacting some of them.
"I see so many students ... working long hours as well as carrying
heavy academic loads," Leigh White, M.D., who works in a student
psychiatry service at Michigan State University, told Psychiatric
News. She finds their struggle disheartening, she said. Sometimes she is
tempted to tell them, "Don't work so hard," but then she recalls,"
They need their job to afford college, to afford medication, and to see
me. It is sort of a Catch-22 situation."
"As an individual I am not, of course, any more immune to the recent
economic forces than my patients are," Charles Berlin, M.D., a
Pittsburgh psychiatrist in private practice, said during an interview."
I worry about my declining investments as I approach retirement as much
as my patients worry about their own finances. That's given rise for me to
need to pay particular attention to my own countertransference feelings when
this topic comes up in the office."
"We have had a number of psychiatrists [leave the state], so it has
significantly elevated my workload," Michael Engel, D.O., a psychiatrist
in private practice in Traverse City, Mich., lamented. Also, "when
patients fear that they are going to experience foreclosure or bankruptcy,
that makes my life as a psychiatrist more stressful because I have more things
to do to help them manage."
"I have been working half time for the state of California and have
been furloughed for 10 percent of it," Robert Burchuk, M.D., of Woodland
Hills, Calif., reported. Burchuk is also president-elect of the Southern
California Psychiatric Society.
"We are on an inner-city urban campus, so we see a fair number of
patients who don't have insurance or who have Medicaid," Daniel Dahl,
M.D., an associate professor of psychiatry and psychiatry residency training
director at the University of Alabama, said. "What would impact us would
be substantial cuts in Medicaid. They would drastically affect the financial
resources of our department. We hope we don't see those cuts, but there is
"Our state legislature has just made massive cuts in mental health
funding," Howard Weeks, M.D., medical director of youth services at the
University of Utah Neuropsychiatric Institute, commented. "That is going
to have a very severe impact over the next year or two ... for our outpatient
services ... as well as for reimbursement for providers." ▪