I have become so frustrated lately because it seems like many of my patients are not being appropriately diagnosed or treated.
I know I'm not a psychiatrist and of course do not have the ability to diagnose, but when I have long-term patients (100+ days) and repeated frequent fliers in an "acute care" treatment facility, I can't help but begin to think these patients are being played for monetary purposes and insurance billing.
I work on an ECT floor, and I always thought that ECT was typically left as the last resort measure for treatment, but I see people being admitted for their first psych breakdown, and the doctors are often in a huge a rush to get them to agree to ECT without even attempting medication stabilization and therapy.
I see patients getting ECT that suffer from dementia/Alzheimers/are 85+ years old, and I am told they get ECT only to control their level of violence/agitation.
I see people who clearly are borderline or another personality II disorder and they too are getting ECT with NO IMPROVEMENT after weeks and weeks of treatment because they aren't getting the in-depth behavior therapies that are so needed.
I see patients who clearly do NOT have mental capacity and the ECT staff rushes in and gets consent to treat and off those people go to get zap zapped and I can't help but think that they have no idea what they just consented to do.
How on earth do I not go crazy myself?
I literally cry when I get home out of the frustrations of feeling like I can't do anything and these people keep returning time and time again - wanting (and getting) their narcotics, their benzos, their sense of entitlement and demands being met - all because they've got insurance and can pay.
(Okay - thanks for letting me vent - please, any suggestions would be greatly appreciated)