What Is a Psychiatrist? Understanding This Critical Health Care Role


11.11.2021

Mental health is an increasingly salient touchstone of medicine, making the role of a psychiatrist all the more critical to helping those who need it. But exactly what is a psychiatrist, and how do they help individuals cope with and overcome mental illness? What role do they play in the healthcare system and what difference can they make for those needing treatment?

We spoke with two practicing psychiatrists to learn more about the incredibly important roles they play. Keep reading to learn more about their day-to-day duties and the difference they can make in the lives of their patients.

What is a psychiatrist?

First, what is a psychiatrist, exactly?

“A psychiatrist is a physician who completed four years of medical school and four years of residency in psychiatry,” explains psychiatrist Dr. Danielle J. Johnson, Fellow of the American Psychiatric Association. “Psychiatrists diagnose, treat, and prevent mental, emotional, and behavioral disorders with the use of medication, neuromodulation, and psychotherapy.”

The main difference between the two is that psychiatrists are medical doctors, while psychologists are not. While both professionals typically practice psychotherapy, only psychiatrists can diagnose conditions and prescribe medications.

Conditions commonly treated by psychiatrists:

Insomnia
Anxiety
Depression
Post-traumatic stress disorder
Bipolar disorder
Dissociative disorders
Schizophrenia
Addiction and substance abuse disorders

Common psychiatrist duties:

Evaluating and diagnosing patients
Prescribing medications
Conducting other forms of treatment, such as psychotherapy or electroconvulsive therapy
Ongoing patient care and evaluation
Medication management

Note that psychiatrists differ from psychologists—it’s a commonly confused area of the field. Both of these professionals work in mental health, but their roles differ significantly. The main difference between the two is that psychiatrists are medical doctors, while psychologists are not. While both professionals typically practice psychotherapy, only psychiatrists can diagnose conditions and prescribe medications.

A day in the life of a psychiatrist

Now that you know a bit about what psychiatrists do, let’s take a look at what their days look like.

“There is no such thing as a typical day,” Dr. Metzger says. “As you can imagine, our days can be quite unpredictable. It obviously varies depending on the level of severity of the patients.”

For example, she explains that a hospital psychiatrist may be more likely to see acute symptoms more frequently than a psychiatrist in private practice.

"As you can imagine, our days can be quite unpredictable."

Dr. Johnson, who works at a private psychiatric hospital, provides both inpatient and outpatient care.

“In the mornings, I provide inpatient care—usually for patients who are suicidal, have attempted suicide, or are severely depressed, manic, or psychotic,” Dr. Johnson explains. “I have rounds with the treatment team to discuss patient care and then see each patient to assess current symptoms, treatment progress, medication effectiveness, or side effects and safety,” she adds.

Because the hospital is affiliated with an academic medical center, part of Dr. Johnson’s days center on teaching. Residents and medical students accompany her in her patient visits as part of their training.

“In the afternoons, I see outpatients for medication management and psychotherapy,” she explains. “Often, patients will see a psychiatrist for medication management and a psychologist or other therapist for psychotherapy, but some psychiatrists do both. The majority of my patients are seen for medication management and the majority have mood disorders.”

Like many doctors, psychiatrists can work in hospitals or clinics. They can work for large healthcare facilities or smaller ones. About half of all psychiatrists in the US  maintain private practice.

The immeasurable rewards of working in psychiatry

In a field as vast and varied as medicine, there are many medical specializations to choose from during medical school. So why should one pursue a career in psychiatry? For starters, the satisfaction of helping patients achieve a higher quality of life is a very rewarding aspect of this field.

“In psychiatry, there are not always tangible outcomes like there are in other specialties, but the intangible outcomes are beautiful,” Dr. Johnson says.

"In psychiatry, there are not always tangible outcomes like there are in other specialties, but the intangible outcomes are beautiful."

“In psychiatry, there are not always tangible outcomes like there are in other specialties, but the intangible outcomes are beautiful,” Dr. Johnson says.

“A person with anxiety is now able to give a speech in a room full of people. A person with depression is no longer missing days at work and received a promotion. A person with mania returned to college. A person with an addiction stays sober. A person with psychosis gets their own apartment. A person who attempted suicide found a reason to live,” Dr. Johnson shares.

Outcomes in psychiatry may not be as black-and-white as in other specialties. For example, a cardiologist may see success in the form of a patient’s blood pressure rates returning to normal levels. But in psychiatry, success reveals itself in a range of immeasurable results.

“I am grateful to be part of someone's journey to mental wellness,” Dr. Metzger states. “As a psychiatrist, you have a tremendous impact as you treat these symptoms where the person not only feels better but you also see improvement in their relationships, career, and other ventures in life. It is a gift to see them get their joy back.”

“I am grateful to be part of someone’s journey to mental wellness.”

Beyond the satisfaction of helping patients overcome their own personal challenges, psychiatry also offers many specialties for doctors to pursue throughout a career.

“I would absolutely recommend a career in psychiatry,” Dr. Metzger says. “It is a career that offers a variety of opportunities, including specialties in forensics, child psychiatry, and substance abuse—just to name a few.”

How do you become a psychiatrist?

Like other medical doctors, psychiatrists must attend medical school to  obtain their medical degree. They must also complete a four-year psychiatric residency in addition to more training in their area of specialty. Finally, they must become licensed in their state and board-certified.

“Psychiatry is a varied field with opportunities to work in multiple types of treatment settings,” Dr. Johnson adds. Psychiatrists may work in a hospital with inpatients or doing consultations. They may work in psychiatric hospitals, jails or prisons, substance use programs, and outpatient facilities such as a private practice. They may also find a career in psychiatric research.

“We see patients as referrals, or patients can directly schedule an appointment without one,” Dr. Metzger explains. “Psychiatrists work in many different settings and with many different professionals. They can work with psychologists, nurses, and licensed social workers.” She goes on to explain that you may see partnerships where a psychiatrist prescribes the medications for a patient and a psychologist conducts the therapy.

Could you change lives as a psychiatrist?

Psychiatrists are the doctors helping patients overcome debilitating mental illness. They’re the ones removing barriers and helping people find a greater quality of life. They’re the ones deconstructing the stigma of mental illness and serving one of the greatest health needs in the US.

And right now, they’re needed more than ever. Alarmingly, the US is facing a psychiatrist shortage in the coming years. According to the US Department of Health and Human Services, the current workforce of about 45,580 psychiatrists must increase by 2,800, or about 6.4 percent, to meet the demand. By 2025, that shortage could be as high as 6,090 psychiatrists, or 12 percent.

If you feel called to help meet this growing demand, it’s time to start mapping out your next steps. In order to gain acceptance into medical school, it’s best to start planning sooner rather than later.

To get started, check out our resource: “Application to Enrollment: The Pre-Med Student’s Comprehensive Guide

This article has been updated in 2021

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