Why "Consultations?"

And why all of the requirements?  Why not just take some new patients like other doctors? 

The short answer is:  primary care doctors in this area are pretty desperate for some help with people whose mental health symptoms seem beyond their training.  Few psychiatrists in this area are "taking new patients", and those who are can have waiting lists of 4-6 months. As you can imagine, the primary care doc's feel very stuck.  Offering the option of at least a consultation -- a diagnostic opinion and some recommendations for treatment, within a week or so rather than a month or more -- has been very welcomed. 

The longer answer (danger! hit your Back button now!) involves the number of patients a psychiatrist actually sees.  It's not a large number.  If patients are seen for 50 minutes, as many psychiatrists prefer for psychotherapy, then about 8 patients a day is quite a lot.  If those patients are seen frequently, then 100 patients or so can easily "fill" a psychiatry practice. 

At that point the rate of "new patients" being seen ends up being determined by the rate at which people get better enough to leave treatment (or cut back to less frequent visits).  After a while this can get pretty slow.  Then the whole system is jammed up, you see? When a new psychiatrist moves here, things improve -- for a while.  Then her or his practice fills up and slows down.  Depending on her style of practice, she might only have taken 100 patients or so from the "pool" of patients wanting to be seen. 

Over the years this area has accumulated a fairly large "pool".  Our public mental health system has been cut back so many times, they're not able to lower the pool much either. 

The result is that primary care doctors have steadily become the main source of mental health care in this area.  Even nationally, more than half of mental health services are provided by primary care doctors.  They really want some help with this.  I enjoy working with them and would like to support their efforts, to make their job a little easier where possible. 

So, when you do all that work in advance, writing down the "history" I need, this keeps the system moving and allows more people to be seen.  Thank you for helping with this process.