Marnin E. Fischbach, M.D. is looking for some understanding:

It is not easy being a psychiatrist in this day and age. I know from personal experience. I am one.

The stigmatization of individuals with mental disorders, while lessened in recent decades, nonetheless persists, and it attaches in the public mind to psychiatric physicians as well. The relative absence of high-tech diagnostic and treatment procedures in our field, in an era of gee-whiz medicine, also contributes to a less-than-positive attitude toward our profession.

Finally, media presentations of psychiatrists as somewhat disturbed themselves, or carrying on inappropriate sexual relations with their patients or family members of patients, or sadistically subjecting patients to cruel electroconvulsive therapy (quite inaccurate in this day and age), both reflect and reinforce popular biases toward psychiatrists and contributes to an economic disparity with other specialist physicians.


Dr. Fischbach makes the point that psychiatrists (and other mental health professionals) deal with patients and families whose symptoms and family dynamics often frighten the public and even non-psychiatric medical professionals.  This requires a lot less talking and doing than other doctors, and a lot more listening which, believe it or not, takes a great deal of skill. Fischbach also says that psychiatrists are expected to factor in and even manage their patients’ complicated medical histories and needs more than ever.  And in the final analysis, psychiatrists make cures that others don’t see:

Finally, contrary to popular thinking, our patients’ symptoms frequently improve, and often quickly. Many outpatient problems resolve within weeks, sometimes several months. Often this involves use of psychiatric medications alone or in combination with some form of psychotherapy performed by an accredited psychologist, psychiatric nurse or psychiatric social worker. These improvements are not as readily visible as are medical recoveries because, given the unfortunate social stigma, even greatly improved patients may be reluctant to openly discuss their psychiatric and psychological care.

I have much faith in our psychiatric profession and great respect for its practitioners. The medical world and the public need to be cautious about their stereotypes and biases, often misbegotten, and recognize the essential importance of the psychiatrist’s role. If they do, this would encourage more medical professionals to become psychiatrists, which would ameliorate the shortage while improving the availability and quality of care offered to patients.

And, yes, it would help if psychiatrists were more generously compensated as well.


There is no doubt a shortage of understanding of mental health disorders from the public and medical community alike, as well as a shortage of access to mental health care in the United States. Improving services and access will benefit all of us, whether we’re talking about basic medical needs or mental health care.  It’s something we should all get behind.