良い精神科医の見分け方、デジタル空間での振る舞いも含めて　#早稲田メンタルクリニック #精神科医 #益田裕介 / How to Identify a Good Psychiatrist

00:50 Treatment Structure 03:51 Preparation 05:59 Medical Treatment 06:56 Non-Clinical Activities 07:30 Establishing a Digital Presence 08:52 What About Digital Spaces? 15:10 Treatment System Today's topic is "How to Identify a Good Psychiatrist." During a recent YouTube Live, someone asked, "What kind of doctor is a good psychiatrist?" I didn't feel like I answered that question well during the live stream, so I'll re-record it on video. The question is, what should you look for? I'll talk about what you should look for in a psychiatrist to determine whether they're a good psychiatrist or not, and whether they're competent or not. ■Treatment Structure First, I think it's a good idea to look at the treatment structure and system. The things you should look at will differ depending on whether the hospital is a general hospital, a psychiatric hospital, or a clinic. University hospitals and general hospitals often treat seriously ill patients. Many patients have physical complications, such as being extremely thin due to an eating disorder, depression with cancer, or steroid-induced psychosis. Psychiatric hospitals have inpatient facilities, so they mainly treat so-called regular depression, bipolar disorder, and schizophrenia. Outpatient care also focuses on preventing relapses for hospitalized patients and providing follow-up care after discharge. Clinics are local doctor's offices, so they can treat anything, but they often see patients with milder conditions. They often see cases that do not require hospitalization. The level of each hospital's facilities determines the patients they can treat and the ability to treat them. Large hospitals are often able to treat them. I run my own practice, so my ability to treat patients is sometimes weaker. It also varies by region. If there is no hospital in an area, the burden on each doctor is heavy, and Tokyo has a lot of hospitals, so I feel like I'm allowed to be selfish in that regard, or rather, I'm allowed to provide medical care at a comfortable pace. You might think that this doctor just prescribes medicine and sees more and more patients because he likes to make money, but it really depends on the region. Each hospital has different responsibilities and roles to fulfill, so just because a certain hospital sees a lot of patients in a short amount of time doesn't necessarily mean that the doctor is bad. There are various reasons for this. Just because a doctor doesn't listen doesn't mean that they're a bad doctor. About five minutes plus a little extra is the norm. Listening for longer than that is quite difficult in reality, and I think that often results in some kind of negative impact. ■ The doctor's own self-understanding Another important factor is whether the doctor is well prepared. Self-understanding, or whether the doctor himself understands himself properly. If a doctor doesn't understand himself, his strengths and weaknesses, it can have a negative impact on patients. For example, if a doctor was severely scolded by his parents as a child, he might unconsciously adopt a critical attitude toward those strict parents. If the patient is a parent, they might start lecturing you, saying you're too strict with your child, or you might feel overly sorry for your child, thinking that their father is being too harsh, or that it's normal for them to repeat a grade and that it's their parents' fault for getting so angry. It's said that deepening self-understanding is important to avoid such things. This kind of venting of feelings is sometimes called "countertransference," although it's a bit different. ■Qualifications There are specialists, so it's important to ask whether they have obtained a specialist qualification. Are they a designated mental health physician? These are also important points. If possible, having a PhD in medicine also shows that you have put in solid research and training. I don't have a PhD, by the way. I wasn't able to go to graduate school at the right time, so I couldn't get one, but that was partly due to my time in the Self-Defense Forces. If you're working within the medical department, it's common for them to have one. While there's nothing particularly wrong with not having a PhD, I think it's better to have a specialist and designated physician degree if you're going to call yourself a psychiatrist. ■Treatment Other important points to consider are whether you can make a proper diagnosis, administer appropriate medication, and administer psychotherapy appropriately. I think the key to assessing a doctor's skill lies in their management skills, such as whether they can properly manage (interdisciplinary collaboration), whether they can quickly explain the need for transfers if they feel they can't treat a patient at their own hospital, whether they can coordinate with welfare services, whether they can explain things like applying for welfare benefits, and whether they can explain disability pe...