How many patients can you see in a day?

Ask a counselor and you might hear of one who has seen 10 clients in a day…10 hours of therapy. I suppose I”ve done as many as 12 or 13 but that was a rare case and likely some emergency.

What about seeing 40… in one day!?

That is what some psychiatrists do. Of course, to do that many, most patients are seen only for 15 minute med checks rather than the 90 minute first session for first-time patients. Psychiatrists used to be the primary therapists. But with the advent of psychiatric medicines,  many psychiatrists no longer do therapy and only make diagnoses and prescribe/manage medicines. For an interesting view from the psychiatrist’s chair, check out this NY Times article interacting with a local psychiatrist who has worked through the transition from therapist to med manager.  See how he tries to not get too involved with patient problems given that he hasn’t the time to do much on the fixing end.

There are only two reasons why anyone would see so many clients in one day

1. Economics. More volume, more money. Plain and simple.

2. Demand. Good psychiatrists are hard to come by. Even more true if you are talking about child psychiatry! If you find a good one, chances are you have to get in line.

Now, before anyone thinks I’m taking shots at psychiatrists, let me tell you I am not. A good psychiatrist is a very helpful aid to us psychologists. Family Docs and other general practitioners may be able to prescribe but I find psychiatrists (good ones!) really know their compounds and are much better at titrating doses. And not all of them just throw pills at the problem. Even in short interactions, the psychiatrist to whom I refer has been able to help my clients understand themselves just a bit better.

Back to the original question: just how many different people can you meet with in a day and still be attentive? When I started out counseling, I could barely see two people in a row before being overwhelmed. Now, I regularly see 8-10 on a day (okay, I only do this one day per week, but before becoming a prof I did 25-30 per week). I can attest that it is a learned skill and I don’t think the last client gets less of me than the first. That said, there is a limit and a point at which what I do suffers.

What is your patient/client limit?

For me, it is less about the number of sessions and more about whether I eat and have a moment to go to the bathroom. There’s nothing that kills the focus as much as a bursting bladder and 45 minutes to go!

I’ll leave you with a funny story. At a doctoral practicum I saw clients late into the evening. My last client of the evening (same person each week) had a habit of bringing me Starbucks coffee. I think he was trying to make sure he was going to get his money’s worth out of me!

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Filed under counseling, counseling skills, Psychiatric Medications, Psychology

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