This post continues on from my post of 4/28/15 about the practice of psychiatry in the outpatient mental health clinic at the Veterans' Affairs Hospital in Memphis, from which I retired a few months ago. In the last post, I discussed the first of two reasons for my quitting my position about a year earlier than I had planned.
The inpatient doc literally begged my supervisor to accommodate my schedule in order to allow me to see them regularly, and she reluctantly agreed. Of course, if I had been the one to ask for psychotherapy time for a patient I was seeing, it was highly unlikely that such accommodations to my schedule would have been forthcoming.
Inpatient treatment could buy time if the suicide risk were very high, but it usually causes patients with BPD to get worse in the long run, and is therefore best avoided except in extreme circumstances. And one still needs to refer the patient for continuing psychotherapy after discharge. That was the very problem the inpatient doctor had with my two therapy patients!