If you asked Americans what psychiatrists do all week, many would probably tell you that they sit next to patients reclining on couches and try, à la Sigmund Freud, to figure out what makes those patients tick or not tick. Well, as any American psychiatrist will tell you, that’s not exactly how it goes.

But what are America’s psychiatrists up to these days? Some of the answers might surprise psychiatrists themselves. They come from the preliminary results of the 1998 National Survey of Psychiatric Practice (NSPP), which was conducted by APA’s American Psychiatric Institute for Research and Education. Among the findings:

• Psychiatrists work, on average, 48 hours a week and spend the bulk of their time in direct patient care. The majority spend most of their patient care time in a private office practice. One-fifth spend most of theirs in an outpatient clinic/HMO type of setting.

• For the most part, psychiatric patients are seen once a week. The patients are, more often than not, 15 to 64 years old, suffering from a mood disorder and receiving psychotherapy and prescribed medications from the psychiatrist.

• However, patient care is not the only activity that psychiatrists do. In fact, they are involved in a variety of other activities, including administration (both patient-related and non-patient-related) 23 percent of their time; consultation (patient-related but not involving direct patient care) 7 percent of their time; and research 4 percent of their time.

Preliminary results obtained from the 1998 survey were also compared with results from APA’s 1988-89 Professional Activities Survey, revealing some interesting changes in psychiatrists’ professional activities during the past decade.

For instance, while psychiatrists do not seem to be working any more hours a week today than they did a decade ago, they appear to be working less in hospitals and more in outpatient clinics, including HMOs, than was formerly the case. Psychiatrists also seem to be seeing a slightly greater number of patients today than a decade ago—39 a week versus 35 a week—but are spending less time with those patients than they used to—42 minutes versus 55 minutes. Further, there appears to have been an increase during the past 10 years in the number of patients diagnosed with a mood disorder.

The 1998 NSPP was sent to a random sample of 1,500 active APA-member psychiatrists. A total of 1,076 responses were received resulting in a response rate of 72 percent. Of the respondents, 42.8 percent were 55 years of age or older, 20.8 percent were 39 years of age or younger, and 28.1 percent were female.

The preliminary survey findings have been presented at several medical meetings, and results of further survey analyses will undoubtedly be submitted to peer-reviewed journals, Ana Suarez, M.P.H., a research associate with the NSPP, told Psychiatric News.