Wednesday, March 07, 2007

Problem Gambler

Dear Abby has been writing about health issues a lot recently, on March 1st she wrote about obstructive sleep apnea.

Today there is a question about gambling:

How do you tell the difference between someone with a gambling problem and someone who is trying to become a poker champion?
The person is my husband, and I'd like to support his dream of being a champion. I have never been around gamblers, and I am not sure where the line is drawn. -

Dear Abbby responds:

Many men and women enjoy gambling as a form of entertainment, and some can (and do) make a living at it. However, for some people gambling can become an addiction. These compulsive gamblers are unable to overcome the impulse to keep on trying, lose more money than they can afford to spend, and sacrifice their lifestyle and their family's future as their futile attempts drive them deeper and deeper into debt. These people need professional help and/or a 12-step program to overcome their addiction.

Since I am winning small amounts of money playing online poker, I guess I am on my way to becoming a poker champion rather than becoming a problem gambler.

Saturday, March 03, 2007

I think I am overdressing at work

our dress should be best for our patients but also serve our own needs, ideally be pleasing to colleagues, and not break any organizational dress codes. Our own narcissistic or exhibitionistic—or perhaps even to some degree comfort—needs should not take precedence.

There seems to be many psychiatrists dressing inappropriately:

Many years later, and not too long ago, I was supervising a woman psychiatrist and noticed a tongue ring as she was describing a patient. When I asked her whether patients noticed the ring (which she had had for months), she said they hardly ever commented. When I brought this subject up to the residency committee, there was no consensus on appropriate dress for residents.

There is limited literature about this subject:

there was only one recent study of psychiatrists conducted at a university hospital outpatient clinic serving mainly poorer patients; the study was entitled “How Should Psychiatrists Dress?—A Survey” (Community Ment. Health J. 2006;42:291–302).
The study found that both patients and psychiatrists generally felt that professional dress was an important part of the doctor-patient relationship. For male psychiatrists, the majority recommended “casual pants and casual shirt,” with tie and dress shirt preferred by only 10%. Because I work half of my time in such a clinical setting, should I not wear the tie I put on each day?

Maybe I should take off my tie when I go to the state psychiatric hospital and put it back on when I arrive at my sleep clinic.