Psychiatrist Spends More Time on Laptop than with Patient

Reader’s Question

I recently went to a new psychiatrist for medication. He walked into the appointment holding a 14 inch laptop. During the time of our session in which I paid the full rate, he asked a question and spent more time tapping and looking at the laptop than engaging in conversation with me. He received a phone call during session, and it was obviously not of an emergency nature. I learned his son’s name, what his son was doing, etc. and how busy his family life was. It took approximately 5 minutes of my session time.

My question is this: Has ethical expectation in this new day of electronics changed in the psychiatric session? Is this normal protocol now? Should I expect this? I’ve had a psychiatrist use a small PDA device that then printed out prescriptions, but her eye contact never left me. I’ve had other psychiatrists have a small pad and jot down notes, while holding eye contact. None of this troubled me. I’ve never had a medical doctor, therapist, or psychiatrist take a private call, during my session. How should I approach this doctor? I would rather keep my location private due to the fact that I’m sure this doctor is a good doctor and may not be aware of how this behavior affects patients.

Our Consulting Clinical Psychologist’s Reply

It looks like you are more socially skilled than your psychiatrist. Even in this age of high-tech electronics, his behavior is rude and insensitive. One aspect of the situation may be your mention of going to him “for medication”. Some psychiatrists see clients for medication while the therapy is provided by another mental health professional. If that’s the case, he may view your case as a “medication only” consultation, feeling the need to establish a therapeutic relationship is minimal.

As you describe, times haven’t changed that much. The clinical expectation of eye contact, privacy (no phone calls), full-attention to the client, and avoiding inappropriate self-disclosure of personal information (his son’s a good baseball player, etc.) holds true today. Professionals often use PDAs, laptops, desktops, dictation equipment, notepads, etc. but they should never be used in a manner that significantly intrudes into the session.

How you approach him depends upon what you need. If you are seeing him for medication only, you can:

1. accept his behavior,
2. verbally request his full attention, or
3. express your dislike for the session interaction and hopefully change his behavior.

If you are seeing him for medication and therapy, you will need to be assertive and require his full attention and minimal multimedia.

You may be correct that he is unaware of how his behavior is perceived by his patients. The demands for documentation are increasing in clinical practice and many professionals try to maximize their use of electronic documentation. Sadly for some, the need for documentation often takes priority in a session and when that happens, the professional has lost the original theme of mental health treatment which is the personal, private, and full-time attention to the concerns of the patient.