Skypiatry, Emergencies and Offices

Yet another patient contact via Skype reveals new questions and possibilities. So far I have not even mentioned the option to all of my patients, since there are some with whom I only want to visit the office. On the other hand a few patients have made it clear for a variety of reasons that they do not want to use Skype. Couple that with what has become a major pre-Skype hassle: getting a signed copy of the agreement under which I conduct these contacts. This convinces me that, rather than only asking select patients to sign the agreement, I plan to ask all to sign it next time they visit the office, so we will have that out of the way just in case we decide to use Skype on the spur of the moment.

Over at Shrinkrap a rich debate over what constitutes a psychiatric emergency raged last week. Of course I remain clear that emergencies demand 911 and emergency rooms, but occasionally psychiatrists and patients will want to get together sooner than they might have planned in non-emergent situations. My office lease ends in November. Even pre-Skype I try to avoid going to the office when I can, preferring to work on BehaveNet and forensic projects from home. With the advent of teleconferenced patient contacts I will need the office even less. So I started thinking maybe I can do with a part-time space. But this means I will have less flexibility for face-to-face visits in an office even though there will be more flexibility for Skype contacts. Suppose I only have the office Mondays and Tuesdays, it's Tuesday evening, and I want to schedule a patient ASAP. We will have to wait five days, unless we make do with Skype. This points to some kind of shared office space where practitioners can schedule 15 minute slots any day as most cost effective. I started getting the word out to colleagues. No idea where this will lead, but I'm thinking the schedule should be online and accessible from a smart phone.