As a therapist, I often find that clients are hesitant or skeptical about taking medications for mental health purposes. Some individuals explain that medication in the past has not worked effectively while others share their distrust in psychiatrists or “pill pushers.” So, I sat with Brian Dixon, M.D. recently to see if he could shed some light on his approach and process to psychiatry.
What led you to practice psychiatry? And how did you know it was right for you?
I knew psychiatry was the ideal specialty after I completed a family medicine rotation in medical school and realized how mental health was a key component in treatment compliance. And when I learned that psychiatrists have more time to truly dig deeply, I knew it was the field for me.
What is your style or approach to working with your patients?
I fully believe in meeting patients where they are and helping them towards their best self; this only occurs when patients are ready for change so I establish people’s motivation for change early in the process.
What have you found to be the most difficult to treat?
My “waterloo” in psychiatry is likely eating disorders. I employ lots of behavioral techniques and though most eating disorders have a large behavioral component, the psychodynamics stretch me pretty thin and puts me at risk for compassion fatigue.
What is the biggest misconception about psychiatry that you have come across?
That it’s fast and easy. Like a surgeon doing a Whipple procedure [a 10-hour delicate pancreas surgery] psychiatrists open up a person’s psyche and help them build insight into themselves. It’s a process that’s scary and complex and can’t be done in a session or two. Reminding the public that as physicians, psychiatrists are trained in all aspects of mental healthcare and building a comprehensive treatment plan takes training and patience and helping someone feel better is a process.
When you notice a patient is worried or anxious about the idea of taking medication, how do you move forward?
First and foremost, the first option is always no medication. As one of my training psychiatrists taught me – no one is born with a Ritalin deficiency – meaning that we use medications currently to bridge people to a time when they are feeling better. If people are interested in medications, I then walk them through all options explaining common risks, benefits, and side effects so that they get to choose the option that works best for them and their situation.
I understand you also see adolescents and children. How young is too young?
There’s a field of infant psychiatry so I’d say no one’s too young! My youngest is 3 and since there are very few medications approved for that age, I blend mainly behavior modification into my treatment plans.
And how do you adjust from working with an adult to working with a minor?
Training. The best part of being a psychiatrist is that you go through an intense residency program for 4-5 years. During that time, you learn to juggle complex treatment choices that come at you from all angles. Thus, it’s not tough to adjust when it’s literally built into our training.
What do you recommend to those who are searching for a psychiatrist? What questions should people ask? What should they be looking for? Or steering away from?
The most important and first question is “Are you ready for change?” It’s okay if someone isn’t ready for change but [instead] reaching towards possible medication (which many psychiatrists tend to use as part of a treatment plan.) If you’re ready to ask, the next question is specialty and focus. I remind patients that orthopedic surgeons are surgeons and could remove your gallbladder but you’d likely want a general surgeon to do it. The same goes for psychiatry. There are generalists and subspecialists, and both genres have focuses so be sure to ask if they’re a good fit. Online reviews are notoriously inaccurate so I encourage everyone to steer clear of what reviews they read in regards to the quality of mental health services in Fort Worth; I know many of the providers and they’re quite good.
In your line of work, it can be very demanding and challenging. So, how do you find balance between tending to patients and taking care of your own self-care needs?
The hardest balance, strangely, isn’t practicing psychiatry (this is where my amazing training kicks in.) Honestly, running a small business is the tougher of the two endeavors, and self-care tends to take a back seat when there’s work to be done until the wee hours. I’m blessed to sing in a great chorus in Dallas and have fantastic friends in Fort Worth to keep me sane.
Lastly, I want to say congratulations on your recent recognitions for 40 under 40 by the Fort Worth Business Press AND Top Doc in Psychiatry by Fort Worth Magazine. How awesome! So, what’s next for you? Can you tell us what you plan to accomplish next?
Thanks! It’s quite an honor to be acknowledged for building a successful private practice both business wise and clinically. My goal for 2017 is to tackle healthcare reform. Our current system is broken as it’s based on commercial insurance. I have a novel solution that returns healthcare to the local level and power to the citizens and I’m sharing it far and wide through all public and social media outlets. My goal is to get my idea into the common discourse so that we can change healthcare starting today.
Something that comes across loud and clear when hanging out with Dr. Dixon is his friendly, down-to-earth disposition. After the interview, Dr. Dixon shared with me his desire to make improvements in how mental health is not only treated but also perceived. He is a man interested in helping others, however he understands and respects his limits. He often integrates the expertise of other professionals to enhance his mental health plan for his patients.
Your mental health is essential in your day-to-day living and making the decision to seek a psychiatrist is not always easy. Some people have preconceived notions about meds and doctors that make it difficult to embrace a consultation with a psychiatrist. I hope today's Q&A helps you gain a better understanding of what to expect when seeking help from a psychiatrist. Thank you, Dr. Dixon, for sharing with us what you do and how you do it!
Brian J. Dixon, M.D. is a Board-Certified Adult, Child & Adolescent Psychiatrist with an active private practice in Fort Worth, TX. He believes in treating the whole patient using a unique blend of behavior modification and therapy while minimizing medications. His practice’s goal is to reintegrate mental health into our modern lifestyles. www.progressivepsychiatry.org