From Fellowship to Independent Practice: An Early Career Psychiatrist’s Experience with Telepsychiatry

Finishing your Fellowship is one of those career moments that’s equal parts exciting and daunting.

After many years of training, supervision and rotations, you’re suddenly expected to step up as a consultant psychiatrist and with that comes a whole new set of questions:

- Where do I practise?

- How do I handle billing, admin and referral networks?

- Do I stay in the public system or try private practice?

- And if I go private, how do I do it without feeling completely on my own?

These are the kinds of questions that Dr Liam Hackett, an early career psychiatrist at Dokotela, found himself grappling with.

His experience offers a refreshingly honest perspective on what that transition can look like and how a supported entry into telepsychiatry helped him build confidence, autonomy and a career he loves.

The Leap Nobody Quite Prepares You For

For many newly fellowed psychiatrists, the jump from registrar to consultant can feel abrupt.

You’ve spent years developing your clinical skills, but the practical realities of running a practice, like billing systems, appointment workflows and understanding legal frameworks, aren’t always things that training covers in depth.

Dr Hackett is honest about this.

“One of my greatest fears starting out was that you’re almost immediately asked to step up from being a registrar to being a consultant psychiatrist,” he says.

“And in that, you have to navigate billing, communicating with public networks, communicating with peers, sending letters, having templates, frameworks and understanding all of the legal systems.”

It’s a reality that many early career psychiatrists will recognise.

The clinical knowledge is there, but the infrastructure around it can feel overwhelming when you’re trying to sort it all out alone.

Not Having to Figure It All Out Alone

This is where Dr Hackett’s experience at Dokotela shifted things for him.

Rather than facing the steep learning curve of private practice in isolation, he found a platform that had already built the systems and support structures he’d assumed he would need to piece together himself.

“Dokotela makes billing transparent. It makes communicating with public networks transparent. It also makes managing appointments, following up with appointments and general practitioners really transparent,” he explains.

“And it gives me all of the tools that I thought I would have to sort out on my own, things like software, the ability to reach out for support from more senior colleagues, all things that I thought I’d have to find through trial and error.”

For early career psychiatrists weighing up their options, this is an important consideration.

Choosing a practice environment with built-in systems, peer review and clinical support can really reduce the stress and risk that comes with entering private practice for the first time.

Broader Than You Might Think

One assumption Dr Hackett had before joining Dokotela was that telepsychiatry would narrow the range of patients he could help.

In his words, he assumed it would “close doors” and limit him to a narrower group of people.

“The opposite is true,” he says.

“Now that I’m working in the space, I see people from all over Australia, people with a variety of different struggles and from different walks of life, and I’m able to help them in a way that’s far more accessible than I ever thought.”

Telepsychiatry doesn’t just offer convenience for the clinician, it extends the reach of specialist care to communities that have historically struggled to access it.

For an early career psychiatrist, that’s an opportunity to do meaningful, varied clinical work from the very start of your career.

A Career That Fits Around Your Life

Sustainability matters, especially early in a career.

Burnout is a real concern across the medical profession and the way you structure your working life from the outset can set the tone for years to come.

Dr Hackett doesn’t shy away from the personal impact that working with Dokotela has had.

“Most of the day involves seeing patients for the time that I dictate and the windows that I think suit me best,” he shares.

“And then at the end of the day, you sign off and you go back to the rest of your life. I think I eat better, I exercise more, I take better care of myself.”

He also notes the small but meaningful advantages of working from home, like being surrounded by your own environment, having the flexibility to access patient records and resources on screen during a session, and even having his miniature dachshund Choriza nearby, which he finds genuinely helps build rapport with younger and neurodiverse patients.

Worth Considering Earlier Than You Think

Perhaps the most telling part of Dr Hackett’s reflection is his one regret: that he didn’t explore telepsychiatry and private practice sooner.

“I didn’t consider telehealth and I didn’t consider private practice until very late in my training and I wish I’d considered it earlier,” he says.

“I have no regrets.”

For registrars approaching Fellowship, or newly fellowed psychiatrists weighing up their next step, keep in mind that you don’t need to wait until you feel completely “ready” to explore private practice.

With the right support, structured systems and a collegial environment around you, it can be a natural progression rather than a daunting leap.

Interested in exploring whether Dokotela could be the right next step for you?

Learn more about working with Dokotela as an early career psychiatrist, or get in touch with our team to start the conversation.

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