I find it hard to believe in a normal healthcare setting the psychatrist is providing the majority of therapy. However, in a private practice setting, surely.

Ah, yeah. I stand corrected. I never really went "through the system", so to speak. My pdoc is actually a researcher, nominally (don't think he's lectured for the past 5 years) an university professor, and sees patients only on mondays.

Regardless, I'm not sure which area you're talking about, but I'm guessing it's rural and the availability of practictioners is low (or the demand for them is also low).

Neither. It's a large city in south america; the contiguous urban area, including juridically separate cities that physically mesh must have about 7-8M people. (Wild guess. It reached 5 when I was a kid.)

You'll remember the majority of work done with a psychiatrist is for more severe mental illnesses

I'd say this talk of "more severe" mental illnesses is slippery in a private practice setting. In a hospital there are cost/benefit analyses that need some standard to go by, but the fact that such standard exists doesn't mean it really applies to the real world -- it's more a reflection of the limitations of the system. (And it's ok that it's limited.)

As far as privately-managed patients go, well, there are cases that require institutionalization or brief but recurrent hospitalizations, but it isn't clear from dx only that a manic-depressive isn't going to require hospitalizations and an institutional nexus in a "healthcare setting", or that a schizophrenic will not just swallow them Risperdals and keep the scary name a secret. Hell, my old pdoc already had a shared practice in another medical specialty when he got depressed enough that he developed psychotic symptoms -- trees talking to him and whatnot -- all while not developing the kind of thought disorders I find common, never having had psychosis. My current pdoc's was actually the old pdoc's pdoc and subsequently mentor. The old pdoc actually had a zesty kind of unipolar depression.

Most of the "low-level" diagnoses are handled by social workers

I'm think your "low-level" diagnoses are what my old pdoc closed shop to work with. Crack addicts, people who keep going back to the streets, old cat ladies, etc. Turns out, these can be medically interesting. Weaning people off hard drugs can be a fascinating pharmacological puzzle; old cat ladies often have animal-born parasites; street dwellers sometimes suffer from dissociative fugues.

Of course, dude's going for the ideals, not the money -- he's arrived to the conclusion that social workers are just trying to reeducate people who have stranger problems.

Full-disclosure: manic-depressive on lithium. On some level I'm harder to manage than your schizophrenic on Seroquel because I have to take blood panels six times a year to check levels and watch my thyroid. Mirror mirror on the wall, who's the most "severe" of all?