while i think psychiatry is entertaining at times, i also find it emotionally draining. i really take my hats off to ppl who pull through- like the cool you! but u forgot a Con- the risk of violence from your patients. i remember almost being on the verge of pressing the emergency alert bell numerous times when i was doing my psych rotation.
http://doctorpsychobabble.com Dr. Psychobabble
this is true. it can be incredibly emotionally draining. and yeah, the risk of violence is definitely another con. however, there are ways to protect yourself. but the chance of being attacked by a patient sometime during your career is actually fairly high.
Jun
while i think psychiatry is entertaining at times, i also find it emotionally draining. i really take my hats off to ppl who pull through- like the cool you! but u forgot a Con- the risk of violence from your patients. i remember almost being on the verge of pressing the emergency alert bell numerous times when i was doing my psych rotation.
http://doctorpsychobabble.com Dr. Psychobabble
this is true. it can be incredibly emotionally draining. and yeah, the risk of violence is definitely another con. however, there are ways to protect yourself. but the chance of being attacked by a patient sometime during your career is actually fairly high.
http://thuchuynh.com thuc
yea, it’s a concern of mine that psychotherapy is becoming less prominent. i’ve been referring patients to psychiatrists for treatment plans and psychologists for psychotherapy hoping that my patients will benefit the most that way. some have given good feedback regarding therapists too.
http://doctorpsychobabble.com Dr. Psychobabble
the good news is that although it’s become less popular, there are still plenty of psychiatrists doing psychotherapy. i’m hoping to be able to find a creative way to continue implementing it in whichever career path i end up choosing…
http://thuchuynh.com thuc
i look forward to hearing your stories as you continue to grow professionally !
http://doctorpsychobabble.com Dr. Psychobabble
ditto to you. and i hope to keep writing!
Empowermenthouse
I find the discussion of fragmentation of care and patient-stealing quite humorous, if not saddish. Since when has it been a problem to respect and incorporate the opinion of “another set of eyes” to address a problem, if it benefits a patient? The solution is quite simple…. cooperation and effective communication…. and that, of course, includes the responsible, straightforward and validated opinion of the patient. An informed wellness-team is the most effective in treating any issue. But that’s simply my opinion….
http://thuchuynh.com thuc
yea, it’s a concern of mine that psychotherapy is becoming less prominent. i’ve been referring patients to psychiatrists for treatment plans and psychologists for psychotherapy hoping that my patients will benefit the most that way. some have given good feedback regarding therapists too.
http://doctorpsychobabble.com Dr. Psychobabble
the good news is that although it’s become less popular, there are still plenty of psychiatrists doing psychotherapy. i’m hoping to be able to find a creative way to continue implementing it in whichever career path i end up choosing…
http://thuchuynh.com thuc
i look forward to hearing your stories as you continue to grow professionally !
http://doctorpsychobabble.com Dr. Psychobabble
ditto to you. and i hope to keep writing!
Empowermenthouse
I find the discussion of fragmentation of care and patient-stealing quite humorous, if not saddish. Since when has it been a problem to respect and incorporate the opinion of “another set of eyes” to address a problem, if it benefits a patient? The solution is quite simple…. cooperation and effective communication…. and that, of course, includes the responsible, straightforward and validated opinion of the patient. An informed wellness-team is the most effective in treating any issue. But that’s simply my opinion….
http://www.facebook.com/rob.lindeman1 Rob Lindeman
Kendra, isn’t a little bit early to pass judgment on your decision, seeing how you’re still in residency? Why don’t you do it for a few years before concluding you made the right choice?
You’re quite right that psychopharm is all there is to psychiatry these days, unless you want to do talk therapy. But then, of course, you don’t need to be a doctor to do that.
So the State’s granting your permission to prescribe medications is all that separates you from non-MD talk-therapists: will you then embrace biological psychiatry and go along for the ride?
FWIW, I pray that the tide of biological psychiatry has peaked and will begin to ebb. There’s been a considerable amount of push-back, now that the emperor has been shown to be butt-naked, as it were.
http://doctorpsychobabble.com Dr. Psychobabble
I don’t think it’s too early. I have a good idea of what psychiatry entails. But yes, we’ll see how my opinion changes in the upcoming years.
The ability to prescribe is not the only thing which separates psychiatrists from psychologists. Another big difference is that since psychiatrists are medical doctors, we are much more able to recognize when medical problems present as psychiatric ones. (Hypothyroidism presenting as depression, etc.) And we are equipped to address these issues. There are other differences, as well, and I think this is why I’m ultimately glad that I chose psychiatry….
http://www.facebook.com/rob.lindeman1 Rob Lindeman
You don’t plan to diagnose and manage medical disease in your practice, do you? As a pediatrician, I would not tolerate that kind of fragmentation of care from docs I refer kids to. It even borders on “patient-stealing”!
For the love of God, leave medical disease to the medical docs, k?
http://doctorpsychobabble.com Dr. Psychobabble
Yes, I absolutely do! Especially if I end up specializing consultation liaison psychiatry, where it’s quite common. I’m sorry if that offends you but I am a medical doctor as well!
http://www.facebook.com/rob.lindeman1 Rob Lindeman
Fragmentation of care is one of the worst problems that our clients face. It doesn’t offend me that you’re a medical doctor. It offends me that you plan to fragment people’s care. It’s a mistake and I hope you won’t do it.
http://doctorpsychobabble.com Dr. Psychobabble
I absolutely agree that fragmentation of care is a big problem. However, that is not what I was implying at all.
Examples:- If a primary medical team calls me for a psychiatry consult because the patient is “acting strangely,” it makes me a good psychiatrist if I can recognize that the patient does not have a primary psychiatric condition, but is actually delirious and needs emergency medical treatment.- If I am seeing a patient in a clinic for the first time with the complaint of new-onset depression, it makes me a good psychiatrist if I check their thyroid function and other pertinent labs.- If I’m treating a patient on the psychiatric inpatient unit, I should be very aware of their medical problems and current treatment (might the patient have lupus related psychosis? or are they on a medication which might have a drug-drug interaction with their psych meds? etc.)
http://www.facebook.com/rob.lindeman1 Rob Lindeman
And once you ascertain that the individual does not have a mental illness, you hand the case back to the internist, right?
http://doctorpsychobabble.com Dr. Psychobabble
Yes, absolutely! And I do it especially quickly if it’s an emergency situation.
http://www.facebook.com/rob.lindeman1 Rob Lindeman
Kendra, isn’t a little bit early to pass judgment on your decision, seeing how you’re still in residency? Why don’t you do it for a few years before concluding you made the right choice?
You’re quite right that psychopharm is all there is to psychiatry these days, unless you want to do talk therapy. But then, of course, you don’t need to be a doctor to do that.
So the State’s granting your permission to prescribe medications is all that separates you from non-MD talk-therapists: will you then embrace biological psychiatry and go along for the ride?
FWIW, I pray that the tide of biological psychiatry has peaked and will begin to ebb. There’s been a considerable amount of push-back, now that the emperor has been shown to be butt-naked, as it were.
http://doctorpsychobabble.com Dr. Psychobabble
I don’t think it’s too early. I have a good idea of what psychiatry entails. But yes, we’ll see how my opinion changes in the upcoming years.
The ability to prescribe is not the only thing which separates psychiatrists from psychologists. Another big difference is that since psychiatrists are medical doctors, we are much more able to recognize when medical problems present as psychiatric ones. (Hypothyroidism presenting as depression, etc.) And we are equipped to address these issues. There are other differences, as well, and I think this is why I’m ultimately glad that I chose psychiatry….
http://www.facebook.com/rob.lindeman1 Rob Lindeman
You don’t plan to diagnose and manage medical disease in your practice, do you? As a pediatrician, I would not tolerate that kind of fragmentation of care from docs I refer kids to. It even borders on “patient-stealing”!
For the love of God, leave medical disease to the medical docs, k?
http://doctorpsychobabble.com Dr. Psychobabble
Yes, I absolutely do! Especially if I end up specializing consultation liaison psychiatry, where it’s quite common. I’m sorry if that offends you but I am a medical doctor as well!
http://www.facebook.com/rob.lindeman1 Rob Lindeman
Fragmentation of care is one of the worst problems that our clients face. It doesn’t offend me that you’re a medical doctor. It offends me that you plan to fragment people’s care. It’s a mistake and I hope you won’t do it.
http://doctorpsychobabble.com Dr. Psychobabble
I absolutely agree that fragmentation of care is a big problem. However, that is not what I was implying at all.
Examples:- If a primary medical team calls me for a psychiatry consult because the patient is “acting strangely,” it makes me a good psychiatrist if I can recognize that the patient does not have a primary psychiatric condition, but is actually delirious and needs emergency medical treatment.- If I am seeing a patient in a clinic for the first time with the complaint of new-onset depression, it makes me a good psychiatrist if I check their thyroid function and other pertinent labs.- If I’m treating a patient on the psychiatric inpatient unit, I should be very aware of their medical problems and current treatment (might the patient have lupus related psychosis? or are they on a medication which might have a drug-drug interaction with their psych meds? etc.)
http://www.facebook.com/rob.lindeman1 Rob Lindeman
And once you ascertain that the individual does not have a mental illness, you hand the case back to the internist, right?
http://doctorpsychobabble.com Dr. Psychobabble
Yes, absolutely! And I do it especially quickly if it’s an emergency situation.
Please check out my latest post on “The Ink Blot” at Medscape/WebMD to read my answer to this question.