On Psychiatry

[docorion]

Some of you have heard my psychiatry rant. In short, it goes like this: Psychiatrists are not doctors, in the "physician" sense. They don't do any of the things I recognize as "being a doctor"; they don't examine patients or their pathologic equivalents (xrays, tissue slides, lab values-doctors do that stuff in some specialities and are still "

Comments

[coorr]

Let me start by saying I tend to agree with you. In my experience I have found psychiatrists to be hard to deal with. The person who was most helpful to me in coping with ADD was a neurologist.

I have seen little evidence that psychiatrists actually apply their medical training in the few ways that one would hope they would. Basic things like checking a patients blood pressure before prescribing a medication that has the side effect (or primary effect) of lowering blood pressure.

But, as you brought up the idea of scans for mental disorders, you might find this article interesting. Its about diagnosing Autisim with an MRI. I suspect you could find a better source for info on it but I did find it very interesting, even if they still cant diagnose ADD with an MRI :-)

[wolfkitn]

Well, I'm a social worker, and I hear you loud and clear. :-) I'm also exhausted so I'm not going to say to what extent I agree, just now... but I'm sure I agree at least a bit

[gardenfey]

Have you ever read "Change Your Mind, Change Your Life"? And if so, what do you think about it? I'd be interested in hearing your opinion.

For a period of about two years in high school, I wanted to be a psychiatrist (and definitely not a psychologist). But, I decided it would be a waste of my math talents. I still find these topics fascinating, though. It seems as I get older, I see more and more cases where behavior starts at the biological level, not the intentional level.

[gardenfey]

Oops, it should be, "Change Your Brain, Change Your Life", by a Dr. Amen.

[randysmith]

To my mind, the existing of the field of psychiatry says that society considers the defining characteristic of a doctor managing drugs, rather than the examination and diagnosis skills that you refer to. I'm not arguing for that point of view (or against it), but I think it is the idea that needs to be confronted and changed to effect the transformation he's suggesting.

[chienne_folle]

I'm a psychologist, and in my experience, most psychiatrists are terrible listeners who are nevertheless puffed up with self-importance. They tend not to be good for clients, and they make all of us look bad.

That said, I do think they have a place, because there are so many physical diseases that can have symptoms that mimic those of mental illnesses. Is it depression or low levels of thyroid hormone? Is it ADD or untreated sleep apnea? Is it depression mixed with anxiety or really bad menopause? I need someone I can send a client to who understands depression but who also has the ability to order tests of T3, T4, and TSH levels and that sort of thing.

[docorion]

Well, I'll say that Carlat addresses those issues, (and mostly dismisses them, properly in my opinion) from the point of view of the psychiatrist

[mzrowan]

psychiatrists are psychologists wearing an MD without good cause or right

Ha, that's funny, my opinion (having done an MA in counselling years ago) was the opposite -- they were MDs wearing the title "psychologist" without good cause or right.

What really chafed my ass was that, in Ontario, any MD from any specialty could up and decide to start offering therapy and get reimbursed for it by the provincial health insurance -- and someone with six years of training in psychology (undergrad and masters) couldn't.

[awfief]

*shrug* for me it's just as well -- I can get an MD to recommend a drug to help a mental problem, and I can work with a psychologist to help with a mental problem. The only thing I need a psychiatrist for is the actual prescription and the 15-minute visit once every 3 months to get the prescription refilled