It is the end of the year, and for me, have to say not enthused there is much room for opportunity to practice psychiatry the way I was trained. Between the standard of care pursued by more than half of patients I interact with just expecting the “cure” for that alleged biochemical imbalance, and what the APA is assaulting the profession with the combination of CPT code changes and the arrival of DSM 5 that is meant solely to justify medication for a bad day, we are doomed as a society until proven otherwise.
Yeah, I hear it over and over again, why so cynical and pessimistic? Well, I have a fair rebuttal: what do other providers have to say and offer for legitimate and long lasting mental health interventions that allow people well rounded opportunities to progress and sustain health and function, while not just coming back in 3-6 months to complain the medications aren’t working, or the diagnosis has changed, or there is a new drug that seems better? Come on, what is psychiatry selling these days? Better living through chemistry until proven otherwise. And, sorry, my non psychiatric colleagues are doing an equal if not more pervasive effort to sell this message, with over 75% of antidepressant prescriptions written by someone else not completing a psychiatric residency.
Well, as of the new year, I am going back to my files I have accumulated and, hopefully mastering the scan process, share some gem handouts/articles that promote mental health stabilization by behavioral, cognitive, and just plain common sense interventions that requires time, energy, patience, and realistic expectation. I would say it would be nice to use these files in my offices and get more patients than not to embrace the philosophies that impact positively on care, but, I can’t tell you how many times I find the handouts left in the office, or just ignored when I ask about what was learned in a follow up visit to just hear “oh, haven’t had time to read it yet.”
So, I hope readers who come here will gain something of interest or worth to use for oneself, or share with a patient. I have no patents or license on what I will be sharing, but I will note what is a reprint that might be by another author who might not share my philanthropy for the readers.
What about the picture at the top? A shirt I found while doing a Locum assignment in Southern Maine back in 2010, and for me, priceless. Because it defines too much of what is psychiatry today!
Maybe I’ll get lucky in travels in the future and a patient will enlighten me with “out of meds, man, life is rather good now!”
Oh, if anyone has any good ideas of what a grounded, well balanced psychiatrist can do in the community besides be a drug pusher, feel free to forward a comment or resource for me to consider other career options. I would appreciate any realistic, sincere ideas.
Happy New Year to all.