Even medics says things without really thinking. In our most unguarded moments we say things to each other (and patients, nursing staff, relatives etc) that is just plain guff.
Here are some FAQs from my colleagues on the subject of psychiatry.
(authors note: I have said some blinders in my time but that is for another post)
Psychiatrists don’t need medical knowledge to practice so should it really be a medical speciality? Wouldn’t making it a separate degree subject help solve the recruitment crisis?
Any psychiatrist worth their salt requires general medical knowledge. I shall prove it to you.
1. Psychiatric patients suffer from medical issues. Like all of us. Some patients with mental health problems are even more at risk of certain illnesses eg heart disease. A psychiatrist should be able to deal with emergencies such as an asthma attack, a heart attack etc as well as general issues like reflux. If someone is acutely admitted you are the only doctor around and people can’t pop out to visit the GP.
2. Psychiatric medications have complex medical side effects. Including some emergencies that can be fatal (though thankfully extremely rare). Older medications can cause movement disorders, newer ones can lead to weight gain, diabetes and heart disease. A psychiatrist has to know how to treat these complications.
3. Psychiatric patients can have poor motivation and complex lifestyles and may have very poor contact with health services. These patients need treatment for chronic health conditions as well as inclusion in public health campaigns eg cancer screening, smoking cessation Etc. A menral health specialist may be their only health service contact.
4. The mortality figures in psychiatry show that currently people with mental health issues generally die of problems related to heart disease. (Not suicide / homicide).
The converse is true as well. Medics need psychiatric knowledge. Remove psychiatry as a medical speciality and it will swiftly drop from the curriculum and people’s priorities. Like it or lump it mental health is extremely common and pops up everywhere. When was the last time a medic learnt about dentistry?
If it is the brain that interests you why not neurology?
I get a lot of people trying to turn me to another profession. The theory of neurology is interesting but its just a bit dry for me. It’s like learning about the circuitry of a computer rather then getting to play it. It’s too dry. All it seems to be is about anatomy and I don’t think I could learn anything about what it is to be a human from that and I feel like I owe it to myself to pursue that interest. At the end of my career I want to feel like I slightly understand human creatures better.
There is lots of psychiatry in GP. Why not become a GP?
Because I want to specialise. Like you did Mr respiratory consultant.
Psychiatric patients don’t get better. Won’t you find that frustrating?
A lot of people do get better particularly with anxiety problems and depression. Some people’s lives re extremely improved with help. Some people become worse and worse yes. There is no medical speciality without its chronic illnesses that cannot be ‘cured’ eg diabetes, COPD, heart failure .. I could go on. No doctor can tell you they have no patients that fail to improve despite everything thrown at them. Or patients that don’t engage.
I will not find that anymore frustrating then treating Parkinson’s or diabetes or lung cancer.
Doesn’t it frustrate you that their is so little science / evidence in psychiatry?
No it doesn’t as there is a wealth of research going on (a lot of it is quite corrupt though…) and so much room for development. The problem of evidence basis is endemic to medicine not just psychiatry. This question may crop up a lot due to the fact medical schools still teach the mono amine theory of depression and not much else. A theory that is pretty much bogus to current psychiatric opinion.
Nobody notices when we are learning old hat theories for everything else though. Medics make the worst scientists as we are resistant to change and have very little spare time for keeping up to date.
I’m sure there are more but I’m late for work. Last day blues! I love my fellow medics really and like I say I run my mouth off a lot too.