That didn’t come out like it should’ve. I know you’ve seen incompetent medical care. I think what I was trying to say was “I’ve also seen my fair share of incompetent medical care, having been in the military.”
Well, when your spouse is in the military, you, for all intents and purposes, are in the military, at least where medical care is concerned. So - been there, done that, sing it brotha, amen.
Word. 
There’s no experience in the world quite like basic training medical hold, though. We had a lot of happy trainees come in for a leg injury and leave two weeks later with a mental health discharge based on psychiatric disorders they’d legitimately developed (or exacerbated) in med hold.
No, I’ve never seen a counselor. I’ll be disowned if I do. That’s basically the long and short of it. So really, nothing anyone says will ever make me see one since I’d like to have some kind of working relationship with my family, and have them treat me with at least a little bit of respect. And no, I’m not really happy. Happiness is a privilege not a right.
I didn’t bring personal experience into this thread until it became relevant to. Really, I’m not very happy about the way a couple of posters have totally derailed the thread and used it to expound on their favorite pet subjects. I’m pleased that a couple of doctors have answered this, though. Now maybe everyone should just let this thread drop off the front page. Okay?
I think that psychiatry is as legitimate a medical field as any, but the complexity of the brain and the subjectivity and wide range of emotional disorders means that psychiatry is not as far along as other fields. I think that in terms of knowledge, psychiatry is at about the place where medicine as a whole was just before the germ theory was accepted–well-meaning and generally headed in the right direction, doing some good, probably just as much harm, and a whole lot of nothing.
Whatever we in the medical field think of psychiatrists, it’s clear that we don’t expect a lot from them. Some shrinks take advantage of this and do the least they can get by with, which is very little indeed. Others try to overcome it by doing everything they possibly can for a patient. Most fall in between somewhere.
I’ve been thinking about the role of psychiatry in what I do (primary care medicine). The minor successes we’ve had in psychiatric medicines (in particular, the SSRIs) are wonderful, of course, but on the other hand they’ve made us responsible for our patients’ emotional states. At least a quarter of my patients are either looking for some pills or are already on some (started by someone else) to fix what is basically a shitty life. (Of course, around here people have the idea that there is a pill for every problem, and it isn’t just psychiatric. I don’t know how many times a day I have a patient who eats nothing but crap and never exercises who doesn’t understand why she doesn’t have any energy and can’t lose weight.)
None of the doctors in this thread agreed with you, so I still don’t get how your mother was right. Therefore, this:
pretty much translates as ‘since none of you agree with me, please go away.’ You aren’t looking for a variety of opinions and you certainly aren’t doing research–not anything like objective research, in any case.
Write what you like–there is plenty of drivel out there. If you need to do this to exercise (yes, not exorcise, because you are clearly strengthening them, not getting rid of them) your demons, go for it. Just be aware of what you are doing.
Well, she’s right in that she can still make me feel guilty about it. In case you haven’t noticed I am very easily guilted, over everything. Like I have a hard time rationalizing buying non-staple food because of all the homeless starving people out there. So of course I’m going to have problems with medical care which is viewed as “frivolous” by a lot of society. And if even some doctors agreed that it was frivolous, that would compound the guilt I would feel by participating in the system. And if that doesn’t make any sense, then just write me off as a crazy person and refuse to have anything more to do with me.
Actually, I am looking for opinions. Look, I know I come across as having my mind already made up, and that I’m sarcastic and rude, but I don’t start posts just to exercise demons (outside the Pit, anyway). Sometimes I throw things in my posts like “I still know I’m right” and “oh, you’re just lying” but you need to just ignore that because it’s not sincere, it’s part of my sarcasm. It would make more sense if you knew me and could see my body movements and the way I say things, I don’t use emoticons so yeah, my posts come off a little sharp, something I noticed a lot when I happened upon a really old post I made.
I guess I am just the kind of person who automatically looks for the hidden rationale in everything. If you (or anyone) talk about the benefits of psychiatry, I’m going to think you’re saying that to get money. OTOH, reading AH3’s posts makes me want to jump to psychiatry’s defense. Just a natural devil’s advocate, I suppose. Which makes it seem like I’m not really listening, but really, I’m just trying to examine all sides of the situation.
And I’ve certainly taken your opinion (and that of other doctors) over that of non-doctors, especially those non-doctors with an agenda to push. Especially as that was the point of this thread in the first place. To poll doctors. And I’ve gotten a good idea of the answer, and it’s not quite what I expected (even if some of you are lying). So thanks. And that is sincere. Consider this an apology, to you and anyone I offended with my sharp-edged posts about psychiatry in the past.
So now can this thread fall off the front page? Thanks.
Ok. Thanks for explaining and apologizing. No more posts from me, but I really wanted to thank you for what you said.
I considered going into psychiatry. I preferred pediatrics, family medicine, internal medicine and radiology. My current job as an emerg doc has me doing all of these things, including working with plenty of difficult psych cases in a small hospital with limited pyschiatric resources.
Many psychiatric and behavioural issues are too complicated to easily test. In cardiology, it is THEORETICALLY easy to measure if drug X lowers someones average blood pressure or reduces the likelihood of a second heart attack. Confounding factors (patient in the study smokes, is 62, had a first heart attack of so-so severity, has these current symptoms) can be controlled to a reasonable degree.
In psychiatry, mood and behaviour between diffferent patients is hard to measure and hard to compare. Confounding factors (patient abused as child, has three family members, four good friends, a stressful job which pays an average wage, a family history of depression, was once raped, sees self as failure since marriage crumbling, drinks eleven beers a week, once used PCP, is fairly religious, has occaqsional pain from an old shingles infection, takes metformin for diabetes) differ so much from person to person that it is very difficult to test how much a medicine helps improve mood or whether performing talk therapy helps a patient with borderline personality. Hiow can you compare patients with such different experiences? Clinical Psych. studies are very hard to do well.
This lack of hard numbers and evidence gives psychiatry a soft reputation. I do not feel this reputation is deserved.
It is true the DSM often seems arbitrary, and practicing psychiatry is a little like “cookbook medicine”. (You probably have these 3 conditions therefore this diagnosis). This is also true of many other areas of medicine, though. (You definitely have these 3 conditions and are therefore diabetic). Labels are not limited to psychiatry.
It is true the brain is poorly understood, that we do not know how some psychiatric drugs work, that our knowledge is limited. The fact we have a long way to go does not change the fact psychiatrists are forced to deal with difficult cases using the tools currently available.
Expectations placed on psychiatrists are often unreasonable. Many psychiatrists make immense differences in the lives of their patients. Some do not, but in fairness, this is not always the easiest, most compliant or most popular group to work with. Many doctors dislike working with psych patients since they are hard to treat, hard to cure, and (compared to a non-psych patient) take a lot more time and resources and cause more hassles (a 14 year old who sets animals on fire for shits and giggles is not always polite to medical staff, oddly enough. Neither are abusive alcoholics who try to piss on the nurses).
So most doctors are happy to pass the buck. Irishgirl says it well in her first post. I’d say 2/3 of psychiatrists are good at what they do and make a small but real positive diffference in very difficult circumstances. I’d say a small percentage of psyhciatrists are candidates for sainthood. I personally wouldn’t take any advice whatsoever from about 1/3 of the psychiatrists I know – who seem absolutely clueless. My pet peeve with psychatrists isn’t their psychiatry (which I’m grateful to access when I can) but the fact that a few psychiatrists simply forget the basics of general medicine. 
As the first reply said, “doctors like to deal with stuff they can fix.” And that will remain fixed. The majority of doctors I know have serious issues dealing with the notion of death, both theirs’ and others’; they’d like to be able to cure people and have them stay cured. The mind, emotions… those are hard to measure, and often their problems don’t have an “end date”: someone with schizofrenia (sp?) can get it under control, but it can’t be cured. That scares most doctors shitless.
IANAD, but both my best friend and my SIL are.
Best friend (medical manager of a retired people’s managed-housing community) thinks of psychiatry as another tool in her box, both “talktalk” and pills. For some situations (for example, exogenic depression, where something has happened that makes you feel bad, but if the problem gets solved you feel good again), talk is better; for others (for example, endogenic depression, where the problem is purely chemical), pills are. When she graduated, she was scared of it; after twelve years dealing with old people in varying states of lucidity, not any more.
SIL is a recent graduate: mentally sick people scare her paper-white and she thinks of psychiatrists as suspicious. They face routinely things that terrify her, so there has to be something strange in them; they’re “not normal”; she applies the same rule to many other activities, not just psychiatrists.
Sorry, I don’t think any of this is true for most doctors. Lots of patients have problems which are unfixable or can only be managed to a limited degree (cancer, chronic pain, eye/ear problems, brittle diabetics, vasculopaths with high blood pressure, etc.) and emotional problems are only one aspect of something one constantly sees in practice.
Most doctors I know do not have serious issues with death. During my training I have seen in great detail how doctors deal with death, and I believe they are better than most folks at handling it. I deal with death frequently in my practice, as do many doctors. (I do not know what neuroses your SIL may or may not have).
Most doctors are happy enough to get serious conditions like schizophrenia under control. This alone can be a very useful and significant accomplishment and as useful as a cure. If you can control something, and restore dignity and quality of life to the same degree as a cure, it is in practice almost as good. Doctors can’t yet cure diabetes, but many diabetic patients who take care can live as long and with as much quality of life as someone who lacks diabetes. This is empowering, not scary.
Colour me tainted.
Hopefully I will get into med the year after next. Right now I am a science student. I grew up in a family where my mother was mentally ill. All I saw was her shovel down drugs and not see any improvement.
The psychiatrists they sent me to didn’t help me. They only gave me the drugs to end my life. “Real” doctors saved it. Of all the psychiatrists/psychologists I have seen, none of them have helped. I just picked myself up and kept on going.
Put me down in the quacks list. Hell, I’m bitter. But I have not met another pre-med student who thinks this.