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View Full Version : The Story of Mr. Brain and Mrs. Mind


Ocean
04-25-2010, 08:42 PM
What? You don't like the title?

I had to give this thread some name. Here (http://www.nytimes.com/2010/04/25/magazine/25Memoir-t.html?src=me&ref=general) is an article from NYTimes.

listener
04-25-2010, 11:07 PM
Thanks. This was a sobering accounting of the current state of psychiatry.

Wonderment
04-25-2010, 11:20 PM
The idea of integrated treatment sounds good, but doesn't it end up putting more therapists out of business? What about a model in which the therapist is next door and works as a team with the psychiatrist? Many non-MDs may have enormous talent as therapists, and many psychiatrist may lack those talents.

I have lived through this exact dilemma with a family member who sees a psychiatrist for 15 min. visits and is referred (somewhat perfunctorily) to a therapist. The path of least resistance for the patient is to chat a bit with the psychiatrist, take the meds and hope for the best.

Also, it's the path of maximum profits for Pharma, insurer and psychiatrist practitioner (as suggested in the article).

Ocean
04-26-2010, 07:34 AM
The idea of integrated treatment sounds good, but doesn't it end up putting more therapists out of business? What about a model in which the therapist is next door and works as a team with the psychiatrist? Many non-MDs may have enormous talent as therapists, and many psychiatrist may lack those talents.

Yes, I like the model you suggest, for the same reasons. I'm very aware of the lack of training and also, lack of interest that many psychiatrist have in psychotherapy. There is an occasional patient that benefits greatly from having treatment with only one provider, but probably the vast majority would do fine with coordinated treatment. I think that the physical proximity (psychiatrist and therapist in the same building) also facilitates adherence to both modalities.

I have lived through this exact dilemma with a family member who sees a psychiatrist for 15 min. visits and is referred (somewhat perfunctorily) to a therapist. The path of least resistance for the patient is to chat a bit with the psychiatrist, take the meds and hope for the best.

Also, it's the path of maximum profits for Pharma, insurer and psychiatrist practitioner (as suggested in the article).

It's clearly a path for maximum profits for insurer. I will guess secondarily, but not necessarily, for pharma and psychiatrist.

There are objections to psychiatrists doing both modalities. However, nurse practitioners, who overall have significantly less training in all areas, have salaries that are much higher than other mental health professionals and approaching that of psychiatrists, have fewer obstacles from insurance companies to do both medications and therapy. Go figure!