Healthy Skepticism Library item: 153

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Publication type: news

Stevenson K.
Health Forum: Out of the game: A frustrated psychiatrist abandons her practice to get out from under 'evaluating and medicating'
Post Gazette (Pittsburgh) 2002 Jun 4

Full text:

They changed the game on me and I am quite angry about it. People often ask me why a board-certified psychiatrist with specialty training in child and adolescent psychiatry has chosen not to practice.

I have decided to shed light on this subject because I have finally found the reason.

I have just finished reading another recruiting letter, looking for a psychiatrist to provide medication management and evaluations for a mental health group in Anywhere, USA. In this day of managed mental healthcare, the role of the psychiatrist is to diagnose mental disorders and to prescribe medications. When the patient is “stable,” the psychiatrist will then see him at approximately three-month intervals for 15-minute medication checks. My job is to pronounce the name of the disorder and to write the prescription to fill it. I receive financial incentives to “evaluate and to medicate” as many patients as possible.

If psychotherapy is called for, then I must refer my patient to a psychotherapist. Never mind that I have received excellent training in psychotherapy. Never mind that my particular gift is in bringing a person to wholeness through the realm of the spoken word. I have even been able to point some of them toward a loving Creator who can bring meaning to their lives of suffering.

Yes, I am angry because I am being used just for my knowledge of drug metabolism, and the interactions of drugs on enzyme systems, yet no one asks me to expound on my understanding of how childhood pain can result in untold suffering in the world of adulthood.

When did the science of medicine supersede the art? When did therapy in a bottle replace the healing balm of one-to-one interaction? I believe in the team approach to healing, yet I have discovered that my role on the treatment team is, “Just diagnose the patient, doctor, and recommend treatment. We’ll take it from there.”

My heart still grieves for those whom society struggles to understand. I still look with compassion on those who suffer from the ravages of mental illness, yet I find that I must strive to ease their suffering in another way. I have not abandoned the principles of good psychiatric practice, but I’ve chosen to pursue my passion for helping hurting people via other avenues.

When productivity is measured in terms of the people’s lives that are changed, and not just by the numbers of patients that are seen, I may return to the practice of psychiatry.