Psych patients in the medical setting

[Pershing]

I like both Psychiatry and Internal Medicine. However, I've found that I don't like evaluating/treating the medical complaints of psych patients in a medical setting (recent example for me are psych patients in the medical ER). Anyone else feel this way? For me, I like inpatient, outpatient, as well as C-L psych. Even though you're working with medical/surgical patients in C-L, you are not the primary provider of their medical/surgical care and are really focusing on their psych care and considering medical factors contributing to their psych presentation. This makes me understand why many physicians get annoyed with psych patients--it's really hard to manage both the medical and psych aspects of care simultaneously.

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[cleareyedguy]

Your complaint is one reason that C-L exists as a subspecialty. The consult psychiatrist is there not only to treat psych illness but to take care of whatever problem is preventing the medical team from efficiently doing its job.

 

[VMSmith]

Yep, when you're on medicine it can be really hard to step back and really take a look at things...you're just worried about getting the things you need to get done, done.

 

[Manicsleep]

I like both Psychiatry and Internal Medicine. However, I've found that I don't like evaluating/treating the medical complaints of psych patients in a medical setting (recent example for me are psych patients in the medical ER). Anyone else feel this way? For me, I like inpatient, outpatient, as well as C-L psych. Even though you're working with medical/surgical patients in C-L, you are not the primary provider of their medical/surgical care and are really focusing on their psych care and considering medical factors contributing to their psych presentation. This makes me understand why many physicians get annoyed with psych patients--it's really hard to manage both the medical and psych aspects of care simultaneously.

You should be evaluating but treatment of those complaints is up to medicine, surgery or whoever is taking care of the patient at the time.
I think the same goes for the primary providers, they should evaluate and be aware of all the issues. If they get irritated, perhaps get a different job where things are a little easier? Or perhaps get better educated so that they don't get so irritated.

Sorry to be preachy but too many ER docs and hospitalists don't want to deal with patients with mental health issues and end up not proving adequate care to those patients.