Psychiatry Making Mainstream News Yet Again!

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Article said:
"When Ms. O’Neil met with the patient and a physician, she realized what was wrong. The doctor wanted to perform a test that required the patient to eat cooked eggs containing radioactive material. The woman appeared “spooked."
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This made me LOL pretty hard! :laugh::laugh::laugh:

I think I would have left AMA as well if I was told this without an explanation! :scared:
 
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We need to have psych consults to alleviate the anxiety patients have dealing with doctors who don't communicate well? Great. Isn't that why we have RNs or have they all been overworked to the point where they have all turned into Nurse Ratched?
Nurse_Ratched.jpg
 
From the article:

"Johns Hopkins Hospital in Baltimore in April launched a program to screen patients for psychological problems shortly after they are admitted."

What about psychiatric problems? They seem to forget about those.

"“It is a different environment than most psychiatrists are used to,” says psychiatrist Melissa Bui, who works half-time in the Brigham and Women’s ICU."

Not true at all. Umm, how about CL psychiatrists?

"“I do bedside psychotherapy,” says Dr. Garza, who aims to identify and treat patients in emotional distress."

Does anyone else do this? Bedside psychotherapy on the inpatient unit of the medical floor? I mean if you have 10+ patients on your team, how in the heck can you manage to do this?

"Too often, medical doctors don’t see beyond the physical ailments they are treating, says Dr. Muskin. “It is tough to have cancer. It is tough to have surgery. You want to chat about it. A lot of psychiatry is chatty,” he says."

I don't remember psychiatry being chatty-er then internal medicine when rounding on patients. I remember IM rounds took hours upon hours, and come on, perceiving that psychiatry is "chatty" is a terrible. And sending in a psychiatrist to "chat" about something is sooooo cost effective.


"When Ms. O’Neil met with the patient and a physician, she realized what was wrong. The doctor wanted to perform a test that required the patient to eat cooked eggs containing radioactive material. The woman appeared “spooked. She looked at him like he had two heads,” says Ms. O’Neil, who was able later to reassure the patient about the test."

This is absolutely absurd that you need a mental health specialist to figure out why the patient refused a test, rather then having the physician themselves ask simple the word "why."

This article is generally okay, but it has its issues. ehh, I guess I'm kind of annoyed by it.
 
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This sounds like one of those "sounds great to people who like seeing words like 'interdisciplinary' and 'synergistic' on Powerpoint slides" types of ideas...
 
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JKinSC said:
Why are you refusing to "think outside of the box" and be a "team player?"
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I mean in all seriousness, it's not a bad program on paper, but in reality it just kind of looks like a less efficient way to run CL. I actually wouldn't be all that surprised to see it result in superior outcomes, but if you need a psychiatrist to follow around a critical care intensivist to tell them "pssst, your patient is getting delirious" then I'm a little concerned about the quality of care in your ICU.

It's like the VA integrated care thread down farther in the forum. The idea's implementation is more important than the quality of the idea. Despite my cynical nature, I'm not about to dismiss this out of hand, but I can see a lot of hospitals attempting to put something like this into place but without a process involved to troubleshoot and adapt to the discrepancies between how something like this works on paper and how it works in reality, and ending up with a lot of frustrated CL psychiatrists.
 
During my recent hospital stay, I found out that there are no doctors available in the overnight hours. There was one doctor in the entire ED who I was told could be consulted in an emergency for the rest of the hospital. I feel like that can't be right, but when I came into the ED it was in the middle of the night and there was only one doctor. And she's apparently the only one available to the rest of the hospital. It took my university a four-year search to attract a psychiatrist. There's no way a hospital that only has one doctor working in entire building is going to hire a psychiatrist to go on rounds. I'm not even sure what they do for patients with psychiatric problems because the hospital has no psychiatric department (none near me do). I assume they ship them to a different hospital.

I suppose if you had a surplus of psychiatrists having one visit every patient would be a nice thing to do, but it seems somewhat wasteful when you think of all the people who can't see a psychiatrist. Plus, it's not as if the other doctors can't tell when a person has psychiatric issues. I guarantee you everyone I encountered in the hospital could tell I had very severe anxiety as well as other hard-to-define neuroses. It would have been nice if a psychiatrist had come to visit me, especially to adjust my medications in a more reasonable way (it's a long story but after surgery they basically stopped almost all my psych meds).
 
birchswing said:
During my recent hospital stay, I found out that there are no doctors available in the overnight hours. There was one doctor in the entire ED who I was told could be consulted in an emergency for the rest of the hospital. I feel like that can't be right, but when I came into the ED it was in the middle of the night and there was only one doctor. And she's apparently the only one available to the rest of the hospital. It took my university a four-year search to attract a psychiatrist. There's no way a hospital that only has one doctor working in entire building is going to hire a psychiatrist to go on rounds. I'm not even sure what they do for patients with psychiatric problems because the hospital has no psychiatric department (none near me do). I assume they ship them to a different hospital.

I suppose if you had a surplus of psychiatrists having one visit every patient would be a nice thing to do, but it seems somewhat wasteful when you think of all the people who can't see a psychiatrist. Plus, it's not as if the other doctors can't tell when a person has psychiatric issues. I guarantee you everyone I encountered in the hospital could tell I had very severe anxiety as well as other hard-to-define neuroses. It would have been nice if a psychiatrist had come to visit me, especially to adjust my medications in a more reasonable way (it's a long story but after surgery they basically stopped almost all my psych meds).
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Naw, the nurses, especially the crusty old, burnt-out types just thought you were intentionally being difficult to make their lives miserable. :D
 
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smalltownpsych said:
Naw, the nurses, especially the crusty old, burnt-out types just thought you were intentionally being difficult to make their lives miserable. :D
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I think I exclusively got the burnt-out types. Everyone always says how it's the nurses that make the experience bearable, but that was not my experience. If I had a concern about low SPO2, off came the pulse oximeter. Concern about high pulse pressure? Off came the blood pressure cuff. What is the point of those things measuring and beeping that you're out of limits if no one cares? I guess there isn't a point because they finally took them off so I wouldn't bother them about the numbers. It was as if they had a day shift at the DMV and the hospital is where they came to sleep and I was waking them up in the middle of the night to ask a question. EMTs on the other hand, in my experience, have always been great. Really nice, really calm. I can't be mad at the nurses though because they must have been through some bad stuff to get so hardened.

EDIT: Didn't see the part you highlighted. Yes, the night nurses I am quite sure believed I was intentionally pissing them off. I think it was more the ED doctors and nurses and surgeon, anesthesiologist who got the anxiety picture pretty quickly. And some of the better nurses before the night shift came. Night shift was like the hospital switched over to a prison.
 
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"I am good at dealing with patients. I talk to the patients so the god damn internists don't have to. What's wrong with you people. " Office space.
 
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Patients with personality disorders can be challenging but working with them can also be rewarding.
 
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Wilf said:
Patients with personality disorders can be challenging but working with them can also be rewarding.
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As true as this likely is, it sounds like it's from a psychology textbook photo caption.

(Also, it says this was a response to my post, but I don't see my post quoted. Maybe just a glitch in the system.)
 
Blitz2006 said:
http://www.wsj.com/articles/hospitals-test-putting-psychiatrists-on-medical-wards-1461604767

The excitement and "integration" of psych continues!
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I think this article hints at another aspect of reality of running a CL service. It is written in a basic way, published in a major business news paper, things that are mentioned appear quite simple if not dumbed down.
And that is the point, because its written for hospital administrators (how have no idea what CL service is or does). It makes a point about value that CL service brings to the system and of course to keep your service and job..
It actually is a big help to all other CL psychiatrists across this county that can use this article when their non-physician administrators come up with cost cutting ideas.
 
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