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The title says it all.
In my opinion more leadership from APA is needed to incorporate advocacy training into graduate curricula.
A psychiatrist is a trained medical physician, a psychologist is not.
A psychiatrist is a trained medical physician, a psychologist is not.
Right, and a Psychiatrist, no matter how large his ego, is not a psychologist.
Mark
What I think is even more interesting and even worth studying is that if you look at all the responses to this question by psychologists and students you see a trend--sophisticated, nuanced attempts to look at the problem from many different angles. The one MD comes on with a black and white answer.
Well, here's another MD answer.
I don't know. You should. And I shouldn't be pressured financially to forgo doing psychotherapy with patients because I can make more doing med checks.
Well, here's another MD answer.
I don't know. You should. And I shouldn't be pressured financially to forgo doing psychotherapy with patients because I can make more doing med checks.
Possibly supply and demand....it is easier to take a pill than to work on problems (although when possible, the outcome seems that gains are maintained better with therapy because patients have an internal locus of control and can attribute the change to themself, increase coping skills for future problems, etc). But, really sometimes it is necessary to use medication.
And obviously, drug companie$.
Well with that logic, once we take the required coursework we should get our Rx Privs and psychiatry should be welcoming this change, finally freeing you all from dreaded med checks. Oh wait, that means that you would have competition, something you absolutely fear from psychologists. Why is there all this fear from the field of Psychiatry?
After all, it's clear to all involved that psychologists on average have more training in psychotherapy than psychiatrists, despite this psychiatrists think that they should be able to engage in psychotherapy. Psychiatry, as a field, gets its panties in a twist when psychologists suggest it should be a two way street.
Mark
Making my point, again. If psychiatrists want to come on here and say "because we are smarter and we deserve it" or even better "I don't know" then why post? I don't know the answers to most questions on SDN forums, so I don't try to answer them.
Well, yeah. That's why I didn't post in this thread in the first place until people started saying that all psychiatrists were arrogant jerks based on one jerky reply from a psychiatrist.
The rest of this discussion is interesting though.
It seems like in some cases the severity of the presenting pychopathology must be considered - where the extra years from a PhD or MD would justify that level of practitioner. I guess it's all because of the fuzziness of the diagnosis.
A
Why isn't everyone annoyed with social workers and master's level practitioners? That's where the pressure is coming from on the therapy end. It seems like in some cases the severity of the presenting pychopathology must be considered - where the extra years from a PhD or MD would justify that level of practitioner. I guess it's all because of the fuzziness of the diagnosis.
average psychologist:
4 yrs college, 5 years grad school, 1 year internship, 1 year postdoc (11 years versus 12 years).
For specialty training, it's 4 yrs college, 5 years grad school, 1 year internship, 2 years postdoc (12 years versus 12 years).
Of course, psychiatrists can do advanced fellowships as well, which ads to their training time.
On average, I think psychiatrists earn more money because they are physicians and, as such, are 1) a more established commodity in the public's eye, the "physician" title come borne with gravitas that "psychologist" does not 2) the AMA is a better organization at protecting scope of practice and supply than is the APA 3) Pharmaceutical companies are a powerful lobby that have been very influential in how psychiatry is practiced 4) billing support in large organizations is usually top notch for physicians and somewhat scattershot for psychologists (this effects reimbursement rate for services) 5) legal hurdles with respect to defining roles (e.g., some states balk at neuropsychologists diagnosing alzheimer's disease, AAN recently tried to leave neuropsychologists our of the diagnostic tree for mild traumatic brain injury [crazy given who drives the research and the testing necessary to properly Dx].
On average, I think psychiatrists earn more money because they are physicians and, as such, are 1) a more established commodity in the public's eye, the "physician" title come borne with gravitas that "psychologist" does not
Amen to that. When people ask me my career and inform them I'd like to go into psychology, I always hear from my family (full of MDs) and from my boyfriend's friends (DOs) "Why don't you go to medical school and become a psychiatrist?" Because its not the same d@M# thing!!
The stigma is certainly there. You always hear people go, "Oh you're a doctor?" then once informed that one is a PhD vs. a physician, they're quite disappointed. Hence this shirt: http://www.cafepress.com/+trust_the_phd_tshirt,350358561
The focus of this thread is exactly the reason psychologists don't make as much. As a profession, we spend so much time comparing ourselves to other professions (we are better than master's level clinicians, should be making as much as psychiatrists, etc), rather than carving our own niche in the health care world. We are not the same as psychiatrists, even if we were given Rx privileges. We are trained in a different tradition (philosophy vs. medicine). If you wanted to do what a psychiatrist does (including take in their salary), you should have gone to med school. It is a shame that therapy is not reimbursed by insurance companies as well as med checks, but that is our fault. We spend too much time commiserating with each other about how unfair the salary disparity is, and too little time advocating for change. And actually, if you compare psychologists to other PhD's (which is what we should be comparing ourselves to), we are on the higher end of the salary scale.
Additionally, from what I know about health care reform, we should all be expecting a huge shift in our role in health care. From what I have learned, it seems psychologists will be more in the treatment planning and administrative role, rather than the actual clinicians carrying out treatment. It looks like psychologists will eventually be working in primary care settings as supervisors of master's level clinicians who are performing the actual therapy. However, I don't think this is necessarily a bad thing. This is an area where we are highly trained and no other profession is comparable in that regard. And actually, if we really carved out that niche, we could conceivably be the supervisor of interdisciplinary treatment teams that include psychiatrists in addition to other clinicians. Perhaps, if we can work on advocating our role in this area, salary increase will not be far behind.
And as an aside, this transition makes sense because (despite what we would like to think) the research shows there is no difference in treatment outcomes based on years of education of the clinician. That is because (speaking from personal experience--I have a master's in counseling and am now in a clinical psych phd program) master's programs solely teach therapy theories and techniques, while psychology programs teach that plus a deep understanding of the human mind/behaviors (i.e., context) from multiple perspectives (e.g. medical, behavioral, interpersonal, etc.), as well as extensive training in the scientific method. This puts us in a unique position to fully understand the the patient's problems from multiple perspectives, determine the best treatment and develop a plan to carry it out. No other profession has the training to do that as successfully as psychologists.
From what I have learned, it seems psychologists will be more in the treatment planning and administrative role, rather than the actual clinicians carrying out treatment. It looks like psychologists will eventually be working in primary care settings as supervisors of master's level clinicians who are performing the actual therapy.
A psychiatrist graduates from medical school with an M.D (average cost of ($150,000) and spends 4 years in residency (with a pay of about $43,000 per yer). Thats a total of 12 yrs of training (4 yrs college, 4 medical school, 4 residency) and heck of alot of debt. We have licensing ability to manage medications. Psychologists and the therapy they provide play a critical role in the treatment of mental illness. So do medications.
Not all psychiatrists care to do talk therapy. And when they do, the training is available to them. I happily refer.
The assumption that all psychiatrists look down on psychologists is rather silly. If anything, we are compared to other physicians, not psychologists, and we are at the bottom of the totem pole in that regard.
See psychiatrists never say WE ARE BETTER AT TREATING THE CRAZY GUY! i dont understand where they get that from