Can You Practice Both Psychiatry and Neurology at the Same Time

[itz9001]

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And I'm not talking about neuropsychiatry either, since it does not have the same emphasis on things as psychiatry or neurology. This is a question I'm honestly curious about, so yeah...

 

[Pons Asinorum]

And I'm not talking about neuropsychiatry either, since it does not have the same emphasis on things as psychiatry or neurology.

That's my favorite sentence of the day...

 

[Drrrrrr. Celty]

There are dual residency programs in psychiatry and neurology.

 

[Electronegative]

can my car's check engine light stop blinking?

 

[indya]

.

 

[Pons Asinorum]

sure.

as long as they are comfortable with it.

Stepping out of hSDN for a little Tuesday night out?

 

[Tolip]

https://freida.ama-assn.org/Freida/...h.do?method=viewDetail&spcCd=755&pageNumber=2

It looks like there are 8 combined psych/neuro programs in the US.

Brown University (Butler Hospital)
Indiana University
Medical University of South Carolina
New York Presbyterian Hospital (Columbia)
New York University School of Medicine
Tulane
University of Massachusetts
West Virginia University

 

[indya]

.

 

[mmmcdowe]

Is anything that I said wrong? Obviously an internist isn't allowed to do neurosurgery, but they could prescribe minor things which they are comfortable with.

I'm pretty sure little of what I write on here is incorrect, but it apparently has no weight because a college student knows more just by virtue of being a college student. You think that it is as if one gains large amounts of wisdom the moment they get their HS diploma, JUST BECAUSE they have their HS diploma.

I think the point being raised is that it isn't just about comfort, it is about scope of practice. I can be as comfortable with doing surgical procedures as I like, but without accreditation I can't go walking into an OR a operate by myself. You have somewhat corrected your statement with what you have now written, but the implication of the first post was that you didn't realize that being a doctor of medicine does not mean you are a doctor of all medicine.

 

[Pons Asinorum]

Is anything that I said wrong? Obviously an internist isn't allowed to do neurosurgery, but they could prescribe minor things which they are comfortable with.

I'm pretty sure little of what I write on here is incorrect, but it apparently has no weight because a college student knows more just by virtue of being a college student. You think that it is as if one gains large amounts of wisdom the moment they get their HS diploma, JUST BECAUSE they have their HS diploma.

I'll leave arguing the correctness of what you say or have said in the past for another day. My problem is that you post things with such assurance, and you frankly don't know what you don't know. Not because of your age, but because you talk out of your ass about things that you just don't know. Take for instance this:

However, the practicality of having a half psych and half neuro practice is another issue.

What do you know about the business of running a combined psych/neuro practice? I don't know the specifics of that question, and I'm old enough to be your father and been around medicine and neuro practices for a long time now. I'm old enough to know what I don't know. That's the problem I (and others if I had to assume) have with a lot of the stuff you pop on here and spout.

 

[Charles_Carmichael]

I think the point being raised is that it isn't just about comfort, it is about scope of practice. I can be as comfortable with doing surgical procedures as I like, but without accreditation I can't go walking into an OR a operate by myself. You have somewhat corrected your statement with what you have now written, but the implication of the first post was that you didn't realize that being a doctor of medicine does not mean you are a doctor of all medicine.

Not true. It actually is primarily about comfort (and standard of care). A medical degree technically grants you unlimited license to practice medicine and surgery. That is, generally, the scope of practice for a physician is unlimited in the practice of medicine. What happens in reality, though, is that physicians limit themselves to practicing in the field they trained in (due to standard of care, hospital privileges, etc).

At least that's what I've gathered. Someone further along in training feel free to correct me if I'm wrong.

 

[indya]

.

 

[mmmcdowe]

Not true. It actually is primarily about comfort (and standard of care). A medical degree technically grants you unlimited license to practice medicine and surgery. That is, generally, the scope of practice for a physician is unlimited in the practice of medicine. What happens in reality, though, is that physicians limit themselves to practicing in the field they trained in (due to standard of care, hospital privileges, etc).

At least that's what I've gathered. Someone further along in training feel free to correct me if I'm wrong.

I think this is more a mis-communication than a disagreement. Realize that standard of care has legal as well as ethical implications for those you fall beneath it. Historically, yes, a degree and elbow grease was all you needed to be on your way, but that is no longer how things work practically regardless of past traditions. An MD degree doesn't, by itself, even grant you ANY power to practice medicine as a physician.

http://en.wikipedia.org/wiki/Medical_license
http://en.wikipedia.org/wiki/American_Board_of_Medical_Specialties
http://en.wikipedia.org/wiki/Higher_education_accreditation_in_the_United_States

 

[indya]

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[Perrotfish]

I'm not sure, but can't you get your license after internship year when you pass Step 3? Someone who does this has no specialty, but can still practice medicine. From what you have said above, how is that possible?

http://en.wikipedia.org/wiki/Internship_(medicine)#United_States

Completing an internship grants you the legal right to practice medicine. That's any medicine, from handing out Metformin to doing neurosurgery. This is a hard, federal standard. Practice medicine without one and you go to jail for quite awhile.

The 'standard of care', on the other hand, if a soft, subjective, ever changing legalism that basically definies at what point you are negligent in practicing a particular type of medicine without more experienced supervision. You can, for example, manage someone's diabetes with just an internship and you won't go to jail because you have a license However because your level of training isn't up to the 'standard of care' (i.e. you don't have an FP residency complete) if they lose a foot because you didn't know what you were doing you could be vulnerable to both civil and criminal litigation. This is often procedure to procedure. For example you could have completed a general surgery residency, but if you've never assisted with a Whipple procedure you would still not be meeting the standard of care if you performed a Whipple on your own.

Since you generally can't get malpractice insurance without having adequate training, and since there is essentially nothing for which just an internship meets the standard of care, for all intents and purposes Inernship only practice has receededto a few malpracice free areas like the military.

 

[mmmcdowe]

I'm not sure, but can't you get your license after internship year when you pass Step 3? Someone who does this has no specialty, but can still practice medicine. From what you have said above, how is that possible?

http://en.wikipedia.org/wiki/Internship_(medicine)#United_States

Well first of all that would still lead into my point about the MD degree itself, but what you are referring to is the General Practitioner, hence the term "general medicine" in that wiki page. This was much bigger in the past, and I'm not entirely sure that they still exist in the context of only internship training anymore (my father actually did this part time while a resident). I have vaguely heard of some states having less than an entire residency requirement in certain fields and specialties where a resident can practice as an independent practitioner, but this is getting more stringent by the year and does NOT give you a license to do anything you feel comfortable because standard of care still applies. If your training falls below it and you get caught in a sticky situation you are toast regardless of how comfortable you were doing a transphenoidal resection. True GPs (not the post-internship thing that I was talking about right now) are still certified. In the past it was through Family Medicine when that was created and most GPs grandfathered themselves into that specialty and now there is a General Practitioner board to certify them as fit for that "specialty". So, I guess the answer to your question is that General Practice is a "specialty" (though in true context exiting general medicine into another field is what "specializing" actually means), or at least used to be.

Spitting on the sidewalk is technically illegal in numerous cities, but in reality how many people actually go to jail for it?