Future of Psychiatry?

[Optimistic]

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I was just wondering how it would effect the demand of psychiatrists if psychologists get the presecrption rights. Do you gus think its gonna have any effect on demand and salary of psychiatrists??
Also is it true that psychiatry is becoming more competetive each year??

 

[john182]

I was just wondering how it would effect the demand of psychiatrists if psychologists get the presecrption rights. Do you gus think its gonna have any effect on demand and salary of psychiatrists??
Also is it true that psychiatry is becoming more competetive each year??

Seeing as GPs prescribe 95% of antidepressants do you think that it has significantly hindered demand and salary of psychiatrists? No....so why would psychologists?

Sure some people might like it, but basically that stats on mental illness are unavoidable and large and treatment requires someone trained in the physical and psychological - i.e., psychiatrists.

Lots of other specialities are "done" - there is a limit to the benefit of changing mortalities from 1 in 10000 to 1 in 10500 and this has happened in 30-40 years of advancing physical and "tangiable" procedures. The future of psychiatry is most likely in neurology - but once again, neurologists have no training in the psychological and behavioural impact of physical/neurological illness (well, to a limited degree but neurologists tend to not understand psychopathology) whereas the interplay of neurological illness and it's behaviour is unique to psychiatrists as the psychologist has no tangiable training in neurology, neuroanatomy or psychopharmacology (yes as small postgraduate courses but without a degree status - perhaps some diploma in pharmacology or something, elsewise it's a 4 year degree of course!). Also, remember that people study psychology to understand "normal" human behaviour first before branching to clinical psychology and eventually to mental illness. A psychiatrist started off as a doctor to help people and the training path from the outset is to "what is abnormal?" as opposed to the "what is normal" route of psychologists.

As such, psychiatry is a unique position and most definitely psychology and neurology are essential adjuncts to psychiatry and mental illness treatment, each has it's own "domain" if you like, but as neuroscience advances the psychiatrist is where it's at, because psychiatry is where it is being advanced.

Psychopathology is the domain unique to the psychiatrist and I would suspect in 10 years the advanced imaging and gene screening will lead to a return to the neuropsychiatry way.

WHy not let psychologists prescribe? 95% of the mentally ill are never seen by psychiatrists anyway - for the love of god it would be better to see a psychologist? But maybe that's to save money on GP prescriptions!

 

[50960]

That was a great response and I agree. If psychologists start prescribing it will not negatively affect psychiatrists a bit. There will always be a need for psychiatrists, and my guess is we will an increased need for psychiatry when psychologists start prescribing. I noticed the more I learned about psychopharm, clinical medicine etc, the more I ordered psychiatric consults for the patients I treat, and the more I relied on psychiatry for help.

🙂

 

[john182]

That was a great response and I agree. If psychologists start prescribing it will not negatively affect psychiatrists a bit. There will always be a need for psychiatrists, and my guess is we will an increased need for psychiatry when psychologists start prescribing. I noticed the more I learned about psychopharm, clinical medicine etc, the more I ordered psychiatric consults for the patients I treat, and the more I relied on psychiatry for help.

🙂

Exactly - psychiatry evolves. Remember a hundred years ago it was neurology (e.g., Freud).

In ancient greece it was almost philosophical (e.g., writings of Aristotle), in the 1940-50s it was asylum based (in the US at least - Germany and UK had advanced considerably) with ECT and the psycho-socio-politcal problems of the 1960s and involuntary treatment.

The 1980s have seen rapid psychopharm development and prescribing much more open.

The 2000s on have shown gene advances, etc., .

And all the way through has been the psychiatrist, assisted by the neurologist, the surgeon (when psychosurgery was in vogue), the psychologist (in the 1990s and hopefully always but you never know with fragile ego problems!) the internist with thyroid/diabetes/post-concussion/epileptic/you name it, the obgyn and endocrine changes of pregnancy and post-partum.

And all through it, there has been more and more recognition of psychiatry as vital to a healthy society - e.g., the high funding in europe and the slaughter of psychiatry by managed care in the US (but I'll leave my politcal views for another time).

The future is bright, regardless.