Gallup poll

[snarfer]

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This poll doesn't realize psychiatrists=medical doctors.

http://www.gallup.com/poll/159035/congress-retains-low-honesty-rating.aspx

 

[AcronymAllergy]

The text below mentions this:

Psychiatrists, who are also medical doctors, have been measured separately in Gallup's honesty and ethics ratings going back to 1976.

Doesn't include the rationale for doing so, though. I wonder if perhaps psychiatrists' ratings were for some reason considered outliers to the remainder of the "medical doctors" grouping, leading to its being broken out as a separate class?

Given the general mental health atmosphere that time, it wouldn't surprise me if all MH-related professions took reputation hits on polls back then. But at the same time, by breaking psychiatrists out from medical doctors (when this doesn't occur with any other physician specialty) could be significantly influencing the results.

 

[notdeadyet]

Doesn't include the rationale for doing so, though. I wonder if perhaps psychiatrists' ratings were for some reason considered outliers to the remainder of the "medical doctors" grouping, leading to its being broken out as a separate class?

That was probably the case then and the poll results show it is likely the case now. When the general public thinks of the title "doctor," they tend to think of a primary care physician and a blurry amalgamation of "specialist" that consists of all the eggheads they've seen in their lives. Most people have never seen a psychiatrist so they are not part of that amalgamation. And most people don't know the difference between a psychiatrist and psychologist so we're a separate entity. Our credibility with the lay public isn't nearly as good as that of a general physician, which is why we show much less in the poll. This doesn't really come as a surprise.

One of the tough pills for medical students to swallow is the idea that many people in the public will not view them as "real doctors." They need to be able to console themselves with the fact that they will be viewed as very real doctors to their patients and their colleagues as they do good work.

 

[peppy]

Whenever someone calls me a psychologist, it helps to remember that a lot of people in the general public think radiologists are just people who took a course at the community college to learn how to perform X-Rays. I've encountered even very educated people who don't realize that there is a specialty of actual doctors trained in reading imaging.
Oh, and every female doctor out there has encountered patients who think they are a nurse, just because they're female.
Pretty sure that most of the people I see on psych consults do believe that I am a real doctor at least. 🙂

 

[AcronymAllergy]

Whenever someone calls me a psychologist, it helps to remember that a lot of people in the general public think radiologists are just people who took a course at the community college to learn how to perform X-Rays. I've encountered even very educated people who don't realize that there is a specialty of actual doctors trained in reading imaging.
Oh, and every female doctor out there has encountered patients who think they are a nurse, just because they're female.
Pretty sure that most of the people I see on psych consults do believe that I am a real doctor at least. 🙂

And on our end (or at least in my experience), the default assumption made by patients more times than not is that I'm a psychiatrist. This often occurs even in the context of a neuropsychological evaluation rather than during an intake or for therapy.

I wonder how their results would look if they broke out one or two other specialties (e.g., radiology, for the reason you've mentioned). I'd be willing to bet that separating only one class of physicians likely influenced the results, and potentially in the negative direction.

 

[snarfer]

We should accept some of the responsibility as well. LCSWs and PhD/PsyDs call us psychopharmacologists/psychiatrists and the other MDs as medical doctors to patients. The majority of psychiatrists I met have mostly given in to them and also refer themselves as psychiatrists, or far worse psychopharmacologists/medication clinicians and all other docs as Medical Doctors. No wonder why reimbursement for our services and general respect continue to decrease. Even our psychiatry initial evaluation is label as "Medication evaluation' at many places.

 

[st2205]

We should accept some of the responsibility as well. LCSWs and PhD/PsyDs call us psychopharmacologists/psychiatrists and the other MDs as medical doctors to patients. The majority of psychiatrists I met have mostly given in to them and also refer themselves as psychiatrists, or far worse psychopharmacologists/medication clinicians and all other docs as Medical Doctors. No wonder why reimbursement for our services and general respect continue to decrease. Even our psychiatry initial evaluation is label as "Medication evaluation' at many places.

This is one of the things I've never understood. The term is PCP. What is medical doctor supposed to mean, anyway? When a diabetic seeing their endocrinologist complains of sinus problems, they tell them to take it up with their PCP, not their medical doctor. I think further perpetuation of "psychologists that prescribe" is to some degree invevitable, but giving in is a little silly.

 

[AcronymAllergy]

We should accept some of the responsibility as well. LCSWs and PhD/PsyDs call us psychopharmacologists/psychiatrists and the other MDs as medical doctors to patients. The majority of psychiatrists I met have mostly given in to them and also refer themselves as psychiatrists, or far worse psychopharmacologists/medication clinicians and all other docs as Medical Doctors. No wonder why reimbursement for our services and general respect continue to decrease. Even our psychiatry initial evaluation is label as "Medication evaluation' at many places.

I can see how a psychologist might specifically ask about a patient's appointments with their psychiatrist, given the nature of our work together. Although in my case, I try to refer to all physicians by specialty (or better yet, by name), as many of the patients I see have a hard time remembering who's who. In my mind at least, it also might encourage these individuals to become more actively involved in, and educated about, their own physical and mental health. My (wild) guess is that perhaps psychologists and master's-level providers referring to "medical doctors" vs. psychiatrists are those who might not have as much experience in multi-disciplinary medical settings...?

I've never heard of a psychiatrist being referred to as a psychopharmacologist/medication clinician, and agree that it's something that shouldn't be perpetuated if for no other reason than that it further muddies the waters. I wonder if it started springing up because of some of the issues we've discussed here (i.e., psychiatrists or hospitals wanting to dissociate from that term because of the negative connotations associated with it)?

In the end, though, I think it behooves everyone to help provide clarification for patients whenever possible.

 

[snarfer]

This is one of the things I've never understood. The term is PCP. What is medical doctor supposed to mean, anyway? When a diabetic seeing their endocrinologist complains of sinus problems, they tell them to take it up with their PCP, not their medical doctor. I think further perpetuation of "psychologists that prescribe" is to some degree invevitable, but giving in is a little silly.

I agree. The only thing we can do is to use the correct terminology when speaking to patients and politely correct others when appropriate. Unfortunately, I have heard several psychiatrists telling patients "you should go see your medical doctor for x, y, z."

 

[surftheiop]

I agree. The only thing we can do is to use the correct terminology when speaking to patients and politely correct others when appropriate. Unfortunately, I have heard several psychiatrists telling patients "you should go see your medical doctor for x, y, z."

I dont think thats unique to psychiatry, I was told almost that exact same thing by an EM doc when I went in for a weekend sports injury awhile back. Honestly I think most patients would be more confused by saying "go to your primary care provider" than "go to your doctor".

 

[OldPsychDoc]

I dont think thats unique to psychiatry, I was told almost that exact same thing by an EM doc when I went in for a weekend sports injury awhile back. Honestly I think most patients would be more confused by saying "go to your primary care provider" than "go to your doctor".

Exactly.

OPD discussing discharge planning with inpatient: "So we need to get you an appointment with your doctor so you can follow up on this high blood pressure."

Patient: "I have an appointment with Dr. (Psychiatrist) next Tuesday."

OPD: "That's great. But who is your Primary Care Doctor?"

Pt: <blank stare>

OPD: "You know--who you see when you get sick? For your annual physical?"

Pt: "Well...I usually just go to the Emergency Room."

OPD: "OK then, we'll make you an appointment with one of our Primary Care Doctors in the Family Practice Clinic."

Pt: "I don't need birth control..."

OPD: "We'll get you in to see a Medical Doctor."

Pt: "OK"

 

[snarfer]

I dont think thats unique to psychiatry, I was told almost that exact same thing by an EM doc when I went in for a weekend sports injury awhile back. Honestly I think most patients would be more confused by saying "go to your primary care provider" than "go to your doctor".

I don't doubt this happening with the other specialties but IMO this being more problematic in psychiatry. I see many patients who are referred from the primary care clinics nearby already on an antidepressant and/or benzo for 'depression and anxiety' and some have undiagnosed mood instability. When I recommend stopping the SSRI, I often get this response "but my medical doctor put me on it, you're a psychiatrist, should you check with him/her first?" I believe patients not realizing who we are can do more harm than good. Spending 1 minute explaining the similarities and differences of who we are can improve care. There is nothing wrong with the term psychiatrist IMHO.