How much Gen Med does a psychiatrist use?

[certified]

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Is seems as though Psychiatrist have the option to throw away their stethoscopes after training? Do many Psychs medically managed (HTN, DM, etc.) their own patients or is it required of them to consult them out to an Internist.

Eventhough Psychiatry Internship requires 6 months of medicine, most Psychiatrist I have met almost exclusively have an Internist medically manage their patients. Is this by choice or by law?

 

[john182]

Is seems as though Psychiatrist have the option to throw away their stethoscopes after training? Do many Psychs medically managed (HTN, DM, etc.) their own patients or is it required of them to consult them out to an Internist.

Eventhough Psychiatry Internship requires 6 months of medicine, most Psychiatrist I have met almost exclusively have an Internist medically manage their patients. Is this by choice or by law?

You'd be brave to assume the responsibility of managing hypertension as a psychiatrist much as an interist would be brave to manage schizophrenia. You can do it, theoretically, but you would not be a professional level doctor in the required field.

I think general medical knowledge is useful to know more of when to get a cardiology, surgical, etc., opinion and the physical aspects to side effects.

 

[Anasazi23]

Is seems as though Psychiatrist have the option to throw away their stethoscopes after training? Do many Psychs medically managed (HTN, DM, etc.) their own patients or is it required of them to consult them out to an Internist.

Eventhough Psychiatry Internship requires 6 months of medicine, most Psychiatrist I have met almost exclusively have an Internist medically manage their patients. Is this by choice or by law?

We manage problems such as htn, dm, cellulitis, and various minor infections all the time. It's required of you in inpatient psych, and is not beyond the scope of your training when you're in outpatient. While a medical referral is always best, there's nothing wrong with treating basic problems within your comfort zone. Some psychiatrists in underserved areas treat even more, since they're often the only doctor patients see at all. Just ensure that you give proper referrals when conditions are more difficult to treat, or are resistant to your treatment.

On my rotation now, we speak of medical issues a great deal with a surprising degree of complexity. I don't know if I could get by without a strong medical background. As I said in another post some time ago...it's not even about treating the medical condition, but having that red flag pop up in your head when you see or examine a patient; a flashback to medical school classes speaking of a rare disease, or a strange presentation, or a similarity to something you saw on your rheum or nephro elective. It's invaluable.

 

[Milo]

Speaking very generally, primary care docs are not overly keen on particpating in the medical care of many of the patients I see as a psychiatric resident.

Would I prefer to see their metabolic syndromes, strep throats and lower back pain managed by a pcp? Hell ya.

Am I going to defer primary care to my patients (when it is largely unavailable to them) for fear of the liability involved in practicing outside of my specialty? Nope.

 

[Poety]

We manage problems such as htn, dm, cellulitis, and various minor infections all the time. It's required of you in inpatient psych, and is not beyond the scope of your training when you're in outpatient. While a medical referral is always best, there's nothing wrong with treating basic problems within your comfort zone. Some psychiatrists in underserved areas treat even more, since they're often the only doctor patients see at all. Just ensure that you give proper referrals when conditions are more difficult to treat, or are resistant to your treatment.

On my rotation now, we speak of medical issues a great deal with a surprising degree of complexity. I don't know if I could get by without a strong medical background. As I said in another post some time ago...it's not even about treating the medical condition, but having that red flag pop up in your head when you see or examine a patient; a flashback to medical school classes speaking of a rare disease, or a strange presentation, or a similarity to something you saw on your rheum or nephro elective. It's invaluable.

YEAH SAZI! This is just the issue that was addressed (and quite well) on my interview today - 🙂

 

[certified]

Thanks for the info guys.

 

[cleareyedguy]

The average outpatient practitioner in big cities does absolutely no medicine. They should be conversant with diseases (at least pronounce them correctly), but they refer all issues related to hypertension, rashes, etc, to internists.

If you do c-l or inpatient work, medicine is important since you'll at least want to know how to triage.

The biggest aspect of medicine that you learn is, however, responsibility for patients, rather than content. And that's why psychiatrists will always be better at dealing with severe mental illness than psychologists, for whom patient responsibility is less of a core issue.