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Having patients on vents is different than managing vents. I certainly won't be adjusting them in a nursing home type patient, but the ER is a brisk drive away.
Psychiatrists taking primary care call?
- Thread starter nancysinatra
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Having patients on vents is different than managing vents. I certainly won't be adjusting them in a nursing home type patient, but the ER is a brisk drive away.
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This disucssion seems to highlight that alot of this is dependent on the individual practitioner's perceieved competence in general medicine. Why such huge variation in perceived competence, especially given the relatively standardized curriculum and training of medical school and the intern year? I have long noticed psychiatrists comfortale level with medicine has ranged from near incompetence to pretty fantasatic. Whats up with that?
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1) Because even though medical exams are extremely difficult, people who have made it that far in medical education are capable of cramming enough to pass them. The difference between picking "C" correctly several years ago and actually practicing clinical medicine is vast.
2) Some programs have intentionally light medicine rotations for people who really want to focus on psychiatry and others have almost a full intern year of medicine. Psychiatry has more variance from program-to-program than most medicine specalties.
3) People choose to keep up with what they keep up with. I don't read any general medical journals or articles but I read several psych only ones every month. Needless to say some medicine knowledge has atrophied despite still being a resident.
Most importantly, it's just about what you do day-to-day. I would not ask a psychologist who does 30 hours of CBT every week to explain to me the validity factors imbeded into the MMPI just like I would not ask a 100% outpatient psychiatrist who works in a large hospital system how to manage post-op erythema or what cream to put onto a vent.
in my experience there is often a negative correlation between how confident a psychiatrist is about their 'general medicine knowledge' and what they actually know/can safely do.
There isn't any question though that regardless of how 'good' one was for the few months of IM as an intern, if you're a long way past that your fund of knowledge in those areas is going to atrophy a good deal. And quite frankly it should. If one has a position that requires them to expend a lot of time managing general medical stuff or if one spends a lot of time 'keeping up with' general medicine stuff, I'd be worried about if they are making adequate progress in their actual career- which is practicing psychiatry.
