Originally posted by medcat3
I think that an illness like Fibromyalgia would definitely benefit from a FP/IM-Psych physician...but that's about it. I want to do Psychiatry, not primary care, and is why I chose a Psych only program. FP/IM-Psych combined residencies typically run 5 years. I've heard that UCSD has a great program. I personally do not see the benefit in doing a combined residency.
Neuro-Psych is somewhat of a different story. Neurologists and Psychiatrist that I speak to feel that the two fields will eventually meet up again in the future as we discover more about brain anatomy and how it relates to behavior.
There are hospitals moving toward a med/psych combined floor. Some studies quote that a high percentage of patients with chronic medical problems have psych illnesses (well, depression comes to mind immediately). Lot of psych patients also have dual diagnosis. Drug rehab definitely has a huge medicine component to it. Furthermore, some physical symptoms can be ambiguous. For example, recurring chest pain with shortness of breath...Is it medical (i.e. angina or hyperthroidism) or psychological (panic attack)?
Lastly, yes, some chronic medical patients who have psych issues are better managed by med-psych docs. In fact, primiary care docs don't want to be bothered by these patients and if possible, they will be more than happy to allow med-psych docs total control over these patients and hand off those "hot potatoes" away.
End-of-life terminal care is also an area where med-psych docs can make a difference. Many patients who give up treatments or consider euthanasia could very well be clinically depressed!!! I do not believe that most docs (be it oncologists or onc surgeons) have the capability to help patients in this type of situation.
This neuro-psych thing, however, bewilders me. I don't foresee any definitive "brain" causes behind personality d/o to be discovered any time soon. Furthermore, much of neurology does not overlap with psych: ex. various muscular disorders, parkinsons, huntingtons, etc. Psychiatrists also don't deal with strokes and lesions of the brain per se.
If you get someone waking up with paraplegia, you send them to neurologists right away (unless it is conversion d/o).
In contrast, a female in her 40's developing chest pain can very likely have either medical and psychological issues.
I just see more overlap between med and psych than between neuro and psych.