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Discussion in 'Psychiatry' started by OldPsychDoc, May 9, 2007.

  1. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
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    So I get this glossy brochure for a CME event from an "Amen Clinic" in CA. They want to train us all to set up SPECT scanners in our offices and routinely scan our patient's brains for diagnostic purposes. You know, so we can show our patients a pretty picture and say "You know how you were saying that you're impulsive? Well here it shows <OMG!> your frontal lobes are ---hypoactive!:eek: "

    So what do you think? Is a scan going to tell you anything you don't already know? Is seeing a picture going to change your patient's mind about their condition? Or is this just a way to enhance one's revenue stream?
     
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  3. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty
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    ....theirs or yours?

    -t
     
  4. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
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    Ours. (Assuming we were to get into this business.)
    From the looks of the website, Dr. Amen's is already pretty well enhanced.

    Which raises the question: who is paying for this?
     
  5. BrianUM

    BrianUM Future M.D
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    If Psychiatry ever becomes neuropsychiatry (more emphasis on eeg, imaging, etc), sign me up...i have heard hearsay that the current movement in psychiatry is to move to neuropsychiatry and there are fellowship opportunities in neuropsychiatry...until then...possibly neurology for me.

    Does anyone know if psychiatry will ever move more towards being like Neurology or IM subspecialties with tests and procedures done in a private practice. I doubt someone with general depression would be willing to sit on a bed and get examined rather than sitting in an office for psychotherapy.
     
  6. Demosthenes

    Demosthenes Member
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    I dunno 'bout that...

    In my experience, an awful lot of people with depression would much rather be told that there's something wrong in their brain, and taking a little pill every day will fix it up just fine. Apparently therapy just isn't necessary, since it's all neurochemistry -- right?

    It's an interesting question, though. I look forward to seeing what turns up in the next decade or so -- I've always thought 296.xx would turn out to be a constellation of different disease states, with similar symptoms, rather than a single entity. It'll be interesting to find out if there's anything to support that.
     
  7. Anasazi23

    Anasazi23 Your Digital Ruler
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    Just today I had a patient tell me that they were interested in seeing this Dr. for a faster cure (some say 1-5 session acc'd to the patient): Apparently it's $500 per intake.

    http://www.kuhncenter.com/

    Opinions?
     
  8. BrianUM

    BrianUM Future M.D
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    sounds really interesting.

    Looking at his CV: http://www.kuhncenter.com/pdf/cv.pdf

    he had a psych residency and an eeg, biofeedback fellowship. The question I have is are insurance companies really going to reimburse for these kind of procedures if a patient isnt paying cash?

    Pending my interests not changing, I am going to look into Neurology w/ Behavioral Neurology and Neuropsychiatry fellowship. Of course, if Psychiatry moves to a paradigm in which there is more objective, Neuropsychiatric testing being done, I may just go Psych instead. Either way the idea of serving this kind of pt pop appeals to me. My mom is a psychologist and my major in college was Psychology so I feel like its always been a part of my life. It would be cool for if one day my mom would give psychotherapy to pts and for pts to come to me for med management and a spect scan, biofeedback, etc. Lets just see how things work out.
     
  9. Doc Samson

    Doc Samson gamma irradiated
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    When I was a resident we had a pt who had moved from the West Coast (Oregon, I think?) show up for an intake carrying one of these (they are quite pretty - much prettier than the typical SPECT image). We all had a good laugh over it - "chief complaint: "My brain is too purple" - but in terms of having any real contribution to diagnosis in general outpatient practice, I don't think it bakes any bread.
     
  10. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
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    I call this the "Tricorder Fallacy"--at least once a month a patient comes for an intake, I take the detailed history, and they ask "but aren't you going to 'run some tests'? Could I have a 'chemical imbalance'? Don't you check a brain scan or something?" (Tempting to send them for a CSF 5HIAA sometimes...)

    I just think that these places raise unrealistic expectations.
     
  11. MBK2003

    MBK2003 Senior Member
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    (Sarcastically) This is awesome, our clinic intake wait list could drop to under 3 months if this is really true, then maybe I'll be able to get our patients on the C/L service a follow-up appointment with psychiatry less than 3 months after they're discharged.

    MBK2003
     

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