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Some people have religious and/or ethical problem with psychaitrists. Scientologists come to mind.
To answer the questions it would be almost impossible to practice EM and refuse to work with any one specialty. You would be unable to see any patients who need that specialty and so would have to dump those patients on your colleagues which would be totally unfair and make you not worth it. You also would not be able to work single coverage which makes you even less worth while as an EP. You really can't be a viable EP an treat all CMS patients for free. I don't know of any group, hospital or position in the whole field that would take someone who can't/won't see CMS patients. Pair that with the psych thing and there's no place out there for someone with those issues.
I can't imagine anything from a hospital down to a doc-in-a-box that would be willing to hire someone that refuses to accept payments from what's usually a reasonable chunk of their patentbase.I was speaking of refusing CMS payments, not refusing the patients.
Wow, what a bizarre post.
Dude starts an account in 2006, but doesn't post anything until yesterday when he goes and starts flipping out in the psych forum for no reason, then comes here and posts this.
Wonder what happened in his life recently?
Oh the fantastic stories behind the scenes at SDN.
I don't think that there's any good discussion that can come from this guy's question. He was clearly a troll. At the risk of avoiding the profanity filter when your rebuttal to a statment is to call someone a "f--ktard" you've demonstrated conclusively that you are a troll and you have nothing useful to add. I answered him early on before he declared himself but I wouldn't do it again. Anyone who's interested in issues related to psychaitry can amble on over to the psych forum.Working with psychiatrists isn't very hard. I know I 'm simplifying the matter hugely, but usually, if someone comes into the ER with depression and they say the S word, I call psychiatry for admission.
At my main campus, the psych resident comes down and admits them, or rarely, discharges them home after arranging follow-up. At a small private hospital, a social worker or psychiatric case worker comes down and decides the disposition while communicating by phone to a psychiatrist. Compared to other specialties (lets face it, about 1/3 of doctors are complete buttholes), psychiatrists are very nice and helpful people (On a personal level, and from the standpoint of patient care, as well as from a "Help me get this person out of my ER" standpoint). I do think that SSRIs are over prescribed, especially in children. I think there is a big problem with a short staffing of psychiatrists, which leads to less time spent doing cognitive therapy.
I remember on my psych rotations in med school, listening to people describe their lives and what they do on a daily basis. I'd think in my head, "You are fat, ugly, unemployed and treat other people rudely, and as a result, no one wants to be your friend. Of course you are depressed." Some attending psychiatrists would listen to them briefly and adjust their medication and send them on their way, not commenting on anything that the patient needed to change about their lives. On occasion, they would refer them to group therapy sessions that were conducted by psychologists. I'm sure they would all love to spend as much time as Freud did back in the day, analysing people and delving into every aspect of their life until the person finds out how to help themselves, but that would mean they would see about 2 patients per day. Like in all specialties, there are great psychiatrists who accomplish much good, and there are others who kind of go through the motions.
Not only are they extremely useful people to help you with suicidal patients, they are really good at reducing symptoms of psychosis. People can really get wacked out when they go off there medications and they have severe psychophrenia. They run a lot of great programs that keep people from being dangerous like depot shots for out-patient schizophrenics.
I would like some additional info about your exposure to psychiatry, and why you think they are such bad people. I really think we could generate some good discussion if you talked about why you think psychiatrists shouldn't exist and backed it up with some evidence, whether it be from personal experience, rumor-mill, or evidence-based literature.
Maybe he'll explain himself if we start cussing at him. Should we make fun of his mom?
I was pretty amazed at how the people in the psychiatry forum continued to take the high road in dealing with that guy for almost the entire thread. Of course it only seemed to make the troll dude more angry...