What's (What was) your motivation??

[titanz7]

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So i am very interested in the field of psychology, but I am pretty ambivalent about Ph.D or Psy.D in psychology because of their limited scope of practice in comparison to psychiatry (from my understanding, such as psychiatry's ability to Rx in addition to psychotherapy, just like Ph.D/PsyD)
I know there are lot more to it, but I just think I can help out more as a medical doctor than a doctor of philosophy. I'm also not sure about the research components of Ph.D/PsyD.
ahem anyways... what my main question is:
did you know that you always wanted to be a psychiatrist before going to medical school?
if yes, what kept you motivated to stick through four years of medical school that isn't really relevant to psychology??

 

[Bartelby]

I originally wanted to go into psychiatry, but for a while was on the fence about going into emergency or family medicine instead. Which is to say, actually enjoying the material and non-psychiatric medical interactions to some extent kept me going. Now that I am an intern it is clear to me how much more I enjoy my psych rotations, but I did not really hate learning and doing the rest.

A psychiatrist should really be a doctor first, ruling out medical illnesses that mimic psychopathology, knowing their toxicology cold, mastering psychopharmacology, and on top of all of that understanding how to talk with patients to both reach accurate diagnoses and incorporate therapy. If the only part of that that interests you is the talking with patients part then that's totally fine, and you will probably be happier doing the PhD or PsyD and getting to do what you most enjoy with all of your time. If you do want the "well rounded" scope of practice you will have to accept that a lot of general medicine training is part of that, with ongoing application especially in inpatient, consult liason, and med management.

 

[peppy]

Agree with Bartelby. As a psychiatry resident my identity is as a physician first and foremost. I enjoy general medicine and really enjoy the ways it applies to psychiatry, so that was enough for me to want to go through med school and internship. If you don't have any interest in general medicine, probably best to stick with psychology. Medicine is not just a job. It is truly a lifestyle. It's not worth it to go into it if you're not really interested in medical aspects of mental health.

 

[dl2dp2]

For a number of reasons, psychiatrists are primarily dealing with the "medical" aspects of mental health, and doing less therapy in general than other clinicians. You can still do *some* therapy if you want, but more than likely most of your work will be psychopharmacological management as an average psychiatrist in an average practice setting. This you need to keep in mind. If you sign up to do psychiatry you are signing up to be a doctor, and that means being organized, checking labs, doing the occasional BP checks, managing constipation and dry mouth, etc. The future of psychiatry is also moving more towards a more medical model, with pharmacogenomics, neuroimaging, biomarker development, measurement based care, etc.

I would encourage you to explore more by talking to professionals, especially younger professionals in all these different fields.

 

[surftheiop]

Only a second year medstudent, so my advice is obviously quite limited. But I think another thing to consider is why your interested in mental illness in the first place.

If your interest is primarily very intellectual and focuses on stuff bordering the philosophical (the mind, "what is a thought",etc.) then medicine (or even PsyD) is probably not the best path to follow. However if your interests are more focused on seeing pain/suffering in the world caused by illness and wanting to work with those people, then you will probably not have much trouble finding meaning in all the non-psychiatric material you learn in medical school. At least this has been my experience, I've enjoyed pre-clinical medical school way more than I expected going in.

 

[DoctorLion]

So I'm curious how you all are feeling about studying psychiatry... Do you love it? Hate it? Wish that you had gone for the Ph'D in psychology?

Also, what made you choose to study psychiatry over psychology?

 

[diagonal]

I don't think you'll find even a PhD in psychology who wish they did that over psychiatry, let alone a psychiatrist.

 

[Bartelby]

So I'm curious how you all are feeling about studying psychiatry... Do you love it? Hate it? Wish that you had gone for the Ph'D in psychology?

Also, what made you choose to study psychiatry over psychology?

As an intern, when I am on IM I burn out a bit. The hours just get to be a grind. On psych, generally I love it. I remember a professor saying she can't believe she gets paid to do what she does; I think I have the potential to get there one day!

Of course there are parts I don't like. I don't sitting there by myself on overnight call, and I like sitting out on the floor having every minor complaint brought to me even less. I hate coming in on a weekend day to do what amounts to a scutwork shift. I also am not a fan of how on many/most/all(?) rotations I work earlier than 9 and later than 5 making something as simple as going to the bank pretty logistically difficult (the grind of the hours and the lack of control of my life is pathetic that way). This, though, is intern year. Those factors will improve later; I will jettison the resident call at some point, I will gain the autonomy to (for example) schedule an afternoon off, I will get more control of my schedule in general and make far more money than I do now for it. Most importantly, even as an intern when I get to do real psychiatry, getting to know patients in a depth that very few other people in their life will while finding a way to make their lives better, I know the field has great long term potential for me personally.

 

[Bartelby]

And as for choosing the MD route over the PhD route (I was torn between these initially) there have been plenty of times I regretted it. In my first year of med school I was about 50/50 between dropping out and going on. The amount of work you put in and the inflexibility of your life in medical school and residency is pretty messed up at times, especially if you have family or other people/things you care about outside of medicine. Still, I really like psychiatry. I don't know that I would do it all again if I were a 22 y/o college grad again, but I don't regret my decision.

 

[BS81]

Personally I never even thought about a psych PhD. I wanted to go to medical school first, and I solidified my choice in psych afterwards. I would rather do IM or EM rather than a psych PhD.

 

[Leo Aquarius]

I love psychiatry for the deep relationships with patients. Never in any other service have I felt such strong patient-physician dynamics as I do in psychiatry. Based on my experience, I believe psychiatry shines above all other medical specialties in this regard.

It accounts for a large rewarding aspect of daily work, worth more than a higher paying tier, but that's just my preference. I'd rather be practicing as a therapist psychiatrist making $270,000 than an anesthesiologist making $370,000. There's more to life than money.

 

[DoctorLion]

I don't think you'll find even a PhD in psychology who wish they did that over psychiatry, let alone a psychiatrist.

I have heard a number of people make similar comments. Is money the real issue here? Obviously there is a salary difference of upwards of $150,000. I have always been of the opinion that people in Ph.D psych programs do so because they are more interested in the psychotherapy approach. Psychiatrists are less likely to conduct psychotherapy (and are finding it increasingly difficult to do so with time constraints etc.). It seems like the fields are vastly different because although Psychiatrists can conduct psychotherapy, they are often not able to, whereas psychologists are garunteed to be able to use this approach. This is the perception that I have arrived at through reading your responses. So one would assume that Psychiatrists become psychiatrists with the knowledge that they will primarily fill the role of medical doctor with a higher level of interpersonal interaction with the patient. Whereas clinical psychologists become psychologist in order to conduct psychotherapy. So it seems like there is a deeper underlying issue here that has nothing to do with whether or not you enjoy what it is that you're doing. $$$

 

[diagonal]

I have heard a number of people make similar comments. Is money the real issue here? Obviously there is a salary difference of upwards of $150,000. I have always been of the opinion that people in Ph.D psych programs do so because they are more interested in the psychotherapy approach. Psychiatrists are less likely to conduct psychotherapy (and are finding it increasingly difficult to do so with time constraints etc.). It seems like the fields are vastly different because although Psychiatrists can conduct psychotherapy, they are often not able to, whereas psychologists are garunteed to be able to use this approach. This is the perception that I have arrived at through reading your responses. So one would assume that Psychiatrists become psychiatrists with the knowledge that they will primarily fill the role of medical doctor with a higher level of interpersonal interaction with the patient. Whereas clinical psychologists become psychologist in order to conduct psychotherapy. So it seems like there is a deeper underlying issue here that has nothing to do with whether or not you enjoy what it is that you're doing. $$$

A psychiatrist conducting psychotherapy would make less than a med management machine, however they would still make more than a clinical psychologist. They would also have much better job security, and many more employment options. Furthermore, the opportunity to go cash-only and do whatever the hell you want to do is still a viable option as well.

And I'll just leave this here:

Adam Carolla does a great bit about how an alien comes down from some planet and wants to know why some people live in big safe houses and drive big safe cars, have hobbies that make them happy, can eat food that they like and can have medical/dental care, while so many others can not? A person then describes how the people who have all those nice things have figured out how to make a bunch of this stuff we call money, while the others couldn't get any of that green stuff. The alien logically decides that money is among the most important things on earth and decides that most of our education must be about how to obtain this green stuff. The person then explains how we don't talk about money or money management issues in school ever, and how if you pick a job just because of money you will be ostracized by others.

Money aint the most important thing, but it sure is a lot more important than most people would like to admit. Doctors too.

 

[michaelrack]

I have heard a number of people make similar comments. Is money the real issue here? Obviously there is a salary difference of upwards of $150,000. I have always been of the opinion that people in Ph.D psych programs do so because they are more interested in the psychotherapy approach. Psychiatrists are less likely to conduct psychotherapy (and are finding it increasingly difficult to do so with time constraints etc.). It seems like the fields are vastly different because although Psychiatrists can conduct psychotherapy, they are often not able to, whereas psychologists are garunteed to be able to use this approach. This is the perception that I have arrived at through reading your responses. So one would assume that Psychiatrists become psychiatrists with the knowledge that they will primarily fill the role of medical doctor with a higher level of interpersonal interaction with the patient. Whereas clinical psychologists become psychologist in order to conduct psychotherapy. So it seems like there is a deeper underlying issue here that has nothing to do with whether or not you enjoy what it is that you're doing. $$$

Psychologists aren't guaranteed to be good at psychotherapy. In addition to (or instead of) psychotherapy, there are other things that many psychologists do such as psychological testing- In fact, only a psychologist can do an MMPI (the company that holds the license will only sell to psychologists)

 

[JourneyAgent]

I had no inkling of psychiatry as my field of interest until I was assigned to take H&P's on all my ED attending's psych patients. And I agree with Leo Aquarius, the draw was getting to know patients as human beings on a much deeper level as being integral to doing your job well that got me hooked.

But I came to med school to be a doctor. And couldn't imagine doing so without this firm intention. I think psychopharm is fascinating and do not understand the criticism of it as a reductionist criticism of psychiatry as a whole, as if saying all we do is psychopharm is some kind of shameful thing. Diligent psychopharm and management of a patients health issues around their psychiatric complaint is sufficient for me to be excited about the field. Whatever I can pick up along the the lines of therapy technique would be awesome as well, but from what if can tell from reading here you have to push yourself with electives and such to be adequate at one or two therapeutic modalities. And that it can aid your medical treatment and inject it with more competence but hardly comprises the bulk of your work unless you set up a practice for rich people who can afford to get therapy from an md/do. Which is a small niche.

A few of my colleagues seemed to have always considered psych and come from psychology backgrounds, but overall we're a small minority in medical training and our exposure is limited in the curriculum, so having a higher number of psychology backgrounds is probably not informative, as to why one or the other.

Like my superiors, I just can't recommend the rigors of medical training, for anyone who doesn't want to be a doctor first. The training is set up to make you exactly that. You'll be in the anatomy tank breaking down a corpse into scraps, grinding it out for the steps, sucking it up on your other rotations for long hours, and being a general intern, before you even get close to touching psychotherapy.

 

[DoctorLion]

You'll be in the anatomy tank breaking down a corpse into scraps, grinding it out for the steps, sucking it up on your other rotations for long hours, and being a general intern, before you even get close to touching psychotherapy.

What??? :O

 

[JourneyAgent]

What??? :O

First year of medical school. You're first patient is a cadaver. You will begin to slowly cut, scrape, saw, and dissect your way through that body until there's nothing left of it. Soaked in the noxious fumes of formaldehyde for days on end as you approach your lab finals. You will catch babies, retract for surgeons, do pelvic and anal exams. The same thing every other budding surgeon or IM doc does before we all separate into our separate fields. The steps--1,2, and three--are our huge licensing exams that you have to conquer to proceed. That make sure you have the same knowledge base as all the other docs.

The point being, is that like it or not you'll be a doc. Not a therapist or a psychologist. I am proud of this fact. And am sacrificing to earn the difference. I have all the respect in the world for all the professions of health care, but being a doc is what I want for myself. You should too, if you go to med school, unequivocally so. Because there's no turning back without tremendous waste of effort and resources.

 

[toothless rufus]

Originally Posted by JourneyAgent View Post
You'll be in the anatomy tankbreaking down a corpse into scraps, grinding it out for the steps, sucking it up on your other rotations for long hours, and being a general intern, before you even get close to touching psychotherapy.What??? :O

He may have pictured turning a cadaver into the consistency of rock salt to melt snow.

 

[JourneyAgent]

He may have pictured turning a cadaver into the consistency of rock salt to melt snow.

I see. I cranked that metaphor to a distorted 11. Or just didn't catch Internet sarcasm. Anyway, I just could imagine 2 more different but superficially similar paths than psychology and psychiatry. Even if there is some eventual overlap. You've either been an M1,2,3,4..intern or you haven't. And without knowing the other side I'm sure it's the same from their point of view.

I really don't understand the general lay conception's ambiguity between these to career paths.

 

[DoctorLion]

I see. I cranked that metaphor to a distorted 11. Or just didn't catch Internet sarcasm. Anyway, I just could imagine 2 more different but superficially similar paths than psychology and psychiatry. Even if there is some eventual overlap. You've either been an M1,2,3,4..intern or you haven't. And without knowing the other side I'm sure it's the same from their point of view.

I really don't understand the general lay conception's ambiguity between these to career paths.

I would love to hear some of the cadaver horror stories from med school!!!

 

[JourneyAgent]

I would love to hear some of the cadaver horror stories from med school!!!

Not sure if you're being sarcastic. But it's not horror. It's just strange and mind blowing. And necessary for building familiarity with the human body. So that my physical exam is informed with 3-dimensional memory and imagination.

 

[diagonal]

Not sure if you're being sarcastic. But it's not horror. It's just strange and mind blowing. And necessary for building familiarity with the human body. So that my physical exam is informed with 3-dimensional memory and imagination.

oh boy

 

[BS81]

I love the smell of bone saw on skull in the morning

Sent from my DROID RAZR using SDN Mobile

 

[JourneyAgent]

oh boy

my bad. I re-read my post. It does sound like grinding up bodies for salting the steps.

I was too anxious to make the point about the difference in the training in a way that would penetrate the lack of experience of psychology premed.

Fail.

 

[surftheiop]

Anatomy lab is a complete non-issue, its probably the single most overhyped/dramatized thing in education.Its not some sort of emotional crucible like some people try to claim, its just another educational thing you do where your going to forget 90%+ of stuff you learn after the exam anyway.

 

[JourneyAgent]

Anatomy lab is a complete non-issue, its probably the single most overhyped/dramatized thing in education.Its not some sort of emotional crucible like some people try to claim, its just another educational thing you do where your going to forget 90%+ of stuff you learn after the exam anyway.

Even if I agreed with you, and I don't, entirely at least. The point is--whether what you take from it is intuitive, subjective, or completely pertinent to your career in surgery--that you have to spend a large amount of effort getting through it. As all the other steps to becoming a board certified physician, of which I implore you to select any of them, for the purpose of saying that ambiguity or a preference for a more psychological professional milieu would not be reason to investigate your doubts before embarking.

So that...one doesn't have to sit through anatomy, over-hyped drama, or not.

 

[Doctor Bagel]

Anatomy lab is a complete non-issue, its probably the single most overhyped/dramatized thing in education.Its not some sort of emotional crucible like some people try to claim, its just another educational thing you do where your going to forget 90%+ of stuff you learn after the exam anyway.

I've got to agree here. I have a hard time even remembering much about anatomy lab and not because it was too traumatic to remember -- it's just a relatively small part of my whole training experience that in the long run didn't make much of an impression. There are a lot of things in life that are harder than medical school. Heck, getting a psychology Ph.D. might be one of them -- I haven't done it, so I don't know.

As for being a physician first, I personally disagree somewhat here, too, in that I feel like such a different type of physician than all the other types of physicians and right now feel like my work is closer to a psychologist's work than to another type of physician's work (and I like it that way). I might take the physician aspects of my training somewhat for granted, though, in that I probably use them much more than I'm aware of. I don't envision having a primary psychopharm type of practice, though, even if that's supposedly what all the psychiatrists out there are doing.

 

[PikminOC]

I love psychiatry for the deep relationships with patients. Never in any other service have I felt such strong patient-physician dynamics as I do in psychiatry. Based on my experience, I believe psychiatry shines above all other medical specialties in this regard.

It accounts for a large rewarding aspect of daily work, worth more than a higher paying tier, but that's just my preference. I'd rather be practicing as a therapist psychiatrist making $270,000 than an anesthesiologist making $370,000. There's more to life than money.

As someone who really really looked into both fields, besides the patient relationship, the HOURS and PHYSICALITY of anesthesia were waaay too much for me. I like having time to think of differing treatments and having time to change medications and treatments in psychiatry.

 

[JourneyAgent]

I've got to agree here. I have a hard time even remembering much about anatomy lab and not because it was too traumatic to remember -- it's just a relatively small part of my whole training experience that in the long run didn't make much of an impression. There are a lot of things in life that are harder than medical school. Heck, getting a psychology Ph.D. might be one of them -- I haven't done it, so I don't know.

As for being a physician first, I personally disagree somewhat here, too, in that I feel like such a different type of physician than all the other types of physicians and right now feel like my work is closer to a psychologist's work than to another type of physician's work (and I like it that way). I might take the physician aspects of my training somewhat for granted, though, in that I probably use them much more than I'm aware of. I don't envision having a primary psychopharm type of practice, though, even if that's supposedly what all the psychiatrists out there are doing.

Well, I guess I can imagine feeling like this in some eventuality. Such as being an upper level resident like yourself. Step 3 fading into the rear view mirror. Psych specialty boards the last event horizon of your entire course of training in sight.

But the OP, if I understand their situation correctly hasn't even sat through chemistry, physics, or the MCAT.

I would suggest that if your recollection of anatomy lab or whathaveyou has collected proper dust--and it rightfully should--in your overall experience that that in itself is telling on just how long the training is. By the time you finish it the beginning is barely recognizable. More nostalgic than pertinent.

To the OP, I suggest that by the time you reenter your sphere of interest that might share the commonality of your current work, you will have forgotten the toils of so many days...that they will be faded memories.

It's not the import of anatomy to psychiatry that I'm making the case for.

Addendum: the only intent of my earlier nonsense was to bring the immediacy of all the hurdles to cross that are entirely un-psych related. And that it's not an adaptive strategy to surmounting all of them to be exclusively interested in psych. A knowledgable psychologist would laugh at the small amount of psych related topics I've been exposed to in the standard curriculum. It'd be like me trying to be a food critic having only eaten hot dogs my entire life. It's luck that I found my way through a bunch of medicine to find the field that interests me above all the others. But the fortune of getting to forget all of this is like a fairy tale compared to what I'm doing now, In the years past to get to now and in the foreseeable future--ie whatever lies on the other end of my next shelf exam.

 

[michaelrack]

I'd rather be practicing as a therapist psychiatrist making $270,000 than an anesthesiologist making $370,000. There's more to life than money.

It is hard for a psychiatrist doing primarily psychotherapy to make anywhere close to 270k, although the best (those with psychoanalytic training) practicing in NY city can make more than an anesthesiologist.

 

[pre med 2014]

I am a lover of liberty and rational thought, there is a social need for freedom loving psychiatrists which motivates me to consider the specialty.

Though I am not sure I could make it through all the nonsense that it takes to become an attending.

 

[surftheiop]

I am a lover of liberty and rational thought, there is a social need for freedom loving psychiatrists which motivates me to consider the specialty.

Though I am not sure I could make it through all the nonsense that it takes to become an attending.

could you tell me a little more about that...

 

[Leo Aquarius]

It is hard for a psychiatrist doing primarily psychotherapy to make anywhere close to 270k, although the best (those with psychoanalytic training) practicing in NY city can make more than an anesthesiologist.

I'd be happy with anything around $200,000 even. That's a ton in my eyes. I once earned $70,000 a year before med school and didn't know what to do with the few thousand dollars I had left over every month. I felt rich.

 

[BS81]

I'd be happy with anything around $200,000 even. That's a ton in my eyes. I once earned $70,000 a year before med school and didn't know what to do with the few thousand dollars I had left over every month. I felt rich.

Add mortgage, wife, kids, cars, retirement plan, etc.

 

[PikminOC]

So i am very interested in the field of psychology, but I am pretty ambivalent about Ph.D or Psy.D in psychology because of their limited scope of practice in comparison to psychiatry (from my understanding, such as psychiatry's ability to Rx in addition to psychotherapy, just like Ph.D/PsyD)
I know there are lot more to it, but I just think I can help out more as a medical doctor than a doctor of philosophy. I'm also not sure about the research components of Ph.D/PsyD.
ahem anyways... what my main question is:
did you know that you always wanted to be a psychiatrist before going to medical school?
if yes, what kept you motivated to stick through four years of medical school that isn't really relevant to psychology??

I did not know which field I was going into when I entered med school. I changed my mind several times.

What kept me motivated is all the different ways a doc can work: solo, hospital, group, locum, research, drug lectures etc. I felt and do feel there will always be a job available and I can pick and choose.

 

[pre med 2014]

could you tell me a little more about that...

Sure I can tell you more. I don't believe people should be deprived of liberty on the basis of questionable science. I have motivation as it would give me the opportunity to help people by confronting the socially damaging portions of psychiatry.

 

[Leo Aquarius]

Everyone, Pre Med 2014 is a troll who hates psychiatry. This person is pretending to be premed applying to psychiatry but is not. From his or her previous threads here are the quotes I found:

"This is completely normal, since psychiatry is an impersonation of medicine, not an actual field of science or medicine.

"Mental problems exist just like pretty sunsets exist. You can use science to determine the sunset is red, but if you say this sunset is pretty you can't falsify that it's pretty. That to me is the number one problem that has always plagued psychiatry and always will. Falsifiability is the hallmark test for a scientific theory.

"Psychiatry includes a great deal of implicit coercion as well as explicit. I don't know how they get away with the straightforward stuff. I think the implicit force is the truly evil portion of the field.

 

[splik]

I don't think he is a troll. He is obviously not the brightest spark in the world and has these adolescent libertarian ideals, which he doesn't realize are incompatible with the ethical practice of medicine and that coercion exists in all of medicine and unlike in psychiatry rarely gets commented on. But I think it is reasonable for people to have misgivings about psychiatry and have questions about the difficult ethical challenges in psychiatry. I got in trouble for refusing to compel an IM antipsychotic for a patient but I just couldn't ethically justify it and of course it makes you look bad because it's as if you're saying your attending is asking you to do something wrong so you're in this impossible possible. He is obviously incredibly naive and does not have the experience or analytic gaze to understand that many of these problems are much more complex than he realizes.

 

[pre med 2014]

Leo Aquariois

I def. don't hate psychiatry, I support voluntary engagement of a doctor patient relationship. In fact if I was against that I'd be just as bad as the involuntary proponents. (in fact one kind of involuntary psychiatry is forcing out conflicting opinions from other psychiatrists, thereby limiting voluntary engagement of psychiatric services)

I'm not satisfied with continuing a bad practice because it's more 'complicated'. I am very interested in just exactly what is the 'complication' that justifies bad psychiatry.

I know one complication is fear for being sued for not doing anything, which is why I'm against that kind of psych mal.

 

[michaelrack]

Leo Aquariois

I def. don't hate psychiatry, I support voluntary engagement of a doctor patient relationship. .

that attitude would make psych consults easy:
"Mr. X is a 25 y.o. male; the chart indicates a past history of schizophrenia. He appeares agitated and has reportedly been making homocidal threats toward his neighbor. He declines to engage with me. Thank you for requesting the consult, I have no recommendations to make."

 

[pre med 2014]

that attitude would make psych consults easy:
"Mr. X is a 25 y.o. male; the chart indicates a past history of schizophrenia. He appeares agitated and has reportedly been making homocidal threats toward his neighbor. He declines to engage with me. Thank you for requesting the consult, I have no recommendations to make."

Sure. Threatening harm is a crime, the police can arrest him.

 

[surftheiop]

Sure. Threatening harm is a crime, the police can arrest him.

wow, I've heard a lot of interesting arguments against pscyh, but "We really should be arresting and incarcerating more mentally ill people" has never been one of them. Especially shocking coming from someone using so much libertarian phrasing.

 

[pre med 2014]

wow, I've heard a lot of interesting arguments against pscyh, but "We really should be arresting and incarcerating more mentally ill people" has never been one of them. Especially shocking coming from someone using so much libertarian phrasing.

No you're being dishonest by phrasing it like that. People who really have schizophrenia benefit more when the diagnosis isn't abused. You can't just absolve someone from guilt because they saw a shrink once in the past, to have schizophrenia you have to hear voices or have visual hallucinations, threatening to kill your neighbor doesn't meet any of the criteria for schizophrenia.

And I don't support using it as a method to increase punishment, or as a punishment for non-criminal behavior. My ideas are actually much better for the mentally ill.

 

[pre med 2014]

it's always about freeing the guilty and punishing the innocent

 

[surftheiop]

it's always about freeing the guilty and punishing the innocent

Generally when people say things like this they are thinking of specific examples, which are you thinking of? Medical doctors certainly aren't infallible.

 

[michaelrack]

Sure. Threatening harm is a crime, the police can arrest him.

I'll give you that one.

Now what if the same schizophrenic (assume it is a valid diagnosis with history of well-documented auditory hallucinations) comes into the ER with a hand laceration. He tells the nurse it is from smashing his own mirror in an attempt to stop the voices, which are telling him to kill his neighbor. He tells the nurse he is trying really hard to resist the voices, but is not sure if he will be able. The ER doc calls you for a psych consult after suturing the laceration. The patient seems agitated but is alert and oriented (and is not making any threats) and declines to engage with you. Past history of violence is documented in the chart.

What do you do now??

 

[pre med 2014]

Well that's a good scenario but most times there's more to the story. I read a story about a local being treated for schizophrenia because he went into a hospital and said voices were telling him to hurt someone. Later he explained he said it to get access for treatment for another psychiatric condition. Yet even knowing this they kept drugging him and treating him on an obvious misdiagnosis.

I mean unless there was more to it, treating him for schizophrenia was totally irrational and inconsistent with logic. This is what I am against.

 

[Bartelby]

Well that's a good scenario but most times there's more to the story. I read a story about a local being treated for schizophrenia because he went into a hospital and said voices were telling him to hurt someone. Later he explained he said it to get access for treatment for another psychiatric condition. Yet even knowing this they kept drugging him and treating him on an obvious misdiagnosis.

You do realize that you didn't answer the question at all don't you? I would be much more interested in your response to michaelrack's question than in the straw man you just threw up.

As for your straw man... don't do that. Diagnose and treat appropriately, revise plans if needed. Problem solved.

 

[pre med 2014]

I'd tell them to take the criminal matter over to the police to handle. They can figure out why he wants to kill his neighbor

 

[OldPsychDoc]

I'd tell them to take the criminal matter over to the police to handle. They can figure out why he wants to kill his neighbor

In the meantime, he's psychotic and in a county holding cell.
Highly therapeutic environment, that...