Why a bad reputation for psych's?

[sistermike]

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Hey im curious. Why do psychiatrist have a bad reputation? Everyone I've really talked to tell me that in the hospital enviornment psychiatrists and the other doctors don't get along.. why? I mean psychiatrists went through the same amount of school as everyone else and did 3 or 4 years of residency, so why the bad wrap for em all? I was thinking of psychiatry.. but ah im going for OB-GYN.

 

[bigfrank]

I think the stigma that surround psychiatry is the same stigma that has plagued the mental health field for years. Anyone who has ever worked for any period of time on an inpatient psychiatric unit will have NO doubt that there are indeed individuals that have mental illness.

I was recently told (by a FP resident) that the only prerequisite involving psychiatry is that one "can't speak English." While this is obviously an idiotic comment, this is exemplary about the pervasive view that many hold towards the psychiatric field.

Personally, I believe the field is extremely rewarding (after speaking to many psychiatrists) while affording one a decent salary and fantastic lifestyle. For example, the medical director of the adult inpatient psychiatric unit where I used to work easily made over $200K/year. I worked the evening shift mostly and never saw him after 4:00pm. He was at home coaching his children's sports.

 

[ckent]

Many psychiatrists suffer from the same disorders their patients suffer from, that's why they chose the field in the first place (these make the poorest psychiatrists too in my opinion). A lot of psychiatry is subjective, the DSM can be pretty random in coming up with diagnoses, so a lot of physicians don't see psychiatrists as knowing what they are doing because patients come in and have different diagnosis with different psychiatrists. A lot of psychiatrists these days are just pill pushers anyways, the real psych work is done by psychologists and social workers. There's that joke around the hospital too that psychiatrists "know nothing and can do nothing". Of course a lot of people say the same thing about FPs too, how they are supposed to be "Jack of all trades" but in reality "expert in none". Go into whatever field you enjoy, there are always people out there that will look down upon your field, even if you are neurosurgeon or any other field. Oh, and another reason why they are not well "respected" is because they don't get paid that much, therefore it's not too difficult to get into their residency program. If you look at the most competetive residency programs, they are always the highest paying ones too. Making a lot of money commands respect in some people's eyes.

 

[KyGrlDr2B]

I don't understand the stigma. Anyone who has ever been depressed realizes how important mental health professionals are. And that's just for depression; add in schizophrenia and everything else and you realize that these people are crucial.

 

[halothane]

well I respect psychiatry. I feel that a good med student who goes into psychiatry has a lot to offer and has in a way made a sacrifice by not going in to say a more respected or lucrative field. Similar to a good student who becomes a school teacher...they give up a lot in terms of monetary compensation. Now what may be giving the feild a low reputation is the fact that it also becomes a haven for people who say do not make it other to specialities...psychiatry being one of the least competitive specialities. Same for school teacher if one becomes a teacher because say he could not get a job with his degree elsewhere then he is a bad teacher as he has not gone into it for the love of it. Money I guess is at the bottom of it all. Psychiatry being one of the lowest paid and the added stigma of being a shrink....and the way media has portrayed shrinks to be eccentric adds to it. If say psychiatry was like radio where one could make 400K + it would have been hot inspite of the stigma.

 

[Kirk]

•••quote:•••Originally posted by Mr. Burns:
•Many psychiatrists suffer from the same disorders their patients suffer from, that's why they chose the field in the first place (these make the poorest psychiatrists too in my opinion).•••••The stigma probably comes from *****s like this spewing their trash.

 

[ckent]

•••quote:•••Originally posted by Kirk:
• •••quote:•••Originally posted by Mr. Burns:
•Many psychiatrists suffer from the same disorders their patients suffer from, that's why they chose the field in the first place (these make the poorest psychiatrists too in my opinion).•••••The stigma probably comes from *****s like this spewing their trash.•••••Believe whatever you want, but I've read and seen a lot of anecdotal evidence that backs up my "trash". I just did a quick internet search for some studies to back me up, but I couldn't find any. I am sure such studies exist though.

 

[bobo]

Wow, anecdotal stories PLUS no evidence of studies you are "sure" exist. Pretty powerful argument.

 

[PainMan]

sounds awfully schizophrenic to me.....

 

[ckent]

•••quote:•••Originally posted by bobo:
•Wow, anecdotal stories PLUS no evidence of studies you are "sure" exist. Pretty powerful argument.•••••🙄

Alright, I didn't say all psychiatrists suffer from the same mental illnesses that their patients have. The original poster was asking why there is a bad reputation for psychiatrists, and I was just stating what I had heard and read. I have read cases of other physicians stating as much, so it is believed by some physicians that many psychiatrists are mentally ill, but I will admit that I do not know for sure if the prevalence of mental illness is higher for psychiatrists then for other specialties. I do vaguely remember seeing a study that stated as much, but if any of you try typing in "psychiatrists" and "mentally ill" into any search engine, you will see how difficult it is to find such a study using an internet or medical search engine. It is a fact that the prevalence of mental illness in physicians and medical students on a whole is higher then the general population, this I do remember reading in an AMSA newsletter. There's nothing wrong with having a mental illness, many people with mental illness can be treated sucessfully with medication and be fully functional physicians. Besides psychiatrists, I do know of many physicians who have picked their specialty based on whatever illness he or she might have (based on anecdotal evidence again, I've seen many cardiologists with heart problems, many psychiatrists with psychiatric problems, many GI docs with GI problems). I do happen to believe that psychiatry is a particular sensitive field to biasness though, and for reasons I don't really care to explain I still believe that there is the risk of psychiatrists who become psychiatrists because they have mental problems to not be as competetent as some of their colleagues in my opinion. I don't mean to imply I think that's the case universally, and I don't mean to offend anyone with that opinion, but that is again, just my opinion.

 

[Sheerstress]

One mental health professional who suffers from bipolar disorder is Kay Redfield Jamison, a clinical psychologist on the psychiatry faculty at Johns Hopkins. She's written about the illness on both a professional and personal level.

 

[Sheerstress]

Getting back to the original question, I think the reason that psychiatry in general has been looked down upon for so long is because relatively little (still) is known about the pathophysiology of the brain, and people have long been suspicious of the way psychiatry was done for so many years.

In the areas of pathophysiology and etiology, psychiatry still lags far behind the rest of medicine, despite advances. For a long time, the field was dominated by individuals such as Freud, and psychoanalysis was the method of choice for many mental health disorders. That, of course, has largely changed - the field now aknowleges that most of the severe illnesses (e.g. schizophrenia, bipolar disorder) substantially involve biological processes, and that issues such as "bad parenting" (for lack of a better term) may play a minimal role in these illnesses.

I find it painful to imagine someone with schizophrenia simply being treated by daily "talk" sessions for years, and being told that his or her illness was the fault of them or their parents. In her biography, Katherine Graham describes how her husband, a world-renowned journalist-publisher, and presidential advisor to JFK, developed bipolar disorder as an adult, and was repeatedly hospitalized until he committed suicide. This was all before the advent of lithium in the US and most other psychotropic medications. Nowadays, not treating those illnesses with meds would be considered malpractice. It doesn't surprise me that people don't always trust psychiatrists.

 

[vhl]

I think psychiatrists are actually paid pretty well compared to primary care docs. I was told that a child and adolescent psychiatrist makes twice as much as a pediatrician, with a much easier lifestyle. That may be an overstatement (it was from a pediatrician!), but the average base salary is higher than the average.

 

[JMD]

Just to lighten up the forum a bit...I think everyone who chooses to take part in the med school admissions process and subjects themselves to years of medical education must have a couple of screws loose. But hey, I'm doing it anyway.

I don't have time to write much now, but I agree with some of the previous posts regarding the fact that the brain is still somewhat of an "uncharted territory" compared to other systems. Psychiatry/science in general has only recently started to discover the biological basis for many mental disorders. I don't think psychiatrists should be respected less because they're treatment options are not as extensive as in some other specialties.

 

[windsurfr]

Keep in mind what you see on the floors during your clinical years of med school is not an real representation of psychiatry. The individuals who actually "make it" to inpatient psych are either extremely chronic, med resistant, drug addicts, or axis 2 patients who are dependant on the system. Even in "acute" crisis inpatient centers this is the case. Most of the psychiatrists who contract through our inpatient units have private outpatient practices, however inpatient psych can be very lucrative.

 

[ApacheIndian]

•••quote:•••Originally posted by Mr. Burns:
•There's that joke around the hospital too that psychiatrists "know nothing and can do nothing" •••••Actually, the joke goes like this...

Neurosurgeons know nothing but do everything.
Neurologists know everything but do nothing.
Psychiatrists know nothing and do nothing.

I've also read of Neurosurgeons' and Neurologists' knowledge of the nervous system being analogous to a mechanic's vs. an automotive engineer's knowledge of a car engine respectively. I'm inferring that this can be extrapolated to compare Gen Surgeons vs. Gastroenterologists, Heart Surgeons vs. Cardiologists, etc. Off the topic a little, but I found all this interesting anyway...

 

[ApacheIndian]

•••quote:•••Originally posted by momoftwo:
•I was told that a child and adolescent psychiatrist makes twice as much as a pediatrician, .•••••2 x zero is still zero :wink: .

 

[ApacheIndian]

For anyone interested in this thread and in Psychiatry in general, I highly recommend Samuel Shem's "Mount Misery." It's the sequel to his infamous "House of God" (if you haven't read it, you should). Both make for entertaining and eye-opening reading.

 

[halothane]

It is truly sad that people look upon those who are entrusted with the mental health of society in such a demeaning manner. Its even more sad that other physicians look at them that way too. Actually some of the brightest guys I went to school with went into Psychiatry. They did have a kind of eccentric thing about their personality...nevertheless they were brilliant. I always thought it was stupid as to how other docs thought shrinks were a lil "odd" but when I went to med school and met up with a few of them I did find them to be a little different like for Eg. my professor of Psychiatry had a tendency to laugh a lot at his own jokes even if he was the only one who found them funny. Then I also found them to be very liberal in prescribing drugs...even if the problem was trivial and of course they tend overanalyse and kinda think that they can read your mind 🙂 Still whether we students felt they were strange because we already had preconceived notions I would not be able to tell. All said and done they play a very important role and we ought to give them credit for the service they do. Laymen making fun of shrinks is exculsable they make jokes about all docs. But as physicians I think its kinda high time we tried to stop laughing at them.

 

[nilblue]

I presume, the 'looking down' of psych people is partly responsible on them as they have allowed it to happen to their speciality, diluting their doc image. Even in these days, a lot of laypeople doesn't understand the difference between a psychiatrist and psychologist.
The identity problem stems from a lot of interaction with the non-med people(psychologists/sociologists etc), who perhaps get more importance than in any other medical speciality, making it more amorphous than anyother speciality.
Thankfully, with strong evidence of biological linking and trying to explain the emotions in biological terms have made life more easy for average med student in understanding principles of psych.
Opinions welcome.

 

[bold and beautiful]

•••quote:••• 2xzero is still zero ••••I don't know about psychiatrists in general. But One of my very close relative is a psychitarist making 400+ a year! Believe it or not. I know it because I worked at her office for a while and was in touch of billing etc

 

[Treybird]

Greetings. I am very interested in forensic psych. My interest would be in profiling and serial murder investigations. Does anybody have any thoughts on this field? I'm not in this room often so if you have any thoughts, or experience, in this field, please e-mail me at [email protected]
Thanks.

 

[Sanman]

hey treybird,
I wouldn't go into forensic psych for that, there are VERY few positions in what you are interested in. By very few,I mean that the FBI has three full-time criminal profilers and they're about the only full-time ones in the country.Check out the link below for more info

<a href="http://flash.lakeheadu.ca/~pals/forensics/forensic.htm" target="_blank">http://flash.lakeheadu.ca/~pals/forensics/forensic.htm</a>

 

[Sheerstress]

Treybird:

A great book that illuminates forensic psychiatry and its worst pathology is "Bad Men do What Good Men Dream" by Robert I. Simon, MD. Check it out if you get the chance.

You can also check out the following links:

<a href="http://faculty.ncwc.edu/toconnor/401/401links.htm" target="_blank">http://faculty.ncwc.edu/toconnor/401/401links.htm</a>

Sheerstress

 

[Treybird]

Thanks for the advice and I will check out those web sites. Have you guys ever read any books by Roy Hazelwood or John Douglass (Mindhunter, The Anatomy of Motive, etc.)? They started the Behavorial Sciences Unit in the FBI. Great stuff. Thanks again.

TB

 

[acurarte]

S. Feud - A neurotic cocaine and tobacco addict with an oedipus complex. The father of modern psychiatry.

Perhaps you can't heal what you haven't suffered in psychiatry?

God bless psychiatrists and more power to them!