All physicians have completed a great deal of training. I am a physician, but I do not treat ear pain, sprained ankles, for example as I would refer the patient to the correct physician. Why are primary care physicians and pediatricians backed into a corner in terms of treating mental illness? In medical school, there is usually only a 4 to 8 week rotation in psychiatry, with minimal training in residency as well.
People say there is a shortage of psychiatrists, however, there is a shortage with many specialties, including endocrinology, orthopedic surgery, and more. People wait for these other specialists, and get appropriate care. Why take on the most complex organ, the human brain, and try to treat mental illness when primary care has minimal psychiatry training? Then primary care physicians continue to try to treat and manage psychiatric illnesses, without having the patient get to a psychiatrist at all?
Psychiatrists have 3 years of residency training in just psychiatry and psychology. I have 2 Board Certifications and am an expert speaker for National Alliance on Mental Illness in Lake County, Illinois. I helped train psychiatrists for the rigorous Board Certification exam. Based on my experiences throughout the country, I have found that what we need is more communication and collaboration, not more prescriptions. Patients come in with myriad complaints and expect their primary care physician to treat them all. I feel for you. I know there is pressure to prescribe and in some cases only 7 minutes is allowed to evaluate and treat all of a patient’s complaints. But not every ailment requires a medication intervention. This is a surefire way to increase complications and overall healthcare costs.
I don’t try to evaluate things outside of my scope of knowledge. We all need to build better boundaries, and patients need to be seen by a psychiatrist when they are complaining of mental illness symptoms. Psychiatrists are trained to evaluate patients, and some even do therapy! We are certainly trained in therapeutic techniques as 3 years of residency is a long time. Many psychiatrists can follow up with patients on a regular basis, and we only focus on mental health complaints. We have time to get to know patients on a biopsychosocial level, the way things should be.
Additionally, there are many drug seekers out there of controlled substance medication, and with stimulants and benzodiazepines, physicians are getting in trouble for overprescribing those as well. I take a great deal of time in my practice to evaluate patients and get to the core of what is going on with the patient. People need to learn appropriate coping skills and be on the correct medication, if they need any at all. Creating addictions is not something physicians want to do, but it can happen. Many times once the doses get out of control, then physicians refer to a psychiatrist. Remember, psychiatrists are physicians first and have the majority of the same training other physicians do, have passed all the same rigorous United States Medical Licensing Exams and completed medical school right next to you. We order lab tests and can focus the treatments.
Please be sure to refer patients to psychiatrists, for optimal patient case, and to decrease iatrogenic illness.