0

The first psychiatric office I rented had two mildly to moderately comfortable chairs in the center, facing in the same direction. We all know that psychiatry started with the patient lying on a couch, staring at the ceiling, and remains that way in “New Yorker” cartoons.  Those of us in the know, we know that Freud was actually a pretty shy guy, not liking to stare his patients in the face, but rather letting their subconsciouses roam freely while staring at the ceiling.

We also know that the subconscious is a scary entity, full of (imagined) murder and rape and pillaging and such. The ideal when I trained was to sit face-to-face across a desk from the patient.  Nobody I know actually did that.  The reality slipped into 90 to 120-degree angles, exactly like what the classical psychiatrist Harry Stack Sullivan recommended. Read more on High Tech-High Touch Psychiatry…

Filed under News, Psychiatrists by on . Comment#

0

Blue Cross of Georgia does not always want to pay for people’s visits to the emergency room. The question, clearly is what they pay for and what they do not. To a certain extent, there are alternatives now that folks saw rarely if at all in the past.

Alternatives like urgent care.  In the trade we call it a “doc in a box.”  Long waits are not uncommon — it is generally one doctor present at a time, with many nurses and technicians who have enough time to at least have an authentic — if brief — interpersonal relationship with the patient. Sometimes people get wheeled into such places. By definition, patients are usually ambulatory in a “walk-in clinic.” I have worked in such places that specialized in psychiatry, where you could see pretty much anything, although prescription refills were clearly dominant. Read more on Avoiding Emergencies In Georgia…

Filed under Doctors, Government, News by on . Comment#

0

I value those behind-the-scenes programs on TV, especially when they warn you of dangers that you may never know. Here is a little behind-the-scenes story that you will really want to read because it might involve you! One of my chief interests in making sure patients are not only treated properly but that all the safeguards and protections are observed.

Read more on Informed Consents Are Often Skipped…

0

By now I think folks on the business management level of health care are at least aware that we Americans spend a lot of money on health care and seem to get very little in return. The author of a provocative piece in Forbes thinks “unnecessary health care” is our worst problem. This statement hit me broadside.  This does seem pretty true for the example she chose, even though it is decidedly outside of my field.

As far as I can figure, this sort of planned emergency delivery she talks about brings nothing to obstetric science or to the quality of human life whatsoever. Around the net, I see estimates of how much of what we do is actually science.  It usually comes out as about 50 or 60%; maybe a little over half. This is happening as part of what seems to be a massive drive towards EBM, known as “Evidence Based Medicine.”

Read more on Too Much Unnecessary Care…

0

Too many Americans can’t afford to and simply do not–take their medicines as prescribed. That estimate is based on information from the (American!) Centers for Disease Control). I have had patients come into my office who take their medications –in both cases, for life-threatening infectious diseases — only every other day, simply because that is all they can afford. I explained to each one individually the idea of the half-life of a drug. They only stay in your body for a certain length of time, then they leave your body in waste products.  That is why taking a drug every other day is not really effective. They both gave me almost exactly the same response — It was all they could afford, and it was probably better than nothing. Read more on Big Pharma Is Capitalism Out Of Control…

0

Chantix is a prescription smoking-cessation aid and has a lovely official website that will give you the information about the drug that the company that makes it provides for patients. This is the package insert a doctor is supposed to read before prescribing.  You will love paragraph 6, about neuropsychiatric side effects. Read more on Drug Companies HAVE To Tell You The Bad News…

Filed under News, prescription drugs by on . Comment#

0

It is only a dim memory for me. Sitting around the black and white television with my folks, watching Alfred Hitchcock walk into his profile, and say things to America in a snarky sort of tone that I could never have used with anybody. Strange, I don’t remember the content of she shows.  Not too surprising — I was only two years old when he came on the air. Read more on Was Alfred Hitchcock the best pharmaceutical rep ever?…

0

Okay, those lovable folks at Purdue Pharmaceutical decided to claim that Oxycontin, one of the favorite drugs at least of the street addicts I have seen and treated at an addiction center, is less “addictive” and less “abusable” than similar drugs.

Read more on Can’t They Sell Enough Oxycontin?…

0
If you were alive and in America in 1971, you probably heard John Denver sing “Take Me Home Country Roads.”

The lyrics start:

“Almost heaven, West Virginia…”

Read more on Almost Heaven West Virginia …

0

While I was training in psychiatry 30 years ago, the field was changing around me.  The older psychoanalysts were forced — reluctantly — to add prescription of psychotropics to their practices or else patients would never make it to their door. Of course, they had little to no training in pharmacology and less interest so they didn’t usually know what they were doing. While I was ascending in the ranks of psychiatric trainees, the best and the brightest of us were ushered into special training in pharmacology research.  I was (and probably still am) about as idealist and apolitical an up-and-coming psychiatrist that anyone could have invented. Read more on The Politics of Drug Development…