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Focus (American Psychiatric Publishing) Oct 2019Medical practice acts and state medical boards have evolved since their conception in the mid-19th century. Today, state medical boards are usually responsible for a... (Review)
Review
Medical practice acts and state medical boards have evolved since their conception in the mid-19th century. Today, state medical boards are usually responsible for a variety of functions, with the main function being the detection and discipline of unprofessional and unethical conduct by physicians and other medical professionals. In this article, a brief history of medical licensing and regulation is first provided, with an overview of the structure and process of state medical boards, and how they vary across states. Next, common causes for medical board complaints are discussed, with a focus on complaints against psychiatrists. Last, the author provides general medical-legal considerations that a psychiatrist should contemplate if he or she is the subject of a medical board complaint.
PubMed: 32047378
DOI: 10.1176/appi.focus.20190020 -
The Indian Journal of Medical Research Apr 2015Organ transplantation has emerged as the saving grace for those who are suffering from end organ disease. Advent of modern surgical procedures and immunosuppressants... (Review)
Review
Organ transplantation has emerged as the saving grace for those who are suffering from end organ disease. Advent of modern surgical procedures and immunosuppressants further decrease morbidity and mortality. Meta-analyses have shown that post-organ transplantation quality of life improves for social, physical and daily activity functioning, but not consistently for psychological health. Psychiatrists can play a useful role not only in selecting the best suitable candidate for the procedure by psychosocial screening but also to tackle post-operation psychological issues that trouble patients as well as caretakers and decrease their quality of life. Issues like selection of patients with psychiatric disorders and substance abuse for transplantation process and their treatment both pre- and post- operation, risky health behaviours, treatment adherence for immunosuppressants and psychological support for caretakers can be better addressed by a psychiatrist who is sensitive towards these issues. Prescribing various psychotropics and immunosuppressants in the background of impaired organ function and drug-drug interaction is further challenging. Thus, psychiatrists need to be knowledgeable about these issues and should be an integral part of organ transplantation team for overall better outcome.
Topics: Humans; Immunosuppressive Agents; Organ Transplantation; Postoperative Period; Psychiatry; Quality of Life; Social Support; Substance-Related Disorders
PubMed: 26112841
DOI: 10.4103/0971-5916.159268 -
Tijdschrift Voor Psychiatrie 2023Language is the most important tool for every psychiatrist and psychotherapist. Metaphors can enhance the effect of language.
BACKGROUND
Language is the most important tool for every psychiatrist and psychotherapist. Metaphors can enhance the effect of language.
AIM
To stimulate reflection on the role of metaphors in psychiatric discourse.
METHOD
Discuss illustrative examples and some relevant studies.
RESULTS
Psychotherapeutic schools each have their own way of using metaphors. Many psychiatrists also like to use them. A successful metaphor refers to the main clinical problem in treatment, contains an element that the patient is still missing, and are adapted to the patient’s person.
CONCLUSION
A personalized application of metaphors works best. Well-chosen metaphors lead to recognition, inspiration and satisfaction for both patient and therapist.
Topics: Humans; Metaphor; Language
PubMed: 36951768
DOI: No ID Found -
Frontiers in Psychiatry 2013A disability assessment for non-therapeutic reasons is the most common evaluation requested of treating psychiatrists. Mental disorders affect approximately 20 percent...
A disability assessment for non-therapeutic reasons is the most common evaluation requested of treating psychiatrists. Mental disorders affect approximately 20 percent of Americans each year. People who are unable to work need some financial assistance. As part of the system, it's our goal to assist them in this process. When a disability claim is filed, psychiatrists take into account the individual's impairments and disabilities. A psychiatrist's evaluation of disability involves knowledge and experience. There are many ethics related challenges, especially when performing disability evaluation of their own patients. Disability training should therefore be part of residency curriculum for training of psychiatry residents.
PubMed: 23785336
DOI: 10.3389/fpsyt.2013.00054 -
Indian Journal of Psychological Medicine 2018Individuals associated with service providing and decision-taking are prone for stress leading to burnout.
BACKGROUND
Individuals associated with service providing and decision-taking are prone for stress leading to burnout.
AIM
The aim of this study is to find out the details of burnout among Psychiatrists in India.
MATERIALS AND METHODS
Copenhagen Burnout Inventory (CBI) with structured biodata sheet was sent to the representative sample of psychiatrists by e-mail. Basic statistical analysis was done to find out prevalence, analyze response pattern, and differences between those with and without burnout.
RESULTS
The number of psychiatrists that responded to survey was 110-81 (74%) male and 29 (26%) female. The number of burnout cases in one or other spheres was 51 in 35 psychiatrists accounting for the prevalence of 46%. 32% of psychiatrists have burnout. Four psychiatrists have burnout in all three dimensions, nine in two dimensions, and 22 in one dimension. Personal burnout topped in the three dimensions (63%) followed by work burnout (24%). Patient burnout was least at 14%.
CONCLUSIONS
Burnout, though not very high, is to be taken seriously by Indian psychiatrists and protective and preventive measures are in order.
PubMed: 29962572
DOI: 10.4103/IJPSYM.IJPSYM_265_17 -
Psychiatria Polska Jun 2017The paper sets out to recall the profile of Karol de Beaurain, a psychiatrist who belonged to the circle of first Poles who used psychoanalysis in treatment. So far, dr... (Review)
Review
The paper sets out to recall the profile of Karol de Beaurain, a psychiatrist who belonged to the circle of first Poles who used psychoanalysis in treatment. So far, dr Beaurain has been known from brief references in publications relating to the life and works of Stanisław Ignacy Witkiewicz (Witkacy) whose psychoanalytic sessions he conducted between 1912 and 1913. De Beaurain was born in 1867 and studied medicine at Swiss universities (Zurich, Berne, Geneva) where he defended his doctoral thesis as well. He was prepared for the career of a health resort physician and when he returned to Poland, he settled down in Poronin where except for working as a district physician, he also engaged in social and cultural activities. Around 1910 his professional interest shifted towards psychiatry and psychotherapy. In the final months of 1911 he relocated to Zakopane where he opened a private practice for "neu-rotic diseases". At the same time he started treating patients with the use of psychoanalytic methods. The first part of the paper concerns the life of doctor de Beaurain from birth and the period of studies and preparation for his professional career until the time when he started his psychoanalytic work.
Topics: History, 20th Century; Humans; Neurotic Disorders; Poland; Psychiatry; Psychoanalysis; Psychotherapy
PubMed: 28866724
DOI: 10.12740/PP/OnlineFirst/63473 -
Tijdschrift Voor Psychiatrie 2019The training curriculum of the psychiatrist needs to be reviewed. To determine the model of the future psychiatrist, the question of how the future psychiatry will look...
The training curriculum of the psychiatrist needs to be reviewed. To determine the model of the future psychiatrist, the question of how the future psychiatry will look needs to be answered first.
AIM: Assessment of relevant developments in psychiatry and the organisation of psychiatric care with the aim to propose a profile of the future psychiatrist.
METHOD: The recent history of psychiatry as a starting point for a vision of the future.
RESULTS: 1. Psychiatry must use an integrative anthropological theory, in order to be able to understand psychopathology in its essence. 2. Content-driven moral leadership is necessary to prevent psychiatry being tempted by hypes. 3. The tacit social contract between the medical profession and society is under pressure; both parties distrust each other and psychiatrists must regain trust and renew the contract. 4. Psychiatric care must remain affordable, which means a review of the current organisation of care; psychiatry will become network psychiatry. 5. Psychiatrists will work in a network of care providers and the patient will be in control. The psychiatrist will have a flexible role, ranging from managerial to supportive and advisory. Keeping psychotherapeutic skills up-to-date is an essential requirement. 6. Future training should focus on the sustainable employability of the psychiatrist as a human being, on knowledge of history of psychiatry and its socio-economic context, and policy and engagement; and on the skill of conceptual thinking (philosophy).
CONCLUSION: The profession of psychiatry needs a new job profile. The process of development and elaboration should contain the following core elements: broad education, conceptual skills, sensitivity for activism, social involvement, and expertise in treatment of patients with complex problems in diverse settings.Topics: Curriculum; Forecasting; Humans; Netherlands; Psychiatry
PubMed: 30896036
DOI: No ID Found -
CMAJ Open 2020Psychotherapy is recommended as a first-line treatment for the management of common psychiatric disorders. The objective of this study was to evaluate the availability...
BACKGROUND
Psychotherapy is recommended as a first-line treatment for the management of common psychiatric disorders. The objective of this study was to evaluate the availability of publicly funded psychotherapy provided by physicians in Ontario by describing primary care physicians (PCPs) and psychiatrists whose practices focus on psychotherapy and comparing them to PCPs and psychiatrists whose practices do not.
METHODS
This was a population-based retrospective cohort study. We included all PCPs and psychiatrists in Ontario who submitted at least 1 billing claim to the Ontario Health Insurance Plan between Apr. 1, 2015, and Mar. 31, 2016, and categorized them as psychotherapists if at least 50% of their outpatient billings were related to the provision of psychotherapy. We measured practice characteristics such as total number of patients and new patients, and average visit frequency for 4 physician categories: PCP nonpsychotherapists, PCP psychotherapists, psychiatrist nonpsychotherapists and psychiatrist psychotherapists. We also measured access to care for people with urgent need for mental health services.
RESULTS
Of 12 772 PCPs, 404 (3.2%) were PCP psychotherapists; of 2150 psychiatrists, 586 (27.3%) were psychotherapists. Primary care physician nonpsychotherapists had the highest number of patients and number of new patients, followed by psychiatrist nonpsychotherapists, PCP psychotherapists and psychiatrist psychotherapists. Primary care physician nonpsychotherapists had the lowest average annual number of visits per patient, whereas both types of psychotherapists had a much greater number of visits per patient. Primary care physician and psychiatrist nonpsychotherapists saw about 25% of patients with urgent needs for mental health services, whereas PCP and psychiatrist psychotherapists saw 1%-3% of these patients.
INTERPRETATION
Physicians who provide publicly funded psychotherapy in Ontario see a small number of patients, and they see few of those with urgent need for mental health services. Our findings suggest that improving access to psychotherapy will require the development of alternative strategies.
Topics: Adult; Aged; Female; Health Services Accessibility; Health Workforce; Humans; Male; Mental Disorders; Mental Health Services; Middle Aged; Ontario; Physicians; Population Surveillance; Practice Patterns, Physicians'; Psychiatry; Psychotherapy; Retrospective Studies
PubMed: 32161044
DOI: 10.9778/cmajo.20190094 -
International Journal of Environmental... Nov 2022Long-term use of benzodiazepine receptor agonists (BZDs) may depend on clinicians' BZD discontinuation strategies. We aimed to explore differences in strategies and...
Long-term use of benzodiazepine receptor agonists (BZDs) may depend on clinicians' BZD discontinuation strategies. We aimed to explore differences in strategies and difficulties with BZD discontinuation between psychiatrists and non-psychiatrists and to identify factors related to difficulties with BZD discontinuation. Japanese physicians affiliated with the Japan Primary Care Association, All Japan Hospital Association, and Japanese Association of Neuro-Psychiatric Clinics were surveyed on the following items: age group, specialty (psychiatric or otherwise), preferred time to start BZD reduction after improvement in symptoms, methods used to discontinue, difficulties regarding BZD discontinuation, and reasons for the difficulties. We obtained 962 responses from physicians (390 from non-psychiatrists and 572 from psychiatrists), of which 94.0% reported difficulty discontinuing BZDs. Non-psychiatrists had more difficulty with BZD discontinuation strategies, while psychiatrists had more difficulty with symptom recurrence/relapse and withdrawal symptoms. Psychiatrists used more candidate strategies in BZD reduction than non-psychiatrists but initiated BZD discontinuation after symptom improvement. Logistic regression analysis showed that psychosocial therapy was associated with less difficulty in BZD discontinuation (odds ratio, 0.438; 95% confidence interval, 0.204-0.942; = 0.035). Educating physicians about psychosocial therapy may alleviate physicians' difficulty in discontinuing BZDs and reduce long-term BZD prescriptions.
Topics: Humans; Benzodiazepines; Substance Withdrawal Syndrome; Physicians; Surveys and Questionnaires; Odds Ratio
PubMed: 36498061
DOI: 10.3390/ijerph192315990 -
Neurotherapeutics : the Journal of the... Jul 2017Since the late 1980s the psychoactive drug 3,4-methylenedioxymethamphetamine (MDMA) has had a well-known history as the recreationally used drug ecstasy. What is less... (Review)
Review
Since the late 1980s the psychoactive drug 3,4-methylenedioxymethamphetamine (MDMA) has had a well-known history as the recreationally used drug ecstasy. What is less well known by the public is that MDMA started its life as a therapeutic agent and that in recent years an increasing amount of clinical research has been undertaken to revisit the drug's medical potential. MDMA has unique pharmacological properties that translate well to its proposed agent to assist trauma-focused psychotherapy. Psychological trauma-especially that which arises early in life from child abuse-underpins many chronic adult mental disorders, including addictions. Several studies of recent years have investigated the potential role of MDMA-assisted psychotherapy as a treatment for post-traumatic stress disorder, with ongoing plans to see MDMA therapy licensed and approved within the next 5 years. Issues of safety and controversy frequently surround this research, owing to MDMA's often negative media-driven bias. However, accurate examination of the relative risks and benefits of clinical MDMA-in contrast to the recreational use of ecstasy-must be considered when assessing its potential benefits and the merits of future research. In this review, the author describes these potential benefits and explores the relatives risks of MDMA-assisted psychotherapy in the context of his experience as a child and adolescent psychiatrist, having seen the relative limitations of current pharmacotherapies and psychotherapies for treating complex post-traumatic stress disorder arising from child abuse.
Topics: Adolescent; Child; Child Abuse; Humans; N-Methyl-3,4-methylenedioxyamphetamine; Psychiatry; Serotonin Agents; Stress Disorders, Post-Traumatic
PubMed: 28477247
DOI: 10.1007/s13311-017-0531-1