Two years ago, psychiatrist Daniel Carlat wrote a piece in the New York Times Magazine called Dr. Drug Rep, in which he told his story of being paid to push the anti-depressant Effexor to his colleagues.
Carlat joins Fresh Air contributor Dave Davies today to talk about his new book, called Unhinged: The Trouble With Psychiatry. But the book isn't just concerned with the influence of drug companies in the profession.
Carlat believes in prescribing medication, but he says too many psychiatrists have all but abandoned talk therapy — leaving in-depth interaction with patients to others — while they pursue medical fixes for mood problems and mental disorders.
"Based on a survey of psychiatrists throughout the United States [conducted by Columbia University], it turns out only 11 percent of all psychiatrists now offer therapy to all of their patients," he explains. "So essentially, 1 out of 10 psychiatrists are really doing psychotherapy on a regular basis."
He says time and billing constraints have also made it difficult for psychiatrists to integrate in-depth sessions back into their practices.
"I have hundreds of patients. And if I start to do one-hour therapy sessions with most of my patients, I am going to have to kick patients out of my practice because I won't have time to see them," he says. "So it's been difficult and I've had to do creative things where I don't do one-hour therapy sessions, I might do 45-minute therapy sessions or half-hour therapy sessions so I can still fit a fair number of people into my practice while performing what I would consider a better quality of psychiatry."
Daniel Carlat was trained at Harvard and is on the faculty of the Tufts Medical School. He edits a monthly newsletter called the Carlat Psychiatry Report.
Tuesday, July 20, 2010
Fresh Air Interview: Psychiatrist Daniel Carlat - 'A Psychiatrist's Prescription For His Profession' : NPR
via npr.org
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2 comments:
It seems to be the case here in Houston too. Most people either can not afford the expense of the rates charged, especially when in 15-30 minute increments. Sure, if time permits a patient may get a few more minutes, but will be charged for two sessions.
There is only one psychiatrist in Houston I know of who practices psychiatry like I believe it was meant to be with actual talk therapy in conjunction with meds if needed. He does not do speaker programs, or wants lunches catered to office, and he has but a few published papers. He has too many patients that depend on him for therapy. He does not let the clock dictate how long he spends with a patient, so you can imagine he does not get out of the office until a couple of hours past normal hrs. He is a one of a kind, a real McCoy.
LaGrone is a psychiatrist more should emulate, because we need them!
American psychiatrists are intentionally taught to manage mental disorders for a patient's lifetime - not cure them. Patients are given a diagnosis that is only a description of the symptoms, then they are allowed to talk about their symptoms, and they are given synthetic drugs in an attempt to control their symptoms. But no where in this 3-step model of psychiatry is there any room to talk about what actually causes the symptoms. It's like having pneumonia and being diagnosed with "Bad Cough Disorder." You're never cured, you just have your illness managed for life.
When my family member became seriously depressed, then psychotic, ALL the psychiatrists claimed he would be mentally ill for life. Instead, I learned to use a real, medical model to find the biological causes and treated those, instead of just throwing drugs at the symptoms. Our family doc and naturopath ordered the right lab tests to find the biological causes, then I corrected his BIOchemistry with BIOchemicals. It's an awesome way to actually recover (or prevent) mental illnesses.
Today my family member works in a white collar job, 100% free of welfare, DSHS, idiot psychiatrists and their miserable drugs. That's real recovery. American psychiatrists are so clueless.
Our Current Regimen of American Psychiatry is just what its initials spell out: C.R.A.P.
Linda Santini at RestoreMyMind . com.
Author of The Secrets to Recovery from Mental Illness.
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