{"id":17880,"date":"2012-01-02T22:57:37","date_gmt":"2012-01-03T03:57:37","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=17880"},"modified":"2012-01-03T02:44:20","modified_gmt":"2012-01-03T07:44:20","slug":"managing-meds-living-their-lives","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2012\/01\/02\/managing-meds-living-their-lives\/","title":{"rendered":"managing meds, living their lives…"},"content":{"rendered":"
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"…I, like you, have seen how psychiatry has changed over the past 35 years I have been in practice. Over half of my practice are 15 min medication management appointments. I have learned to enjoy that as well as the psychotherapy I still do. There is a skill in med management and staying current is always a challenge. I remember when I was first out of training "poly pharmacy" was looked at askance, now it is the norm. To your suggestion. At both the summer and winter meeting usually have a lecture or two concerning pharmacology. By the design of the meetings, these are not meant to be all inclusive. I have found that the review courses such as offered by Harvard are the most useful. Web site is http:\/\/cme.hms.harvard.edu\/cmeups\/pdf\/03124280.pdf<\/a><\/strong><\/u>."<\/em><\/sup><\/td>\n<\/tr>\n<\/table>\n

Earlier in the year, I wrote our Psychiatric Association about having seen or been called about many cases of misdiagnosed or mismanaged psychotropic drug withdrawal syndromes, suggesting a professional meeting with a theme like Psychotropic Drug Withdrawal Syndromes: Management and Treatment<\/font><\/strong>. What was on my mind was trying to help my colleagues be hyper-aware of the withdrawal states. My agenda was obviously to try to stop psychiatrists misinterpreting withdrawal states as increased or recurring illness and adding even more medication. Seemed like a reasonable thought. But I guess he thought I was asking for help for myself instead of suggesting that my colleagues needed the help. Oh well. But I clicked on the link anyway and it lead me to last year’s Master Pharmacology CME. This was the front of that Harvard brochure:<\/p>\n

<\/a>
[click for original]<\/sup><\/p>\n

I remembered it from last year. A number of us wrote Dr. Salzman about it, asking why he had Nemeroff, Schatzberg, and Yonkers after their COI problems and investigation by the Senate [cme…<\/font><\/strong><\/u><\/a>]. He responded nicely assuring us there was no problem and the CME was being well received. So I thought I’d look at this year’s Psychopharmacology Master Class just to see what was up a year later:<\/p>\n

<\/a>
[click for original]<\/sup><\/p>\n

For what it’s worth, Dr. Salzman seems to be going it alone this year – no other faculty listed. Maybe enrollment was down last year? or maybe the toxic former stars are finally losing their appeal? <\/p>\n

That response at the top is from an old friend and a very decent guy. It’s typical – an acceptance of the way things are now for psychiatrists – not, I think, by choice. Comments like "Over half of my practice are 15 min medication management appointments. I have learned to enjoy that as well as the psychotherapy I still do. There is a skill in med management and staying current is always a challenge. I remember when I was first out of training ‘poly pharmacy’ was looked at askance, now it is the norm.<\/em>" are common when I run into people. My point is that when I come across old colleagues, they’re just doing what they do now – a lot of med checks. There’s no alarm, no sense that there are problems. It’s just the way it is. He recommended a CME and linked to one filled with discredited KOLs apparently unaware that he was doing that. He likewise missed the point of my letter which was pretty explicit – people aren’t so up on the drug withdrawal syndromes. <\/p>\n

So as much as I’d like to think that psychiatrists are disgruntled at their lot in modern medicine, in so far as I can see – they aren’t. They’re busying themselves doing their med checks, reading their journals, going to their CMEs to keep current. They don’t see the specialty as being in any particular state of crisis. The answer to my question from the other day wondering why there aren’t more psychiatrists alarmed about the DSM-5 [where are the psychiatrists?<\/font><\/a><\/strong><\/u>] is that they’re just out there doing their jobs managing meds, living their lives. I don’t think the downside of this new place they’ve been relegated has quite sunk in yet… <\/div>\n","protected":false},"excerpt":{"rendered":"

"…I, like you, have seen how psychiatry has changed over the past 35 years I have been in practice. Over half of my practice are 15 min medication management appointments. I have learned to enjoy that as well as the psychotherapy I still do. There is a skill in med management and staying current is […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-17880","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/17880","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=17880"}],"version-history":[{"count":15,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/17880\/revisions"}],"predecessor-version":[{"id":17895,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/17880\/revisions\/17895"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=17880"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=17880"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=17880"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}