{"id":45697,"date":"2014-04-18T14:10:16","date_gmt":"2014-04-18T18:10:16","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=45697"},"modified":"2014-04-19T18:22:50","modified_gmt":"2014-04-19T22:22:50","slug":"in-the-comments","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/04\/18\/in-the-comments\/","title":{"rendered":"in the comments…"},"content":{"rendered":"\n
Comments from three psychiatrists to the last post: three wishes…<\/a> – all focused on the APA push for Collaborative Care<\/em> [AKA Integrative Care<\/em>]. <\/div>\n
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I don’t think the APA’s initiative on collaborative care has anything to do with getting other doctors to see psychiatrists as real doctors. Psychiatrists who practice like real doctors are seen as real doctors without PR fluff form the APA. The emphasis on collaborative care by the APA is a function of their political ineffectiveness in supporting the current practice environment and it is also the way oligarchies function. Once managed care friendly contingents get a hold inside of the organization and "cost effectiveness" and "evidence-based" become buzzwords the resulting corporate approach is predictable. If Ioannidis<\/a> has taught anything – it should be that anyone can come up with the evidence they want and there is ample evidence for that.<\/div>\n
George Dawson<\/a>, MD, DFAPA<\/div>\n<\/blockquote>\n
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Regarding the APA’s push for "integrative care" and more specifically about having psychiatrists embedded in internal medicine\/primary care practices as the Brave New World. I was chewing the fat with my suite partner in my private practice, who is an excellent psychiatrist doing mainly medication management and consultation for psychologists and social workers. He’s a good guy with 35+ years of experience. After discussing Kupfer’s COI issues and the use of "computerized adaptive testing" for depression and anxiety, he shrugged and offered: "It won’t go anywhere. The Internal Medicine docs hate us" [meaning psychiatrists]. I laughed. APA at work for you! Not!<\/div>\n
Tom<\/a><\/div>\n<\/blockquote>\n
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Just saw this article<\/a> by Jeffrey Lieberman today on integrated care. Some real gems in there, including this:<\/div>\n