{"id":57830,"date":"2015-06-12T19:36:43","date_gmt":"2015-06-12T23:36:43","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=57830"},"modified":"2015-06-12T20:59:10","modified_gmt":"2015-06-13T00:59:10","slug":"the-way-of-things","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/06\/12\/the-way-of-things\/","title":{"rendered":"the way of things…"},"content":{"rendered":"
In psychiatry thinks…<\/a>, I was complaining that many critics pretend that all psychiatrists can be represented as a single homogeneous group – being of one mind. Recently, George Dawson<\/font> of Real Psychiatry<\/font><\/a> came at the same point from a somewhat different direction in his post The Myth of Monolithic Psychiatry<\/a>: <\/div>\n
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Psychiatrists have the most diverse population of any medical specialty and it is the farthest to the left. More psychiatrists are liberals and psychiatry is the only specialty group that is predominately predominately composed of Democrats.  The broad range of interests of psychiatrists are evident at any American Psychiatric Association<\/em> [APA] meeting and various annual subspecialty meetings. Courses are available on a broad range of medical, neuroscientific, and psychosocial topics. Psychiatrists work in a number of specialty areas and it is very likely that certain practices are highly specialized and focus only on the diagnosis and treatment of specific conditions.  That is not the structure of a monolith.  The total number of psychiatrists varies on the source.  The American Medical Association<\/em> [AMA] census in 2010<\/a> put the number at 42,885.  The Census<\/a> put the number at 40,600 in 2009 and of those 26,200 were office based.     According to the Bureau of Labor Statistics<\/a> there are only about 25,000 psychiatrists who are employees of organizations.  The remainder are in private practice.  The American Psychiatric Association<\/em> sent me the following data on the membership for the past 15 years.<\/div>\n


[redrawn to include full ordinate scale]<\/sup><\/p>\n

As a measure of monolithic behavior,  in one of the most critical APA election in recent years regarding maintenance of certification [MOC] only 6,943 members voted.  Action requires a vote of at least 40% of the membership.  Interestingly the MOC vote occurred in 2011, the year of the lowest number of members.  The total vote was not close to the 40% number, but it exceeded the vote<\/a> for the President Elect and Secretary by about 1,300 votes each. Presidents are typically elected by less than 20% of the members.  These facts illustrate that the majority of psychiatrists in this country at any one time are being directly influenced by employers and in the overwhelming number of cases those employers are managed care organizations whose policies are generally inimical to quality psychiatric care.  It is also apparent from the vote and the election patterns within the APA, that there is not a lot of political activism or interest for that matter.  Hardly the behavior of a monolith…<\/p>\n

Supplementary 2<\/font><\/strong>:  <\/em>Psychiatry is dwarfed by the number of other mental health providers including 88,000 Family Practice specialists, 162,400 Internists,  100,000 psychologists and 120,000  Social Workers.  I don’t know the number of Psychiatric Nurse Practitioners or Physician Assistants whose primary role is to prescribe psychotropic drugs, but I will happy to add it if somebody has that information.  Although I am sure that some of the physicians in these primary care groups don’t prescribe some psychotropics, I am sure that 80% of all psychotropic medications in the US and most western countries are not<\/em> prescribed by psychiatrists… <\/div>\n<\/blockquote>\n
I’d say that’s as an accurate accounting of things as you’ll find. He mentions Robert Whitaker in the post giving examples where "psychiatry" is used as an anthropomorphized noun – an organism. It’s even more apparent among some who blog on Whitaker’s web-site, Mad in America – Philip Hickey [Psychiatry On The Defensive, But Ceding No Ground<\/a>], Bruce Levine [Psychiatry has a Major Credibility Problem<\/a>], etc. It’s surprising in that psychologists and psychiatrists often work in close proximity. Seems like they’d know that the term "herding cats" would be a good one to describe psychiatrists. My experience has been that if you engage in a discussion of this point with critics, you’re immediately accused of being defensive, disavowing responsibility, or being in denial, rather than simply stating the way of things…<\/div>\n","protected":false},"excerpt":{"rendered":"

In psychiatry thinks…, I was complaining that many critics pretend that all psychiatrists can be represented as a single homogeneous group – being of one mind. Recently, George Dawson of Real Psychiatry came at the same point from a somewhat different direction in his post The Myth of Monolithic Psychiatry: Psychiatrists have the most diverse […]<\/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":[5],"tags":[],"class_list":["post-57830","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/57830","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=57830"}],"version-history":[{"count":12,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/57830\/revisions"}],"predecessor-version":[{"id":57850,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/57830\/revisions\/57850"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=57830"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=57830"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=57830"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}