Being a Doctor

Posted on September 18, 2007

I recently attended the annual American Conference on Psychiatric Disorders, which was held here in New York City on September 7th and 8th. This was a chance for me to reconnect with others in my profession, and to catch up on some of the latest research, which I feel the need to do periodically as I tend to be relatively isolated in my private clinical practice. During one of the initial sessions, the presenter projected this slide summarizing his definition of a physician:

“A physician is
-An expert at a particular set of skills
(History, examination, differential diagnosis)
-The custodian of a body of knowledge
-An advocate for the patient”

A sub context of the presentation, was that psychiatry in the past had been overly concerned with therapeutic issues, as there had been relatively little known about actual (biological) causes of mental illness.

I have to admit feeling very disappointed as I heard that definition. As a result of our training, we do have expertise in a certain set of skills, and carry a certain unique body of knowledge and experience which differentiates us from our peers in mental health. But I think we miss the mark entirely if we do not place firmly in the center of our definition the role of healer.

I know in my own case, my desire to become a physician was all about being able to help people who were ill in the most effective manner possible. And for me, especially as a psychiatrist, the “how” is just as important as the “what”. How people perceive me, how I relate to them, can make all the difference in a patient’s outcome, and I don’t believe the above definition captures that. Interpersonal therapeutics are extremely important, and will always remain so, despite whatever advances we may make in genetic or molecular neuropsychiatry or neurobiology. There are a number of trends in modern psychiatric training that are troubling to me, and that of minimizing interpersonal therapeutics, in favor of diagnostic classification and over-reliance on pharmacology, is one. I hope to discuss others as time goes by.

‘Tags’Psychiatry’

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