Posted by Cam W. on February 19, 2000, at 10:05:40
In reply to Re: Pharmacy v Psychiatry Psychology , posted by medlib on February 19, 2000, at 1:55:56
> > > > I will agree that for problems to do not mean long term therapy a pdoc is fine but no Pdoc that I have ever seen in 15 yrs ca or will do the kind of in depth disection of personality and behavior like a psycholigist.
> > >
> > > James, before 1985 or so, all the psychoanalysts in this country were MDs. In any case, I don't think taking classes is primarily what makes a person a good talk therapist; rather, it's supervised experience, which psychiatrists and clinical psychologists certainly get plenty of.
> > >
> > > I don't think clinical psychologists have a good enough understanding of medication that they would necessarily be a good fit for someone who takes meds. IME, they tend to attribute mood and behavior changes to environmental factors (rather than to the medication or to the illness itself), even when it doesn't make much sense to do so.
> >
> > All - I don't understand this debate, Would not a psychopharmacologist be a pharmacologist with a postgraduate specialty in neurophysiology. A pharmacology undergraduate would train in the Faculty of Pharmacy & the Pharmaceutical Sciences and then go on to study the mechanisms of the brain and its relation to the effects of medicinal chemical substances. This person would not need to know how to diagnose (psychiatrist) or do psychotherapy (psychologist), but would need just a basic understanding of the principles of these diciplines. He/she wouldn't need to know these arts in depth. I believe a good psychopharmacologist would need more than just the basics of drug pharmacokinetics, pharmacodynamics, biochemistry, microbiology, medicinal chemistry, etc. to be able to do his job. These fields are more likely to intensively covered under the umbrella of Pharmacy than Medicine or Psychology. This is how I see it. It may be right, it may be wrong, but I'd put my money on a good pharmacist over a good psychiatrist or a good psychologist on the topic of pharmacotherapy, any day. To build the solidest house, you have to begin with the strongest foundation.....Rebuttals would be appreciated, please. - Cam W.
>
> Cam-
> Are you a psychopharmacologist? Do you see patients in a clinical setting? Clearly, you have accurately defined the noun and delineated optimal training for the task, but I think you make an even better case for a TEAM approach to the clinical treatment of "mentally ill" patients.
> (Notice that I didn't say "treatment of mental illness.")
> Much has been written about how, as the volume of medical information grows exponentially, the slice of it one can be an "expert" on grows smaller and smaller--and how the resulting fragmentation of medical care practically requires patients to become their own treatment managers. This bulletin board is good evidence of that phenomenon, and you can "see" the frustration it engenders in nearly every post.
> Sure, patients who have a serious clinical illness need a good psychopharmacologist, and your contributions on this board are highly valued (by me and everyone else, I'm positive)--but, most of us who depend on Rxs also need Dx and Tx! When is the outpatient psych clinical community going to get its act(s) together?
> It's probably quite different in Canada, but, in the US, the specialist run-around is often a health-endangering, and sometimes life-threatening, process. Managed care will eventually kill it off, and that won't necessarily be an improvement.
> Oh well, guess I'll climb down off my soapbox and go drug myself to sleep.
> Side note--Historically, the original use of the Internet was for peer consultation. Thanks to Dr. Bob (THANKS!) the original purpose is alive and well, only the "peers" are now the patients.
> medlibJanet - I don't know about any associations, but yes, I have had a couple of major depressive episodes since my son died at birth in 1993. My philosophy towards life is: "Are you kind", from the Grateful Dead song 'Uncle John's Band'. I know there is a hidden double meaning with reference to drug use, but I feel I should try to help people who are in the pain, I have felt myself have felt. I believe that through compassion, empathy, understanding and my specialized knowledge, I can help ease some people's pain and show them how to live with their afflictions, while staying within the realm of my expertise. I cannot counsel; I cannot diagnose; but I can try (when it is necessary to be taking medication) to make the dosing schedule as easy as possible, to minimize side effects and to maximize compliance. In this way, one can recieve the most from their medicatons. I believe that compliance can be further enhanced by relating how, to the best of my knowledge, the medications work to someone who is taking them. This allows that person to make an informed choice on his medication. Never take my advice on faith. Always get a second opinion and discuss these with your doctor. I am but a link in the machine. Sincerely - Cam W.
medlib - I work halftime for a Mental Health Clinic and half time in a community pharmacy, in a larger Canadian city. My boss contracts me out to the government MH clinic. I am their pharmacy consultant. What do I do? Sometimes I'm not even sure. I give presentations to anyone who will listen, on a wide range of psychiatric medications; I review drug profiles and make recommendations; I give on-the-spot advice to clients, therapists, nurses, doctors, and administrators. I do work closely with most of the nurses and psychiatrists to formulate care plans for our clients and help to tweak these care plans as needed. All this was made possible when one wonderful and brilliant COO (chief operating officer) of the Alberta Mental Health Board (Eleanor Grant) decided that her group needed a pharmacist to compliment her extremely competent staff. I believe she is always looking better ways to improve the lot of those afflicted with mental disorders. She is one incredible lady.
So, basically I work for a community drug store and use my knowledge of dealing with people and their medication (and other drug) use in the community to help those with mental disorders (along with the support and education they receive from the rest of the team) to live in society, to the best of their ability. Idealistic? - yes; Frustrating? - sometimes; Satisfying? - enormously. Sorry for babbling, but you asked. Sincerely - Cam W.
P.S. If I need to be labeled, call me a Neuropsychiatric Community Pharmacist (we came up with that having beers after a psych lecture).
poster:Cam W.
thread:21801
URL: http://www.dr-bob.org/babble/20000209/msgs/22456.html