Psychiatry`s identity problem

A lot of people are unsure what the difference is between a psychiatrist and a psychologist. Often, the two terms are used interchangeably, but these are two very different professions.

Recently I did a small survey of 50 consecutive new patients who came to see me. I asked each patient the following question: A psychiatrist is a medical specialist who initially went to medical school and took the same courses as your family Dr, surgeon or other specialist – True or False?

Thirty-two percent of these patients who had already been referred to see me said this was false when in fact it is true. Psychiatrists go to medical school and specialize after obtaining their MD and so have the same basic training as all other MD’s.

They were also asked: The terms psychologist and psychiatrist are interchangeable and mean the same thing – True or False?

Ten percent said this was true when in fact it is false. Psychologists have quite different training which does not include medical school.

This is an important distinction because while psychologists can be very beneficial, they are not medically trained and do not prescribe medication in most jurisdictions. They are not as well equipped to understand the biological aspects of psychiatric disorders or the relationships between psychiatric disorders and other medical illnesses. On the other hand, many psychologists are better trained in certain kinds of psychological testing that may be necessary to measure cognitive functioning such as memory, concentration and problem solving. Many clinical psychologists are quite well trained in various kinds of psychotherapy or talk therapy.

Psychiatric treatment is paid for by provincial health insurance such as the Medical Service Plan (MSP) in BC. That means that even without extended medical coverage, a person can see a psychiatrist and receive treatment for a mental illness. There are no limits to the number of sessions per year or the number of years of therapy, as some of these illnesses are life-long.

A referral to a psychiatrist by a family doctor is usually necessary for outpatient treatment and must be renewed every 6 months.

Even when medications are used, there are other facets to treatment in almost every case. First and foremost is education. Giving information about the disorder and why it has occurred is a crucial first step. There may be genetic predispositions, environmental contributions or both, as is usually the case. Providing education about the treatment is also important - why it is recommended and how it will work to alleviate the problem. In some cases no medication is necessary and instead it will be important to identify real life problems and how to work to solve them.

Your psychiatrist may be involved in helping you qualify for insurance payments, social assistance, Canada Pension Plan or to assist with various legal problems where a medical opinion is required. If you are off work for psychological reasons your insurance company will often require a psychiatric opinion to justify your insurance claim.

Your psychiatrist is not interested in judging you and will not think less of you because of the problems you bring. We deal with difficult situations all the time and are here for one reason – to hear your problem and work with you to find a solution.


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