You should not see psychiatrists with less than 10 years of clinical experience after residency training. The reason is that it takes about 10 years to develop enough clinical sophistication to become a master clinician in psychiatry. Before becoming a master clinician in psychiatry, psychiatrists are limited in what they can do to help patients with mental illness. The problem for new trainees in psychiatry is that psychiatry is the only medical specialty that does not study and does not base its diagnoses on the organ of interest. In other words, psychiatry leaves out the brain when making “diagnoses” and treatment plans for people with mental illness.
Look around at the other medical specialties:
- Cardiologists study and examine the heart
- Ophthalmologists study and examine the eye
- Nephrologists study and examine the kidney
- Psychiatrists ignore the brain
The 1990s was the Decade of the Brain, where research was supposed to give psychiatry new insights into the pathophysiology and causes of brain disorders such as mental illness. However, despite the large amounts of grant money awarded to multiple research institutions to find the cause and cure of mental illness, the Decade of the Brain and the 2000`s have come up empty handed, and now it appears that the 2010`s will also come up empty handed, as evidenced by the checklist, descriptive psychiatry that is the DSM-V.
The real problem with psychiatry is that it is more art than science. The master clinician with at least 10 years experience has seen multitudes of patients to differentiate what is mental illness, and what is normal behavior, for instance. New trainees in psychiatry resort to their DSM checklists, as they do not have a prior reference of clinical experience from which to formulate their cases. As such, new trainees will diagnose more false positives…in other words, the new trainees will diagnose someone with mental illness, when in fact they are just presenting with symptoms that are temporarily out of the normal range, but they do eventually return back to normal range. And not only do new trainees make overdiagnoses of mental illness, they also tend to botch treatment plans, and become too focused on medication treatment, rather than provide holistic treatment and start with more conservative, effective, and safer treatment, like psychotherapy.
To address this problem in psychiatry where diagnostic reliability only occurs after 10 years of clinical experience, the field needs to find biological markers to help diagnose mental illness, and thereby increase diagnostic reliability amongst the junior ranks of psychiatrists. And when we finally can use biological markers in psychiatry, then we can then attempt to cure or modify the pathological brain process in question.
Only when psychiatry makes the brain its organ of interest can it move forward and help the younger psychiatrists with their diagnostic abilities. The DSM-V continues to ignore the brain, and is not an advance for psychiatry. So don’t see a psychiatrist with less than 10 years of clinical experience, as you may be misdiagnosed, or mislabelled.