Speaking To Patients
Posted by Dr. Vollmer on June 24, 2015
Talking drugs, as I call it, is a favorite pastime of mine. By that I mean that I like to talk about psychopharmacology in the context of human suffering. This, one might say, is my dog and pony show. Usually my audience ranges from medical students, psychiatric residents, child psychiatry fellows, art therapy students, or master level clinicians. Each group brings a unique perspective to my talk. Today, I expanded further by talking to patients, a group of folks who are on psychotropics, prescribed by other clinicians. “I used to talk to my psychiatrist for an hour, but now I see him for fifteen minutes. I say a key word, and he jumps to a particular medication. I do not know what happened,” says an audience member, illustrating my persistent point that psychiatry has lost its way. To prescribe medications, the first order of business is to establish trust with the patient, I explain, articulating the physician’s side of the street. I continued with a frequent example. I see patients in a substance abuse rehabilitation facility. “How are you?” I ask, “Fine,” they respond. If I were to end the session at that point I would have documented that the patient is doing well. However, if I wait, and follow-up with a few probing questions, I learn a different story, often involving some major life event, like a relapse, or a break-up, or a family member with a new diagnosis of cancer. Time is critical to uncovering the details of the patient’s interior. I continue explaining my dismay over the fifteen minute appointment, and once again there is a sense of gratitude, that someone wants to listen and prescribe medication. So, if you readers want me to come to talk about psychotropic medications, I would be happy to. Just know that I maintain my stance that listening and prescribing are both critical to the experience. Anyone listening to that?