Magazine article Clinical Psychiatry News

Perspective

Magazine article Clinical Psychiatry News

Perspective

Article excerpt

The lack of integration between the management of emotional and physical wellness in psychiatric patients is largely a consequence of the absence of a true public health philosophy among physicians.

Most medicine is practiced by looking for symptoms of illness rather than for the opportunity to prevent illness. Until there is broader acceptance of a preventive care model of patient management--and until a payment structure that compensates clinicians for tending to both mental and physical conditions is implemented--continued segregation is all but guaranteed.

Other obstacles interfere as well. Many medical physicians have long been prejudiced against mentally ill patients, and as such have often been blind to good practices when treating them. It is as if the mental illness either diminishes the validity of physical complaints or causes them.

In my 35 years of clinical practice, I have seen countless mentally ill patients with diagnoses missed by internists who believed the presenting symptoms were "all in their heads" without ever taking a thorough history or physical exam. Another problem is that many psychiatrists and physical health physicians simply expect the other to take care of mental or physical concerns without verifying that this is happening. …

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