Have you seen any psychiatrists go back and become family docs or IM or other specialty after years of being psychiatrists. In my psych residency we had various people, some mid-later career, like IM or ophtho switching into psych.
Have you seen any psychiatrists go back and become family docs or IM or other specialty after years of being psychiatrists. In my psych residency we had various people, some mid-later career, like IM or ophtho switching into psych.
I've never seen this direction. One benefit psychiatry has is the low level of wear and tear on our bodies. Probably the lowest of any specialty. Going back in the other direction, doing overnights and 24s, as a resident? Nooo thank you.Have you seen any psychiatrists go back and become family docs or IM or other specialty after years of being psychiatrists. In my psych residency we had various people, some mid-later career, like IM or ophtho switching into psych.
I should really look into getting obesity boarded, but paying fees/dues and whatever requirements for another board is ugh...I've never seen this direction. One benefit psychiatry has is the low level of wear and tear on our bodies. Probably the lowest of any specialty. Going back in the other direction, doing overnights and 24s, as a resident? Nooo thank you.
It's not exactly the same but when older medical students (30+ at time of starting medical school) have tried to do very physically demanding residencies (surgery, etc) I have seen it go poorly multiple times. Some parts of medicine really are a young person's game.
If desperate to get out of psych or just to expand, obesity medicine has a CME/practice pathway and a psychiatrist could probably carve out a really nice niche there.
You have to be kidding me if you think psychiatry, the field of medicine most reliant on human connection, is going to be replaced by AI before FM. FM has so much more room for disruption based on vitals, lab data, etc than psychiatry. I am willing to bet that robots are doing surgery autonomously or with minimal human imput before psychiatry is replaced by AI.When AI makes psychiatry obsolete just wondering about going back to FM or something. I was pretty good a DREs in med school.
You’re troll rightWhen AI makes psychiatry obsolete just wondering about going back to FM or something. I was pretty good a DREs in med school.
Suppose that depends on the specific sense of the word "digital"The computer can do a better DRE than you, guaranteed.
You have to be kidding me if you think psychiatry, the field of medicine most reliant on human connection, is going to be replaced by AI before FM. FM has so much more room for disruption based on vitals, lab data, etc than psychiatry. I am willing to bet that robots are doing surgery autonomously or with minimal human imput before psychiatry is replaced by AI.
Keep in mind that LLMs need data to improve, we have such a hard time having meaningful outcome data for most of our interventions to even know best practices in most places that until every person has a computer chip in their brain, we are not going anywhere.
You’re troll right
antipsychotic - ozempic pipeline anyone?Tell me more about this obesity medicine opportunity.
Maybe a shock for you...same thing different day for me, lolOne thing I'll warn you, it's a shock, the moment you become a resident or fellow, nobody wants to hear what you think any more. Like Rodney Dangerfield in Back to School, you don't get any respect.
I mean I think this is pretty bad advice..you want a psychiatrist to practice dermatology without doing a residency?One thing I'll warn you, it's a shock, the moment you become a resident or fellow, nobody wants to hear what you think any more. Like Rodney Dangerfield in Back to School, you don't get any respect.
To paraphrase another movie, Air Bud, there's no rule saying that a psychiatrist can't pretend to be a dermatologist. Take some classes, learn some basic procedures, do cosmetic stuff for cash. Don't do this for, like, oncology.
An article titled “How Ozempic accidentally became an anxiety wonder drug” came across my newsfeed but was behind a paywall. Seems like this could actually become a viable clinic to market…antipsychotic - ozempic pipeline anyone?
Meh I think the "human connection" in psychiatry is overblown. The majority are just like other doctors, I've never noticed a greater amount of compassion or empathy in psychiatrists compared to other doctors.You have to be kidding me if you think psychiatry, the field of medicine most reliant on human connection, is going to be replaced by AI before FM. FM has so much more room for disruption based on vitals, lab data, etc than psychiatry. I am willing to bet that robots are doing surgery autonomously or with minimal human imput before psychiatry is replaced by AI.
Keep in mind that LLMs need data to improve, we have such a hard time having meaningful outcome data for most of our interventions to even know best practices in most places that until every person has a computer chip in their brain, we are not going anywhere.
Meh I think the "human connection" in psychiatry is overblown. The majority are just like other doctors, I've never noticed a greater amount of compassion or empathy in psychiatrists compared to other doctors.
The patient explains their symptoms, the doctor listens (usually pretty stoically) and prescribes a pill that may help resolve the problem. Very much in line with the rest of medicine.
I think psychs are just as likely as FM doctors to be automated, but fortunately as it stands, that risk is very low at the moment as patients like interacting with humans.
The risk is a head to head study of AI + midlevels vs physicians. If they start getting objectively equal or better outcomes then I can see physicians getting replaced.
Meh I think the "human connection" in psychiatry is overblown. The majority are just like other doctors, I've never noticed a greater amount of compassion or empathy in psychiatrists compared to other doctors.
The patient explains their symptoms, the doctor listens (usually pretty stoically) and prescribes a pill that may help resolve the problem. Very much in line with the rest of medicine.
I think psychs are just as likely as FM doctors to be automated, but fortunately as it stands, that risk is very low at the moment as patients like interacting with humans.
The risk is a head to head study of AI + midlevels vs physicians. If they start getting objectively equal or better outcomes then I can see physicians getting replaced.
I haven’t seen this occur, but I’m sure it has happened. I’d ask why you want to do this though.
If you really need change, a fellowship makes more sense. Repeatedly apply pain if needed, addiction, sleep, forensics, obesity medicine, C&L, etc.
Retraining in IM or many other fields is signing up for 3+ years of 80 hour weeks at $50k/year for the potential to make less money. If you really want out, take 2 FT psych jobs making $300k+ each (very doable in 80 hours). Live on $50k for 3-5 years. At the end, you won’t need to take a medical job paying less than psych money. With likely past money you have saved, there should be enough to change careers into almost anything you want.
No specialty will be completely "replaced" by AI, but a large amount of work that is currently done be physicians will be done/informed by AI. Psychiatry is by the far the field that is most well placed for this. The DSM from DSM-III onwards was basically written to computerize psychiatric diagnosis. Bob Spitzer, the architect of the DSM-III project believed that the future of psychiatry was going to be computerized and developed the first program to make computerized psychiatric diagnosis by decision tree as early as the 1960s. Computerized diagnoses can effectively diagnose mood, anxiety, personality disorders, PTSD, addiction, eating disorders and a bunch of other common mental disorders. Psychosis is the one area that has been failed by this approach and it may be much longer that AI can be trained to detect das Praecox-Gefühl.
You also have to remember the levers of power aren't controlled by physicians or patients but corporate hospital systems, private equity, pharma, insurance companies and the federal government. None of these stakeholders care about "human connection" and even if they do, psychiatrists are seen as too expensive to provide this when non-physicians can do this better and more cheaply. We already have collaborative care where patients aren't seen by a psychiatrist and diagnosis and treatment are based on questionnaires and population-based registries. We also have e-consults, asynchronous telepsychiatry, and tech companies who rely on on questionnaires to make diagnoses. Hims/Hers basically has psychiatrist review forms to rx pills. Those ADHD companies like Cerebral and Done had patients complete a 1 min questionnaire to issue an rx for stimulants in lieu of a comprehensive interview. Many psychological tests and their interpretation (even if somewhat wanting) are computerized, in addition to a bunch of companies using cognitive testing and other bedside psychiatric measures. Computerized CBT goes back 20 years, and there are many CBT and mindfulness based apps on the market now. There's also Woebot which is now using LLMs to enhance its delivery of "therapy." Finally, the depth and complexity of our work is not something that the aforementioned stakeholders understand or appreciate.
I believe there will always be a demand and benefit to person-centered, person-provided psychiatric care for those that can afford it. But it is becoming an expensive luxury and everyone else is going to see AI-informed care used to make basic diagnoses of things like depression, anxiety, bipolar, PTSD, ADHD. Psychiatrists will still have a role in more complex cases, psychosis, treatment-resistant cases but a lot of bread and butter mental health cases will experience AI-informed care to dispense SSRIs etc to the masses. Rather than revolution, this is a natural evolution of where mental healthcare has already gone.
Psychosis is the one area that has been failed by this approach and it may be much longer that AI can be trained to detect das Praecox-Gefühl.
I believe there will always be a demand and benefit to person-centered, person-provided psychiatric care for those that can afford it. But it is becoming an expensive luxury and everyone else is going to see AI-informed care used to make basic diagnoses of things like depression, anxiety, bipolar, PTSD, ADHD. Psychiatrists will still have a role in more complex cases, psychosis, treatment-resistant cases but a lot of bread and butter mental health cases will experience AI-informed care to dispense SSRIs etc to the masses. Rather than revolution, this is a natural evolution of where mental healthcare has already gone.
This just does not match my experience of practicing psychiatry at all. I think maybe 5-10% max of my patients would fall into basic uncomplicated text book style cases without significant comorbidity or treatment refractory concerns. In fact ,I recall medical students and residents bemoan the complexity of patients in comparison to step 3/shelf style multiple choice questions. We already have an infrastructure to dispense SSRIs to the masses (or psychostimulants in peds) called primary care, and somehow the wait to see a child/adolescent psychiatrist even with top-of-the-line private insurance is several months at every place within a 30 minute drive of my practice. Say every medicaid patient in the country gets AI based meds with a single group of doctors overseeing that, we would still be unable to simply see every private insurance/cash pay patient in my area.No specialty will be completely "replaced" by AI, but a large amount of work that is currently done be physicians will be done/informed by AI. Psychiatry is by the far the field that is most well placed for this. The DSM from DSM-III onwards was basically written to computerize psychiatric diagnosis. Bob Spitzer, the architect of the DSM-III project believed that the future of psychiatry was going to be computerized and developed the first program to make computerized psychiatric diagnosis by decision tree as early as the 1960s. Computerized diagnoses can effectively diagnose mood, anxiety, personality disorders, PTSD, addiction, eating disorders and a bunch of other common mental disorders. Psychosis is the one area that has been failed by this approach and it may be much longer that AI can be trained to detect das Praecox-Gefühl.
You also have to remember the levers of power aren't controlled by physicians or patients but corporate hospital systems, private equity, pharma, insurance companies and the federal government. None of these stakeholders care about "human connection" and even if they do, psychiatrists are seen as too expensive to provide this when non-physicians can do this better and more cheaply. We already have collaborative care where patients aren't seen by a psychiatrist and diagnosis and treatment are based on questionnaires and population-based registries. We also have e-consults, asynchronous telepsychiatry, and tech companies who rely on on questionnaires to make diagnoses. Hims/Hers basically has psychiatrist review forms to rx pills. Those ADHD companies like Cerebral and Done had patients complete a 1 min questionnaire to issue an rx for stimulants in lieu of a comprehensive interview. Many psychological tests and their interpretation (even if somewhat wanting) are computerized, in addition to a bunch of companies using cognitive testing and other bedside psychiatric measures. Computerized CBT goes back 20 years, and there are many CBT and mindfulness based apps on the market now. There's also Woebot which is now using LLMs to enhance its delivery of "therapy." Finally, the depth and complexity of our work is not something that the aforementioned stakeholders understand or appreciate.
I believe there will always be a demand and benefit to person-centered, person-provided psychiatric care for those that can afford it. But it is becoming an expensive luxury and everyone else is going to see AI-informed care used to make basic diagnoses of things like depression, anxiety, bipolar, PTSD, ADHD. Psychiatrists will still have a role in more complex cases, psychosis, treatment-resistant cases but a lot of bread and butter mental health cases will experience AI-informed care to dispense SSRIs etc to the masses. Rather than revolution, this is a natural evolution of where mental healthcare has already gone.