Psychiatry: a specialized profession or a medical specialty?

摘要: The paper by Heinz Katschnig is a thoughtful description of the challenges faced psychiatrists worldwide, providing an interesting opportunity to reflect upon what profession really means. dilemma may be put through following question: if psychiatry (and psychiatrists) are solution, which in fact problem? “eliminative procedure” should lead us question would happen psychiatric disappears. Would health populations deteriorate? people suffer more? anyone notice that we do not have anymore? All these hard questions. They pose and answer. A institutionalized response social demand. demand simply need or wish. It wish consciously perceived for whose satisfaction they willing pay, i.e., provide practitioners with honor (honoraria), money, prestige, power love. It important stress desire lies providers services 1. One most unfortunate developments postmodernist societies consists development expertocracies, is, groups experts who believe progress advancement rely exclusively on their own needs interests. Sometimes, this leads ignore original created expertise. Experts concerned improvement knowledge base, refer peers approval acceptance contend know real without confronting changing realities. typical paternalism medical profession, characterized beneficence autonomy, rough form expertocratic thinking based idea “doctors best”. The criticized warning review fundaments its alleged influence human affairs. As many other knowledge-based professions, cognitive side has been considered basis professional psychiatrists. However, terms specialized information, current could subsumed under neurology, psychology, work, policy making. Searching base appropriate, it appropriate considering results. fashionable “evidence-based” practice does apply practices diagnosis, treatment, prevention. aspects seemingly heterogeneous ranging from Bohemian speculation hardcore empirical research, find reasonable harmonization within individual In order all discourses constituting historical resemble “Renaissance men” seldom case, particularly era state-controlled market-driven 2. If anything, done reformulate actual comprising so disparate different practices. This reformulation can only dispassionate analysis care systems permit. defense nowadays cannot contested professions limited laws, regulations, pressure society. As proposal, I strongly appreciate, thus justify expert role kind might able provide, much as “value-based” integration 3. psychiatrist represent general harmonizer information uses prudent counselor, therapist promoter colliding physicians, psychologists, lawyers, workers. From competition integration, going intermediate stage cooperation, systemic organizers research insist remain one among specialties which, necessity, render claims irrelevant. Psychiatry become solving problems integrality approach relevance no provide. This, course, mean reorienting teaching, training, practice, but perception now being uncovered discussed 4.