The Royal College of Psychiatrists has a current campaign to increase recruitment to psychiatry. It has this tag #choosepsychiatry.
Stephen Fry, despite having been diagnosed with prostate cancer, gave up his time to personally support this campaign. Fry is a national treasure because of the wonderful creative, open and intelligent man that he is.
I am coming towards the end of my career. I feel most fortunate to have been a doctor, to listen and learn from those who have confidentially entrusted me to share their experiences, stories, troubles, wonders and concerns. I have done my best to help people when in a time of need.
However, I will leave my profession of psychiatry with very real concerns. I do hope that the concerns that I have might help the #choosepsychiatry campaign. I want to be positive.
I cannot escape a deep concern that my profession is now prescribing psychiatric medications far too widely, and is not explaining to those prescribed, that there is a dearth of evidence to base long term treatment with such drugs. My concern is the potential for prescribed harm to many.
I cannot offer the wisdom of Stephen Fry, all I can offer are a few of my own considerations to junior doctors:
- listen to the evidence of experience (lived experience)
- that evidence informed medicine also requires philosophical considerations
- that words and numbers matter equally, but both represent ‘losses’ in terms of actual experience
- that ethics should underpin all that we do
- that transparency of competing interests is essential to science
- that over-medicalisation is a matter that we need to consider seriously
- that the idea of ‘two cultures’, science and arts, is an artificial divide that should be challenged
- that subjectivity needs to be reintegrated into science
- that wider reading and exploration of the world round about us, adds, rather than detracts from being a skilled and caring professional
- that the history of medicine reminds us that critical thinking is necessary to establishment practice
- that good intentions are not sufficient. Professionals are just as vulnerable to exhibiting stigma as any other person