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>Why does a heart surgeon need to know anything about psychiatry? Heart surgeons have patients with psychiatric problems. And patients are typically on psychia

>Why does a heart surgeon need to know anything about psychiatry? Heart surgeons have patients with psychiatric problems. And patients are typically on psychiatric medications, which have cardiac side effects. More broadly, heart surgeons are also general surgeons, and some psychiatry base knowledge is necessary to understand their patients. Heart surgeons don't have to be psychiatrists, but they need some knowledge in it, which is why it's a 4 week rotation in medical school.

treis 8y ago
>Heart surgeons have patients with psychiatric problems. Which they don't treat. That's why we have psychiatrists. >And patients are typically on psychiatric medications, which have cardiac side effects. Which is something a cardiologist should know. Knowing which mental illness they treat and how it does that isn't relevant.
- DanBC 8y ago
  > >Heart surgeons have patients with psychiatric problems. > Which they don't treat. That's why we have psychiatrists. People with mental illness also have heart problems that need heart surgery. It'd be nice if heart surgeons had a bit of understanding of psychiatry so they can avoid diagnostic overshadowing. This is a significant problem that contributes to the shorted lifespan of people with severe mental illness. https://meta4rn.com/2018/12/15/shadow/ https://meta4rn.com/2018/12/15/shadow/
  - treis 8y ago
    How to treat heart problems in the mentally ill would be useful training for a cardiologist. How to treat mental illness isn't.
- markroseman 8y ago
  Compliance with medication regimes and followup care can affect outcomes in cardiology, as in other areas. Understanding a patient's psychiatric illness, psychosocial functioning, and other factors can help predict treatment compliance. That in turn may influence the treatment regime the cardiologist recommends. Medications that are prone to abuse, ones that may be more complex to take, ones that can be dangerous if someone takes too many... all are things the cardiologist should be aware of which takes some basic psychiatric knowledge. There are few in cardiology, but many physical health meds can definitely create psychiatric side effects. How do you differentiate those from an existing psychiatric illness? There's a large body of literature that recognizes the links between cardiac care and mental health, resulting in poorer outcomes, increased system utilization and costs, etc. Saying "this is my area, that's yours" exacerbates this problem.
- jacques_chester 8y ago
  The common theme in these subthreads is that you consider your ignorance as a superior source of knowledge. That since you personally don't know about a thing, the thing doesn't exist. It's difficult to unhorse a debating partner who refuses to allow any evidence but their own imagination.
  - treis 8y ago
    You have evidence that cardiologists trained in psychiatry are measurably better than those that aren't?
    - rscho 8y ago
      Just let it go. You are making an apex fool of yourself in the eyes of each and every health professional reading this. It would be strictly impossible for hospitals to function based on your opinions, which is why the supporting data you are calling for does not exist. We don't pretend to program better than you do or demand solid data to support your pet language/paradigm. Have a little understanding of others for a change. You are part of the problem, not the solution. Working on that would be the real improvement.
      - treis 8y ago
        >It would be strictly impossible for hospitals to function based on your opinions, which is why the supporting data you are calling for does not exist. Oh nonsense. There's plenty of evidence that lower trained providers are just as effective as doctors. Midwives are equal or better than doctors: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004667.pub3/abstract https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... No difference between Nurse Practioners and Drs: https://www.ncbi.nlm.nih.gov/books/NBK384613/ https://www.ncbi.nlm.nih.gov/books/NBK384613/ Of course we don't have studies comparing what the equivalent radiologist not because it's strictly impossible for it to happen. But because it's strictly illegal. There's also evidence that the way doctors are trained isn't the only possible way. Humanities and social science majors who omitted organic chemistry, physics, and calculus, and did not take the MCAT do just as well as traditional students: https://journals.lww.com/academicmedicine/Fulltext/2010/08000/Challenging_Traditional_Premedical_Requirements_as.26.aspx https://journals.lww.com/academicmedicine/Fulltext/2010/0800... Performance in medical school does not correlate with performance in residency: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951767/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951767/ >Just let it go. You are making an apex fool of yourself in the eyes of each and every health professional reading this Put up or shut up. Where is your evidence based argument that cardiologists who have a psych rotation have measurably better patient out comes than those that don't. Or that a radiologist with more biochem knowledge is a better one?

treis 8y ago

>Heart surgeons have patients with psychiatric problems. Which they don't treat. That's why we have psychiatrists. >And patients are typically on psychiatric medications, which have cardiac side effects. Which is something a cardiologist should know. Knowing which mental illness they treat and how it does that isn't relevant.

DanBC 8y ago
> >Heart surgeons have patients with psychiatric problems. > Which they don't treat. That's why we have psychiatrists. People with mental illness also have heart problems that need heart surgery. It'd be nice if heart surgeons had a bit of understanding of psychiatry so they can avoid diagnostic overshadowing. This is a significant problem that contributes to the shorted lifespan of people with severe mental illness. https://meta4rn.com/2018/12/15/shadow/ https://meta4rn.com/2018/12/15/shadow/
- treis 8y ago
  How to treat heart problems in the mentally ill would be useful training for a cardiologist. How to treat mental illness isn't.
markroseman 8y ago
Compliance with medication regimes and followup care can affect outcomes in cardiology, as in other areas. Understanding a patient's psychiatric illness, psychosocial functioning, and other factors can help predict treatment compliance. That in turn may influence the treatment regime the cardiologist recommends. Medications that are prone to abuse, ones that may be more complex to take, ones that can be dangerous if someone takes too many... all are things the cardiologist should be aware of which takes some basic psychiatric knowledge. There are few in cardiology, but many physical health meds can definitely create psychiatric side effects. How do you differentiate those from an existing psychiatric illness? There's a large body of literature that recognizes the links between cardiac care and mental health, resulting in poorer outcomes, increased system utilization and costs, etc. Saying "this is my area, that's yours" exacerbates this problem.
jacques_chester 8y ago
The common theme in these subthreads is that you consider your ignorance as a superior source of knowledge. That since you personally don't know about a thing, the thing doesn't exist. It's difficult to unhorse a debating partner who refuses to allow any evidence but their own imagination.
- treis 8y ago
  You have evidence that cardiologists trained in psychiatry are measurably better than those that aren't?
  - rscho 8y ago
    Just let it go. You are making an apex fool of yourself in the eyes of each and every health professional reading this. It would be strictly impossible for hospitals to function based on your opinions, which is why the supporting data you are calling for does not exist. We don't pretend to program better than you do or demand solid data to support your pet language/paradigm. Have a little understanding of others for a change. You are part of the problem, not the solution. Working on that would be the real improvement.
    - treis 8y ago
      >It would be strictly impossible for hospitals to function based on your opinions, which is why the supporting data you are calling for does not exist. Oh nonsense. There's plenty of evidence that lower trained providers are just as effective as doctors. Midwives are equal or better than doctors: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004667.pub3/abstract https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... No difference between Nurse Practioners and Drs: https://www.ncbi.nlm.nih.gov/books/NBK384613/ https://www.ncbi.nlm.nih.gov/books/NBK384613/ Of course we don't have studies comparing what the equivalent radiologist not because it's strictly impossible for it to happen. But because it's strictly illegal. There's also evidence that the way doctors are trained isn't the only possible way. Humanities and social science majors who omitted organic chemistry, physics, and calculus, and did not take the MCAT do just as well as traditional students: https://journals.lww.com/academicmedicine/Fulltext/2010/08000/Challenging_Traditional_Premedical_Requirements_as.26.aspx https://journals.lww.com/academicmedicine/Fulltext/2010/0800... Performance in medical school does not correlate with performance in residency: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951767/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951767/ >Just let it go. You are making an apex fool of yourself in the eyes of each and every health professional reading this Put up or shut up. Where is your evidence based argument that cardiologists who have a psych rotation have measurably better patient out comes than those that don't. Or that a radiologist with more biochem knowledge is a better one?