Sidney Weissman, MD

If history serves as a guide, psychologists are likely to obtain prescriptive authority in significant portions of the country within the next 10 years.

The ABIM is not sure whether the MOC program accomplishes a critical goal of ensuring maintenance of physician competency and has suspended the Practice Assessment, Patient Voice and Patient Safety requirements of MOC for at least 2 years.

The first half of the 20th century saw 2 world wars, indiscriminate aerial bombing of civilians, the dropping of the atomic bomb, and the Holocaust-all of which created intense trauma for soldiers and civilians.Yet it was not until the American intervention in a post-colonial civil war in Southeast Asia that the psychiatric community in the 1970s formally described what we now call PTSD.

Who speaks for doctors these days? The answer was simple 100 years ago. The AMA spoke for the nation’s physicians and concurrently spoke to the nation’s desire for quality healthcare. . . .Today, fewer than 20% of physicians are AMA members.

If psychiatry reduces or abandons its engagement with psychology and social science in understanding and treating mental disorders and focuses predominantly on the biological factors of mental disorders, what will our role as psychiatrists be?

Two perspectives regarding the American Board of Psychiatry and Neurology’s (ABPN) Maintenance of Certification (MOC) program.

Dr Weissman discusses psychiatric residency recruitment by looking at the forces that affect a student’s selection of a psychiatric career rather than at what the influences have been during the past 5 years.

America, it seems, is shy about 45,000 psychiatrists. That’s the premise of a controversial article entitled “45,000 More Psychiatrists Anyone?” by Dr Dan Carlat, that was published in the August 2010 issue of Psychiatric Times….and it’s that article that Dr Sidney Weissman has chosen as his Top Paper of the Year.

ABMS has responded to society’s demand for action to ensure the sustained competence of America’s physicians when they are in unsupervised practice and to ensure that clinicians provide quality care.

During residency training, young doctors learn the requisite skills, knowledge, and values essential to the practice of medicine. We will all agree that to learn, the resident must have the desire and drive to master the essential knowledge and skills of his or her specialty.

The varied proponents of models for the regulation of CME programs for physicians would all agree that the primary charge of these programs is to provide physicians with scientifically unbiased information on issues or knowledge that affects medical practice.

Psychiatrists are being marginalized in this current era of managed care and treatment teams. What can be done to secure the psychiatrist's role in the diagnosis and treatment of patients?

Despite expressed concerns by government agencies about the surplus of graduate physicians and residents, the net effect of the surplus is to restrain the growth of medical costs. For these reasons, until it can be proven that a physician surplus has negatively impacted patient care or until U.S. medical graduates cannot obtain medical positions, I do not anticipate a reduction of house staff positions.

A number of parameters determine how many psychiatrists our nation needs. First is the incidence and prevalence of mental disorders. Second is the kind of clinical care individuals with mental disorders will need, and who will provide that care. Individuals with mental disorders require a thorough diagnostic assessment. Does this need to be provided by a psychiatrist? Obviously, some individuals will need medications as an aspect of their care. These medications must be prescribed by a physician. Does that physician need to be a psychiatrist? Some individuals with mental disorders will need psychotherapy. Does the psychotherapy need to be provided by a psychiatrist?