The use of Bipolar Disorder in psychiatry is akin to “chest pain” in cardiology.  One does not know if there is a strong cardiac role to chest pain when it first presents, and even when it is ruled in as a factor per cardiovascular problems, still an effort to pin down to where and how it is the problem.

So, how many out there either as provider, patient, or connected other to a patient, hear this term used often at literally moment one when a person comes in with “mood problems”?  I am sick of it, and I am even more sick of hearing colleagues then want to debate not what drug to provide, but how many drugS to provide.  Bipolar Disorder is presented as a chronic condition that needs polypharmacy to knock out elephants.

And then there were several articles in the November issue of Clinical Psychiatry News, one noting the long wait times for patients to be discharged from ERs, another how more physicians are just throwing up their hands and becoming employees of hospitals, and the last article, “Access issues looming as more docs eye exit from Clinical Practice”, I’ll link that one for those interested:


You cannot have a soul and be an honest, committed provider in this country anymore, hence why you read in there:

“Given the volume of change, it is no surprise that physician morale is low, Dr. Ray said. “One of the first things that jumps out is morale. The question was ‘what best describes your professional morale about your current feelings and the current state of the medical profession?’ and 54% were somewhat or very negative; 46% were positive/somewhat positive/very positive. The very negatives were twice what the very positives were,” he noted.”

Then at the end this, “I think it all bounces back to interference with the doctor/patient relationship and the fact that [physicians] feel like there are distractions within the practice of medicine due to the regulatory environment,” he said “They are not allowed to make decisions like they want to make in the best interest of their patients based on their training and their studying and their special experience with that patient. It creates this barrier with this professional satisfaction that they want to receive from taking care of patients.”

Why I have been doing Locum work these past 7 years for the most part.  Administration alone at most of the sites I have worked have no clue to honestly and effectively advocate for both patients and providers, nope, just about PR, money, and control.

One week to go, debating I should go to Twitter?…

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sunrise shot


bow to leader

black and white guys

crabby hat

hope and freedom