Well, now I know I haven’t missed providing outpatient care after the one year hiatus I took working for the State of Maryland at their chronic care facilities.  Yep, the never ending pursuit of dependency, entitlement, and enabling has been unchanged from my travels prior.  And what makes it the worst is how providers are the most egregious in promoting these pathetic, pathological, and compromising behaviors not only in the patients, but among clinicians as well.

Can’t say “no” to patients, can’t make patients participate in therapy, can’t hold people accountable WHEN patients overtly screw up, and the most annoying and unredeemable matter of drug seeking that gets legitimized and rationalized.  I hate it, I won’t support it, and I won’t condone it.

And now, let’s take a tangential turn to a couple of ridiculous reads in the usual throw aways, Current Psychiatry, from that shill and pharma sell out Editor in Chief Henry “I gotta hankering for money” Nasrallah, and from Clinical Psychiatry News,  a Glenn M Losack letter to the editor.

First, Shill Nasrallah’s editorial piece “For first episode psychosis, Psychiatrists should behave like cardiologists”, as he makes a case that a psychotic break is “a brain attack”, and how psychiatrists should put all patients on injectable antipsychotics at this moment one, the way I read it irregardless if the cause of psychosis is schizophrenia or just happens to be a by product of a mood disorder, or good forbid occult substance abuse???

Because Shill Nasrallah is in the back pocket of Abilify and Invega, I’ll bet good money that is completely true.  Here’s the lame editorial, read it and creep, er, weep, or is it reap, nah, that’s Shill’s agenda…

(Current Psychiatry makes one be a member, so this other link is a summary):


I’ll type the last paragraph of Shill’s original column, to help my typing skills and to show how ridiculous he thinks:

“As psychiatric practitioners, we must be clinically aggressive during the “FEP [First Episode Psychosis]window of opportunity”, to avoid a second episode, thereby bending the curve of the downhill trajectory that occurs after second episodes.  We must behave like cardiologists, and relentlessly protect patients who suffer a first “brain attack” from experiencing a relapse.  No doubt, any psychiatrist who have a family member with FEP would channel their inner cardiologist and implement the evidence-based recommendations described above, but then shouldn’t we apply the same standard to every FEP patient we see?”

As for this Dr Losack, well, I hope folks have better luck finding the link, as I exhausted my efforts, but will sum up this psychiatrists points to “How to Save Psychiatry”.

First, he tells us of his “quite a lot of experience” per his 60 short term jobs over the past 36 years, working in New York/New Jersey/Connecticut areas in “every conceivable job for psychiatrists”.  This taught him these things:  Psychiatry is in trouble because of the shortage of psychiatrists and he claims there are places offering $50,000 PER WEEK for inpatient jobs [after reading that I knew the remaining three columns would be both hilarious and hideous]; then psychiatry will lose its prestige because of NPs and PAs; next, millions of Americans in rural areas aren’t being treated by docs, that then leads to his next point how telepsychiatry is for him at least the perfect position as he can treat patients from his Manhattan apartment, as he has no costs to accrue working for a Locums.

But, number 5 of his experienced teaching is the most absurd, and this coming from an alleged MD:  “I think it makes absolutely no sense for an MD or DO to do a 4 year residency any longer in psychiatry.”  He goes on to outline how a 2-2 &1/2 years of training that is basic medicine, 1 year inpatient, and 1 year outpatient would suffice.  Oh, and then his theme to all this winds up:  “a psychiatrist could be earning close to $200,000 instead to pay back loans.”

I end with what this cretin is really about, and how it is so disingenuous, dishonest, and rather disdainful for CPN to print this shit correspondence in the first place:  “Locum Tenens has allowed me to follow my passions in music, photography, and travel and earn a decent living doing so”, and then he includes his own links that are printed in the article to follow him?!

Which brings us back to the point of this article:  dependency, entitlement, and enabling is f—-g up everything in mental health care at least, and we have to read it from the pricks like Nasrallah and this New York loser Losack who get exposure in print from popular throw aways.

Sad, isn’t it?

Oh, and a take on the Losack letter from this colleague:

Changing The Three Legged Stool

Good luck this Fall…

funny psychiatrist cartoon

Sums up the characterological crap running the profession.