The following was written by Dr. Doug Weir, a psychiatrist and a former OMA President.
The Tentative Physician Services Agreement:
Why I Am Voting YES
by Dr. Doug Weir Continue reading
Page 45 of 55
OMA Section on Psychiatry Position on tPSA
The OMA Section on Psychiatry emailed out the following statement. It’s unanimously approved.
I’ve attached the Tariff Analysis by Dr. Sonu Gaind. Dr. Gaind is the president of the Canadian Psychiatric Association.
Yes or No on tPSA
In the last few days, I’ve received more than a dozen emails and read a score of tweets – and that’s just from the two organized campaigns. As Ontario doctors get ready to weigh in on the Ontario government offer, there are many opinions being offered up.
I’ll disclose that I’m a member of the OMA’s Section on Psychiatry Executive.
How to cast your ballot on the three questions?
I’d like to focus on two letters that are relevant to Ontario psychiatrists. The goal here isn’t to lobby you but to help inform you.
The next two posts are worth reading and considering.
Paper with an N of 14 Lands NYT Story
There is more to this story than a paper with a tiny sample of people — yes, just 14 — landing in The New York Times.
Benedict Carey is an excellent reporter and he looks at the Hearing Voices Network, which attempts to help people with psychosis without labels like patients. And without medications.
Benedict Carey
Here’s the link for “An Alternative Form of Mental Health Care Gains a Foothold”:
And, yes, the article closes by mentioning a Psychiatric Services paper with an n of 14.
Quick question: if we were talking about a group promoting, say, breast cancer treatment without chemo or radiation, would they have gotten so much attention?
A Podcast Worth Listening To
I’m a big fan of the National Elf Service — a nice collection of bloggers writing about the literature.
Recently, they have started doing Podcasts, and the project doesn’t disappoint.
There are several good Podcasts in the series, but I particularly like the interview with Oxford’s Willem Kuryken on mindfulness.
Kuryken, as you will recall, has been the first author of a couple of excellent new papers that I have been highlighted in the Reading of the Week. Here, he talks thoughtfully about the topic he knows best. There are good insights on depression and relapse prevention — and more.
https://soundcloud.com/national-elf-service/mindfulness-with-willem-kuyken
Willem Kurken
On The Night Table: The New Depression Guidelines
On the night table…
“Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder”
The CANMAT group’s latest work is published in The Canadian Journal of Psychiatry.
The full documents are now online first.
Find them here:
http://cpa.sagepub.com/content/early/recent
My sense after a first read? Excellent and practical.
Reading of the Week: Mental Illness and Bay St., and More
From the Editor
Recently, I spoke with a woman I hadn’t met before – a friend of a friend, gathered over coffee by a kitchen table. When she found out that I was a psychiatrist, she talked about her daughter’s struggle with mental illness and I thought how rarely people spoke to me about such things just a decade ago.
As people grow more comfortable talking about their experiences and their family’s experiences with mental illness and as stigma slowly fades, these conversations on Main Street, so to speak – at our kitchen tables and at our kids’ baseball games – are growing more and more common. But people in the corporate world are also growing more aware of the need for us to address mental health problems. No wonder. Consider that the single biggest reason for people to be on disability in Canada is mental illness. And so, there are conversations on Bay Street, too.
In this week’s Reading, we consider a new essay from the Harvard Business Review. In it, CEO Kelsey Meyer talks about her company’s development of a mental health policy.
Also in the Reading: journalist Scott Stossel reviews Dr. Peter Kramer new book on antidepressants – and his own experience with medications.
Please note that the Readings will be “going fishing” for the next two weeks, returning on 11 August.
Reading of the Week: Can We Prevent Psychosis? Part 2 of 2
From the Editor
Is an ounce of prevention worth a pound of cure? As noted last week, psychiatry tends to emphasize the treatment of illness, not its prevention. But preventing illness is our ultimate goal.
Can we prevent psychotic illness?
Prevention is built on two things: we need to identify at risk individuals, and then we need to use appropriate measures to prevent the illness.
Last week. The psychosis risk calculator.
This week. Cost-effective prevention.
In this week’s Reading, we look at a paper that considers CBT to prevent psychosis in an ultra high-risk group; the paper also considers the cost-effectiveness of the intervention. So is Ben Franklin right in arguing that an ounce of prevention is worth a pound of cure? The paper doesn’t weigh in on Franklin, of course, but it does find that CBT is economically sound with an 83% likelihood of reducing the transition to psychosis and at a lower cost.
Reading of the Week: Can We Prevent Psychosis? Part 1 of 2
From the Editor
Here’s a quick statistical summary of the Readings for the past 12 months.
Total: 48.
Number discussing the prevention of mental illness: One.
Is an ounce of prevention really worth a pound of cure?
Like all of medicine, psychiatry tends to emphasize the treatment of illness, not its prevention. This isn’t the result of a vast medical-industrial conspiracy, of course, but the reality that our field is young and the causes of mental illness aren’t well understood.
But preventing illness is our ultimate goal. Consider the suffering and cost that could be avoided if a person at risk of psychosis didn’t convert, as an example.
Can we prevent psychotic illness?
Prevention is built on two things: we need to identify at risk individuals, and then we need to use appropriate measures to prevent the illness.
Over the next two weeks, we look at a few papers that seek to identify at risk individuals and prevent psychosis in them.
This week. The psychosis risk calculator.
Next week. Cost-effective prevention.
In this week’s paper from The American Journal of Psychiatry, Cannon et al. develop a risk calculator to predict psychotic disorder. The tool they develop has an accuracy rate of 71% – comparable to calculators used for determining cancer recurrence.
Reading of the Week: Do the Meds Work? Peter Kramer’s Essay, and More
From the Editor
Do the pills really work?
It’s a question that we clinicians are repeatedly asked. Antidepressants are widely prescribed, but often doubted – by our patients and by people in general.
This week, we look at an essay penned by Dr. Peter Kramer, an American psychiatrist. Dr. Kramer, you may recall, made a name for himself two decades ago by extolling the super-therapeutic powers of Prozac. Today, he has a more modest goal: explaining the role of antidepressants in the treatment of depression.
Then, looking to The New England Journal of Medicine, we consider a paper that discusses the rise and, perhaps, fall of randomized controlled trials as the “gold standard” of medical research.
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