Lockup Doc

We probably all know people who seem out of touch with their emotions. We may suspect that they are distressed, but typically they say that they feel fine emotionally.

I’m not talking about people with social anxiety issues or stoicism who hold back their feelings and simply need to learn to express them. I’m referring to those who truly don’t know what they’re feeling. Or, if they do, they have great difficulty putting those feelings into words. The lightning bolt of major depression could strike them, but they would be clueless to articulate how they felt. In fact, they may be more likely to seek medical care for somatic symptoms if clinically depressed. Read more…

This article was published on the popular medical blog, KevinMD, on February 16, 2010. I wish to express many thanks to Dr. Kevin Pho for accepting my guest post.

It covers a topic about which I feel strongly and that I have pondered many times in recent years. My real hope is that it will not only be thought-provoking but also will positively impact the medical care for those people living with developmental disabilities.

Click here to go to KevinMD to read the article.

I know an elderly psychiatrist who used to do some small-time farming. I was always impressed with how many things he could buy without his wife objecting. Many of the items he purchased could have been considered, depending on one’s viewpoint, “tools” or “toys” (power tools, trucks, old tractors, etc.). There seemed to be two reasons he was able to do so. First, he had a great strategy. Anytime he bought something for himself, he either bought the same thing for his wife or bought her something equivalent. If he bought a Grand Cherokee, she got one, too. It must have been expensive, but it probably helped him to avoid years of marital discord and ultimately Dr. Phil telling him to “get real.” The second reason he got away with buying so much stuff was, as he told me, because “the tool always creates the job.” He loved all of these toys, and he had a special knack for always proving how useful each of them was because he inevitably would find the “need” that the tool would fulfill.

Is the social media craze similar to my psychiatrist friend’s farm tools? Read more…

Fortunately most patients are honest. They mean what they say, and they realize that ultimately it is in their own best interests to be truthful about their health issues. However, it is a stark reality that many patients lie to health care professionals.

According to a WebMD survey about patients lying to doctors, out of nearly 1,500 respondents, 45% admitted they had either lied (13%) or “stretched the truth” (32%).

It is likely that an even larger percentage of jail and prison inmates lie to health care providers.

Patients are untruthful for different reasons.

People everywhere typically want Read more…

A few months ago I performed an inpatient consultation on a non-incarcerated patient. His psychiatric care was being managed by a neurologist in another community.

I was shocked and disappointed when his family informed me that the neurologist told them that if the patient sought a medical opinion elsewhere, the neurologist would no longer treat the patient.

Even on a bad day I cannot fathom exuding such arrogance and insecurity! Hopefully this doctor’s attitude about second opinions is the exception and not the rule among physicians. However, this situation sparked my curiosity about second opinions.

Throughout my career, I’ve often encouraged my patients to obtain second opinions, either when Read more…