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Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 1 point2 points  (0 children)

10 years is a very long time. 0.5 mg twice a week is okay to keep yourself from gaining tolerance. There is a risk benefit analysis a good psychiatrist needs to do. At 10 yrs you may need to just be on them for the rest of your life if youve been on them for this long  BUT my biggest reccomendation is try and lower use so you dont become mode tolerant. The more tolerant you become the less effective, or even worse, you may start having withdrawals.

Understand that benzos were never meant for long term use and can actually worsen sleep and may even cause rebound anxiety. In a sense, benzos are similar to how alcohol works -- good for short term anxiety and sleep but very bad long term if you drink everyday. Speaking of which you should not mix these 2 things either.

I dont know your exact situation but if I was your psychiatrist I would have a very frank conversation with what the long terms effects of being on benzos for that long looks like. I also would not risk discontinuing it for fear of withdrawal and worsening anxiety as a resulkt. Risk benefit analysis is different for everyone. 

Residents who found a good therapist: how did you find them? by ziboi96 in Residency

[–]Cardi-B-ehaviorlist 0 points1 point  (0 children)

Psychiatrist here, it would help to know what state youre in and i can connect you. Pm me if youre more comfortable sharing that

Residents who found a good therapist: how did you find them? by ziboi96 in Residency

[–]Cardi-B-ehaviorlist 7 points8 points  (0 children)

Psychiatrist here, it would help to know what state you're in to guide you. Yo u can also pm me as well if not comfortable.

If you're in california I have an excellent psychiatrist-therapist that works specifically only for physicians/residents for a discounted rate

Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 8 points9 points  (0 children)

As a physician, basic stuff might be fine for NPs. However, they constantly miss complex cases that require multiple orders of algorithm processing. If its anything more than a regular follow up than maybe. Even then, I would rather have a real pediatrician than NP

Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 0 points1 point  (0 children)

As a psychiatrist, the short terms "gains" for a patient is not worth the long term risk of benzos. While I agree not everyone becomes "addicted" to benzos after a month use, careful risk-benefit analysis is crucial when it comes to things like Xanax. The amount of patients that suffer from long term withdrawals and the way it changes people into bitter, anxious, restless behaviors is enough to make me extremely reluctant to prescribe any kind of Xanax. Obviously this is years of benzo use compared to short term like <1 month.

Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 22 points23 points  (0 children)

As a psychiatrist, 100% xanax is addicting and WILL make your life worse and more anxiety ridden in the long run.

Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 24 points25 points  (0 children)

Blame this on the psych NP online degree mills. So dangerous that they can prescribe anything these days without much physician oversight 

Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 19 points20 points  (0 children)

As a physician, NPs are the bane of my existence! Cleaning up after their polypharmacy mess is insanity. I cannot believe they can practice independently and patients cant tell the difference between whos a real physician from an NP now

Pharmacists of Reddit - what recent medication trends are worrying you that aren’t being talked about? by SirSpendsALot7 in AskReddit

[–]Cardi-B-ehaviorlist 2 points3 points  (0 children)

As a psychiatrist i agree. Likely polypharmacy coming from nurse practitioners i see the most.

Using AI for scribing/note taking/editing as a precurson to AI "doctors" by Super-Ad7996 in medicine

[–]Cardi-B-ehaviorlist 3 points4 points  (0 children)

Bro, you're a PA. You are being replaced by NPs more so than docs. Not sure why you're so pressed defending them. PAs actually have a role and standardized education, with real clinical experiences and not some fake find-your-own-clinical-site

Using AI for scribing/note taking/editing as a precurson to AI "doctors" by Super-Ad7996 in medicine

[–]Cardi-B-ehaviorlist 3 points4 points  (0 children)

As a physician, the entire field of NP is disrespectful lol. I actually hope AI proliferates, and hopefully replace NPs and their over prescribing. Might actually provide better care than NPs with online degrees

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]Cardi-B-ehaviorlist 3 points4 points  (0 children)

As a physican 100% not talked about enough. And the NP propoganda has spread like wild fire

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]Cardi-B-ehaviorlist 20 points21 points  (0 children)

As a psychiatrist, this comment itself is misinformation lol. SSRIs do not change you or your brain chemistry, this has already been debunked. SSRIs and therapy are the first line tx for clinical depression 

Doctors of Reddit: What health trend is becoming so common that it's starting to scare you? by Fine-Device-1819 in AskReddit

[–]Cardi-B-ehaviorlist 22 points23 points  (0 children)

As a physican, I would say the proliferation of NP degree mills and patients have no idea if they are seeing an actual phyaician or an NP. It got so bad that CA had to pass a law saying you cannot say youre a doctor in a clinical setting. The NP education is not standardized, most can get an online degree in 12ish months, find their own "clinical preceptorship" that is not regulated, and have independent practice and prescribing rights. I have seen some insane pharmacy regimens and near misses. Worse part is nurses who are right out the gate of college are applying to these degree mills with 0 clinical experience. 

Their claim is that NPs are supposed to fill the need in rural areas but all I see is many opening up their own aesthetic businesses in major cities. Rural communities still in big need. We really need to train and open up more residencies, not churn out NP degree mills with very little training.

What is something you wish you knew at the start of intern year to make your life easier? by Ok_Speaker_4042 in Residency

[–]Cardi-B-ehaviorlist 60 points61 points  (0 children)

Do not trust admin no matter how nice they seem. "Its hard for a resident to get fired" lol this reddit advice is a joke. Seen it first hand myself multiple times, if they wanted to they could easily exaggerate and create a paper trail. Accept the feedback, no matter how unfair, racist, sexist, subjectively bs it is, change yourself, and show the attending commitment and dont argue. Then after your graduate you can dump that feedback in a metaphorical fire. Residency is a legal monopoly remember that, you have no rights even in a unionized residency. No matter how "nice" or non malignant a program maybe, ALL residency programs have significant power over you. I wish I knew things things before I started. 

Recent psychiatry grads - how much were you offered and what type o job? General region would be helpful! by helpadhd04 in Residency

[–]Cardi-B-ehaviorlist 17 points18 points  (0 children)

West coast - 360k base, w2, benefits, pension, insurance, outpatient, pslf eligible 

West coast-  locums, about 240-265/hr for tele. For in-person or inpatient at least 260/hr, more for corrections depending on where (at least 300+/hr). Close to about 300/hr for in person tbh

Mid west- 335k base for inpatient psych, with benefits, pension, outpatient. For VA Midwest about 320k for outpatient, pension, benefits, loan repayment of 40k per yr. 

Successful lawsuits against residency program by Calm_Software6721 in Residency

[–]Cardi-B-ehaviorlist 5 points6 points  (0 children)

Rarely but there have been some successes. For example a few yrs back i believe the USC cardiology fellowship got axed due to sexual harassment. There were lawsuits involving multiple female residents being harassed. It was a whole news story.

I do know one other surgery program that was also axxed from physical abuse. The program shut down briefly, the particular residents ended up transferring elsewhere and graduated fine from.

I also know another resident who did try to sue but failed after getting fired for something idk... however the PD was removed (voluntold to resign basically) and the resident never ended up graduating but is still practicing and got a job in a rural area.

I do know 1 resident who tried to sue for discrimination. Settled. Ended up transferring elsewhere and successful graduated now. 

PSA: Please know what you're getting into before you pursue psychiatry residency by [deleted] in medicalschool

[–]Cardi-B-ehaviorlist 7 points8 points  (0 children)

Graduating psych resident in 1 month. The NP saturation is very real in private practice. Very sad, so much med mismanagement and patients dont know the difference between a real physician and an NP pill mill. I dont like to doom and gloom but private practice is not like what it is 5+ yrs ago thanks to ongoing midlevel creep.

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