I couldn’t agree more with Dr. Henry A. Nasrallah’s editorial, “Integrating psychiatry with other medical specialties” (From the Editor, Current Psychiatry, September 2010, p. 14-15). We cannot expect our colleagues to take us seriously if we don’t afford ourselves self-respect. I came from family practice to psychiatry and have found it a convoluted place with identity issues. We want to be taken seriously but separate ourselves. I am also taken aback by blurry boundaries, starting with the term “client.” When did “patient” become a dirty word? We are doctors, not “friends” or “coaches.” In no other field of medicine is being a doctor or patient treated as a contagion to be avoided. Patient is a sacred term that implies trust and accountability. If I strive to maintain this boundary and sacred trust by wearing my lab coat and referring to my patients as “Mr.” or “Mrs.” rather than by their first name, am I somehow being elitist? Our patients have enough hurdles and gray areas in their lives; the patient-doctor relationship shouldn’t be 1 of them. We have a duty to walk a fine line with utmost care because our treatment is founded on that patient-doctor relationship. As a mentor once said, “In surgery they use scalpels. In psychiatry, we are the scalpels.”
Elizabeth Faust, MD
Psychiatrist
Iowa City, IA