Comment on NYTimes article on death of psychotherapy for psychiatrists-is it so bad?

I say good riddance to the one parent model of Psychiatry (Talk doesn’t pay, so Psychiatry turns instead to drug therapy, March 6, 2011).  For too long psychoanalytic treatment models have been allowed to dominate the profession.  Major Psychiatric illnesses have a clear biologic basis and the treatment is extremely complex.  While psychopharmacology has progressed so has psychotherapy techniques.  I seriously doubt that anyone can be an adequate master of both.  The role of the modern psychiatrist is to be the director of a team, assessing, diagnosing, and providing appropriate psychopharmacologic intervention compatible with a multitude of physical concerns while collaborating with well-trained psychotherapists.  In the one parent psychoanalytic model, the psychiatrist is often derailed from finding psychotherapy coping techniques while switching hats to see if a medication change is in order.  The data needed to determine what medication is best overlaps little with the data needed to develop a comprehensive cognitive behavioral coping strategy.  Having a separate therapist who cannot prescribe medications forces the patient and therapist to devise strategies for coping while medications are given needed time to work.  This avoids harmful premature medication changes in desperate efforts to reduce symptoms.  This is not just a cost issue.  I have been using this model of collaborative treatment successfully for over 20 years and is the model of choice for hospitalized patients.  Do you expect your orthopedist to provide your physical therapy?  Both require highly technical skill sets.  Psychiatrists have complained about such “divided” treatment.  I see it more as the two-parent model collaborating while providing complementary interventions for the benefit of patient.
      In addition, psychiatrists complaining about not being paid for doing psychotherapy often belittle the skill of none physician therapists.  I personally received therapy from three different individuals, an MD, PhD and MSW.  I can say the most helpful was the MSW.  The patient's treatment experience and outcome is greatly enhanced by a collaborative effort as each can add insights to help the mutual effort.  This is true of every complex endeavor from flying a plane to surgery.