Restoring wisdom to the practice of psychiatry.

OBJECTIVE

While psychiatry is an exciting and rewarding discipline of medicine, the practice of psychiatry has become increasingly simplistic. This address seeks to identify some of the influences that underlie this phenomenon.

CONCLUSIONS

The influences include an increased demand for services and pressure on beds, the sway of the pharmaceutical industry with a biological approach being promulgated, excessive managerial constraints with an emphasis on efficiency versus effectiveness, and the acceptance of DSM diagnostic categories of uncertain validity. I argue that we need to rediscover a more wise approach to psychiatric practice. We have to insist upon changes to our training such that trainees are encouraged to get to know their patients and understand them from a biopsychosocial perspective. As a profession, we have to insist on proper care for our patients and work with managers and bureaucrats to ensure that the management of our patients is centred on quality of care and effectiveness over and above efficiency.