Feminist Interview Essay
The prescribing health provider I interviewed is a part-time psychiatrist at the VA Long Beach Healthcare System. To begin, I started the interview by inquiring how she prepared herself to work in the field of psychiatry. For her undergraduate study, she stated that her major was in biology at first but, after being fascinated to learn about psychological aspects of chronic medical illnesses in her health psychology class, she changed her major to psychology. Then, she went to medical school to study psychiatry and got her Doctor of Medicine (M.D.) degree. After residency and the training, she became board certified to practice psychiatry. She has been working at the VA Long Beach Healthcare System for the past 8 years. Her job duties entail
…show more content…
conducting intake interviews the patients at the Combat Trauma Clinic, screening for posttraumatic stress disorder (PTSD), which is a diagnostic criteria for enrollment, developing treatment plans, prescribing and managing medication, and conducting individual and group psychotherapy. When I asked how long she sees her patient for a session, she stated that she takes about 30 minutes, which is much longer than I expected. The age range of her patients is from 19 to 90, although she has seen female patients, and they are predominantly male. Their diagnostic types include PTSD, depression, anxiety, alcohol use disorder, substance use disorder, and others. When I asked about her own prescription of psychotropic medications, she reported using selective serotonin reuptake inhibitors (SSRIs) after gathering information on the severity of symptomatology, prior drug history, use of substance, race, gender, and other individual factors.
She has encountered many PTSD patients with sleep disturbance (i.e., difficulty falling or staying asleep or restless sleep), which is included in Diagnostic and Statistical Manual of Mental Disorders (5th ed.) as a diagnostic criterion for PTSD (American Psychiatric Association, 2013). To help patients with PTSD and the sleep difficulty, she stated that she prescribes trazodone (Desyrel) or mirtazapine (Remeron) with an SSRI for more natural sleep and less stressful waking …show more content…
period. As she prescribes anti-depressants, she considers whether more sedating or stimulating one is a good match with the presenting symptoms. For those who are highly aroused (e.g., patients with PTSD or anxiety), the sedating anti-depressants, paroxetine (Paxil) or mirtazapine (Remeron) would be used over bupropion (Wellbutrin), which is an activating anti-depressant. Sharpless and Barber (2011) reviewed the current pharmacological and psychological interventions available for patients with PTSD. Their review indicated that paroxetine (Paxil) is one of the first-line treatments along with sertraline (Zoloft) and venlafaxine (Effexor), and that the first two selective serotonin reuptake inhibitors (Paxil and Zoloft) are Food and Drug Administration approved to treat patients with PTSD (Sharpless & Barber, 2011). Their review further indicated that prazosin (Minipress), D-cyloserine (Seromycin), and atypical anti-psychotics are most widely used as adjunctive pharmacological agents for treating PTSD. When I asked whether she recommends psychotherapy for her patients or not, she stated that she does recommend it so her patients can benefit from combined treatment of pharmacotherapy and psychotherapy, which is more efficacious than a single-modality treatment. She utilizes cognitive processing therapy (CPT) at the clinic, which is one of the recommended psychotherapy by Sharpless and Barber (2011). Besides CPT, they also suggested prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR) psychotherapies with the choice of medication that is promising (e.g., Paxil, Zoloft, or Effexor) to treat PTSD. This interview with a currently practicing psychiatrist has influenced the way I viewed psychopharmacology. I used to consider the use of psychotropic drugs as a last course of action with clients in psychotherapy. My lack of interest or rather ignorance of psychotropic drugs possibly comes from having no personal experience taking them, cultural factor, and the personal bias towards them. However, as I learned about the collaborative work of professionals (psychiatrist, social worker, counselor/therapist, and others), I realized the importance of combined psychotherapy and medication to provide the best treatments possible for each patient. The psychiatrist at the VA Long Beach Healthcare System was approachable, so this interview experience helped me feel more positive towards psychiatrists in general. Thus, next time my client is unsure what he is taking, how long he should be taking, or experiencing adverse effects, I would like to consult with a prescribing health provider when I used to say, “check with your doctor.” Since I considered this class assignment of interviewing prescribing professional as an opportunity for me to get abundant information, I interviewed another prescribing health provider who is a physician. David is currently practicing in Torrance, California, and he has been working as a physician for the past 25 years. His job duties entail patient care, management, and prescribing mediation. His office hours are Monday to Friday from 8:30am to 5:30pm. In fact, he stated his “actual working” hours as 16 hours per day. His patients are 70% Korean and the rest includes Caucasian, Hispanic, Chinese, and other ethnic groups. He predominantly sees elderly age over 65, particularly more women than men because men’s life span lasts 5-7 years less than women’s. He spends about 15 to 30 minutes per session with his patients. Although his three major medications are anti-hypertensive, anti-cholesterol, and anti-diabetic drugs, he does use psychotropic medications such as sertraline (Zoloft), escitalopram (Lexapro), and paroxetine (Paxil) for younger generation. In addition, for anti-anxiety medication, he reported using lorazepam (Ativan) and alprazolam (Xanax). He stated that he would initially combine anti-anxiety medication and SSRIs together, and then, have his patients off the anti-anxiety medication after certain period of time. When I asked whether David recommends counseling or any other mental health services for his patients or not, he immediately responded yes. He does consult with a psychiatrist and refer his patients for mental health problems such as severe depression, anxiety, panic attack, and suicidal ideation, while he follows up with them for medical problems. When I asked how often he decides/determines who need medications and what kinds to give them, he stated that the question is somewhat broad to answer. The severity of symptomatology is what contributes the most when he prescribes medication. When I asked what it is that he likes the most about his professional role, he stated the fact that he is helping people with physical and mental health problems.
On the contrary, he stated that what he does like least about his professional role is the fact that government is too controlling and that there is lack of autonomy as a doctor. He stated that, since the government pays for the patient health care, it directs doctors what to do when it is not convincing or does not make sense to doctors. For the biggest disappointments or challenges with his present patient population, he stated that some of his patients think that the insurance is free that they try to overutilize what they can possibly
receive. As I previously mentioned about David’s long working hours (i.e., 16 hours/day), he described that his “good day” at work would be when he can finish his work in a reasonable time. His bad day at work would be when he has too much work to do (e.g., paperwork) or is confronted by his patient or patient’s family. When he finds his patients to have similar value or belief, it helps connect with his patients even more. For example, as he mostly sees elderly patients who are Christian, he suggests them to go visit a pastor for counseling or build a support system with people in their own church. My last interview question was how long he sees himself doing current professional practice, and he responded with “another 15-20 years.” After my second interview, I realized that there is one thing in common with David’s perspective with the way I perceive psychopharmacology. David stated that he tries his best to prescribe the least amount of medication as possible (not only psychotropic drugs but others as well) that is still effective for the presenting symptomatology, which confirmed what my professor in psychopharmacology class has emphasized (Cervantes, 2015). It was interesting to me that many of his patients are Korean who come in for medical problem and overtuilize the treatment, yet they underutilize the psychotherapy or other mental health services in the community due to existing cultural bias (Atkinson & Gim, 1989). In my experience working with Korean population, I believe that merely having this awareness is not sufficient, but encouraging the significance of receiving professional help for their mental illness and helping clients increase their knowledge base of psychopharmacology are needed. This not only applies to one specific population, but to all clients who come in to our offices. After conducting interviews with prescribing health providers and learning about different psychotropic medications in my psychopharmacology class, I certainly feel more comfortable and confident to ask and discuss about psychotropic medication with my clients at the clinic.
conducting intake interviews the patients at the Combat Trauma Clinic, screening for posttraumatic stress disorder (PTSD), which is a diagnostic criteria for enrollment, developing treatment plans, prescribing and managing medication, and conducting individual and group psychotherapy. When I asked how long she sees her patient for a session, she stated that she takes about 30 minutes, which is much longer than I expected. The age range of her patients is from 19 to 90, although she has seen female patients, and they are predominantly male. Their diagnostic types include PTSD, depression, anxiety, alcohol use disorder, substance use disorder, and others. When I asked about her own prescription of psychotropic medications, she reported using selective serotonin reuptake inhibitors (SSRIs) after gathering information on the severity of symptomatology, prior drug history, use of substance, race, gender, and other individual factors.
She has encountered many PTSD patients with sleep disturbance (i.e., difficulty falling or staying asleep or restless sleep), which is included in Diagnostic and Statistical Manual of Mental Disorders (5th ed.) as a diagnostic criterion for PTSD (American Psychiatric Association, 2013). To help patients with PTSD and the sleep difficulty, she stated that she prescribes trazodone (Desyrel) or mirtazapine (Remeron) with an SSRI for more natural sleep and less stressful waking …show more content…
period. As she prescribes anti-depressants, she considers whether more sedating or stimulating one is a good match with the presenting symptoms. For those who are highly aroused (e.g., patients with PTSD or anxiety), the sedating anti-depressants, paroxetine (Paxil) or mirtazapine (Remeron) would be used over bupropion (Wellbutrin), which is an activating anti-depressant. Sharpless and Barber (2011) reviewed the current pharmacological and psychological interventions available for patients with PTSD. Their review indicated that paroxetine (Paxil) is one of the first-line treatments along with sertraline (Zoloft) and venlafaxine (Effexor), and that the first two selective serotonin reuptake inhibitors (Paxil and Zoloft) are Food and Drug Administration approved to treat patients with PTSD (Sharpless & Barber, 2011). Their review further indicated that prazosin (Minipress), D-cyloserine (Seromycin), and atypical anti-psychotics are most widely used as adjunctive pharmacological agents for treating PTSD. When I asked whether she recommends psychotherapy for her patients or not, she stated that she does recommend it so her patients can benefit from combined treatment of pharmacotherapy and psychotherapy, which is more efficacious than a single-modality treatment. She utilizes cognitive processing therapy (CPT) at the clinic, which is one of the recommended psychotherapy by Sharpless and Barber (2011). Besides CPT, they also suggested prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR) psychotherapies with the choice of medication that is promising (e.g., Paxil, Zoloft, or Effexor) to treat PTSD. This interview with a currently practicing psychiatrist has influenced the way I viewed psychopharmacology. I used to consider the use of psychotropic drugs as a last course of action with clients in psychotherapy. My lack of interest or rather ignorance of psychotropic drugs possibly comes from having no personal experience taking them, cultural factor, and the personal bias towards them. However, as I learned about the collaborative work of professionals (psychiatrist, social worker, counselor/therapist, and others), I realized the importance of combined psychotherapy and medication to provide the best treatments possible for each patient. The psychiatrist at the VA Long Beach Healthcare System was approachable, so this interview experience helped me feel more positive towards psychiatrists in general. Thus, next time my client is unsure what he is taking, how long he should be taking, or experiencing adverse effects, I would like to consult with a prescribing health provider when I used to say, “check with your doctor.” Since I considered this class assignment of interviewing prescribing professional as an opportunity for me to get abundant information, I interviewed another prescribing health provider who is a physician. David is currently practicing in Torrance, California, and he has been working as a physician for the past 25 years. His job duties entail patient care, management, and prescribing mediation. His office hours are Monday to Friday from 8:30am to 5:30pm. In fact, he stated his “actual working” hours as 16 hours per day. His patients are 70% Korean and the rest includes Caucasian, Hispanic, Chinese, and other ethnic groups. He predominantly sees elderly age over 65, particularly more women than men because men’s life span lasts 5-7 years less than women’s. He spends about 15 to 30 minutes per session with his patients. Although his three major medications are anti-hypertensive, anti-cholesterol, and anti-diabetic drugs, he does use psychotropic medications such as sertraline (Zoloft), escitalopram (Lexapro), and paroxetine (Paxil) for younger generation. In addition, for anti-anxiety medication, he reported using lorazepam (Ativan) and alprazolam (Xanax). He stated that he would initially combine anti-anxiety medication and SSRIs together, and then, have his patients off the anti-anxiety medication after certain period of time. When I asked whether David recommends counseling or any other mental health services for his patients or not, he immediately responded yes. He does consult with a psychiatrist and refer his patients for mental health problems such as severe depression, anxiety, panic attack, and suicidal ideation, while he follows up with them for medical problems. When I asked how often he decides/determines who need medications and what kinds to give them, he stated that the question is somewhat broad to answer. The severity of symptomatology is what contributes the most when he prescribes medication. When I asked what it is that he likes the most about his professional role, he stated the fact that he is helping people with physical and mental health problems.
On the contrary, he stated that what he does like least about his professional role is the fact that government is too controlling and that there is lack of autonomy as a doctor. He stated that, since the government pays for the patient health care, it directs doctors what to do when it is not convincing or does not make sense to doctors. For the biggest disappointments or challenges with his present patient population, he stated that some of his patients think that the insurance is free that they try to overutilize what they can possibly
receive. As I previously mentioned about David’s long working hours (i.e., 16 hours/day), he described that his “good day” at work would be when he can finish his work in a reasonable time. His bad day at work would be when he has too much work to do (e.g., paperwork) or is confronted by his patient or patient’s family. When he finds his patients to have similar value or belief, it helps connect with his patients even more. For example, as he mostly sees elderly patients who are Christian, he suggests them to go visit a pastor for counseling or build a support system with people in their own church. My last interview question was how long he sees himself doing current professional practice, and he responded with “another 15-20 years.” After my second interview, I realized that there is one thing in common with David’s perspective with the way I perceive psychopharmacology. David stated that he tries his best to prescribe the least amount of medication as possible (not only psychotropic drugs but others as well) that is still effective for the presenting symptomatology, which confirmed what my professor in psychopharmacology class has emphasized (Cervantes, 2015). It was interesting to me that many of his patients are Korean who come in for medical problem and overtuilize the treatment, yet they underutilize the psychotherapy or other mental health services in the community due to existing cultural bias (Atkinson & Gim, 1989). In my experience working with Korean population, I believe that merely having this awareness is not sufficient, but encouraging the significance of receiving professional help for their mental illness and helping clients increase their knowledge base of psychopharmacology are needed. This not only applies to one specific population, but to all clients who come in to our offices. After conducting interviews with prescribing health providers and learning about different psychotropic medications in my psychopharmacology class, I certainly feel more comfortable and confident to ask and discuss about psychotropic medication with my clients at the clinic.