All Psyched Up: Professional silos

By Dr. Linda Hancock on March 6, 2020.

office@drlindahancock.com

I was raised in a small town in southern Saskatchewan. We had a couple of doctors and a small hospital but seldom had any contact with “specialists” and if required, needed to drive almost an hour to the nearest city for assessment and treatment.

The doctors made house calls back then and took care of all our physical and mental illnesses with only the aid of instruments carried in a black bag.

Things are VERY different today. It is unusual to think that a doctor might make a house call and those in the medical profession have a narrow scope of practice that clearly defines what they will and will not do. That might not include what we think they should do or what we need.

I recently enjoyed the book “The Checklist Manifesto” by Atul Gawande, a doctor who makes the argument that we now not only have specialists but also super specialists. For example, in the past we might have thought that we just needed to find a surgeon to operate on our knee. Now we need to ensure that we find a surgeon who actually is specialized in knee surgery.

This became very real to me last year when my daughter-in-law had a growth the size of a golf ball on her lung. She lives in Saskatoon where there are several large hospitals but was told that there was only one specialist in western Canada who could perform the operation. He was in Calgary!

When is comes to mental health we face the same complexities. There are psychiatrists who specialize in thought and mood disorders. They can prescribe and hospitalize but appointments are usually difficult to get and short in duration. In Alberta, they are covered under the provincial funding so there isn’t any charge for their “patients.”

Psychologists cannot prescribe or hospitalize and have different specializations. Some focus on children, or adults, couples, businesses or groups. Their practices may offer clinical (mental illness), educational, research, or counselling services. Some do assessment while others provide therapy.

Those who describe themselves as therapists or counsellors usually have less training than psychiatrists or psychologists and tend to work in specific areas such as addictions, parenting, or career issues.

And then there are the family physicians who, because of time constraints and long waiting lists, frequently refer those with special needs to other professionals.

Our system has strayed a long way from the single rural doctor who deal with everything. Now we are faced with trying to understand professional silos. Dividing our health system into specialized areas of practice usually means that there is confusion for the general public. Where do you go? How can you get help?

The secret to finding someone who can deal with a problem is threefold:

1. Know what you need and want from a service. Is it suicide prevention, assessment for career training, treatment for depression or just someone who can listen?

2. Do some research. Most professionals have a website or an intake system that allows you to ask good questions. Find out if there is a charge for sessions. Do you need to do paperwork in advance of the first appointment? What types of services are offered?

3. Be ready and willing to set goals and work towards there achievement.

There aren’t any magic solutions and change requires your time and energy. There isn’t any professional who can your problems but if you are committed to change and prepared to make the effort, I know that progress will occur.

Dr. Linda Hancock, the author of “Life is An Adventure…every step of the way” and “Open for Business Success” is a Registered Psychologist who has a private practice in Medicine Hat. She can be reached at 403-529-6877 or through email office@drlindahancock.com

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