DSM5 in Distress

We need a common sense approach to balance the important value of patient freedom with the equally important value of personal and public safety.

The doctor/patient relationship has been the central instrument of healing throughout the history of medicine, but has become a lost art. We have to teach doctors to better understand their patients so that they can become better healing instruments.

The exponential growth in the use of psycho-stimulants, anti-depressants, and anti-psychotic drugs often harms children more than helps them. This Checklist to help clinicians think through the necessary steps before prescribing medicines.

A kid not going to school is a crisis for family and school. Parents and teachers often feel helpless and perplexed. The kid may quickly spiral down into increased anxiety, avoidance, despair, and gaming. Starting treatment early reduces the risks the child will develop severe school refusal and become completely homebound.

Accumulating evidence now proves that much of arthroscopic (keyhole) knee surgery may be unnecessary because the results are no better than placebo. This is an especially startling finding because this is the second most common surgical procedure in the world (after cataract surgery).

Health

Life Is Not a Premortality Condition

Allen J Frances M.D. on April 21, 2015

Western medical science has changed life into a premortality condition and death into a failure of treatment.

Western medical science has changed life into a premortality condition and death into a failure of treatment.

There is no worse death than a hospital death. Dying well means dying at home. This requires preparation and preparation requires recognizing that dying is a necessary, and indeed desirable, part of life. Preparing for a good death may be one of the best decisions you will ever make in your life.

Psychiatry

What's in a Name?

Allen J Frances M.D. on April 5, 2015

Diagnosis and empathy are necessary partners in any therapeutic relationship, fully complementary and in no way incompatible.

Diagnosis and empathy are necessary partners in any therapeutic relationship, fully complementary and in no way incompatible.

The most "difficult" patients often eventually form the deepest relationships and have the most satisfying outcomes.

Falling is a major cause of disability and death. Physical exercise and specific balance tasks greatly reduce the risks. People who don't change their behavior to prevent falls are almost sure to have them.

In Greek myth, Cassandra was cursed with the gift of seeing the future without having any power to change it. I now know the feeling. What a mess.

As a last resort for behaviorally disturbed kids, wilderness programs provide a new chapter and offer an opportunity for greater self-control, self-esteem, and wisdom. They are good for the kids, their families, the juvenile justice system, and society.

Treatments that work well for most don't work well for all. And even effective treatments have side effects and complications. This is true of medication and surgery—and it is also true of psychotherapy.

It has been my life’s passion to help the victims of mental illness discover that they can again be loveable, loving, purposeful people with the ability no longer to be overwhelmed by their illness.

Randomized placebo controlled studies have been the gold standard in medical research, but some believe they have been so corrupted by Pharma that they cannot be trusted.

Surgeons are too quick to operate on back pain and doctors are to quick to prescribe dangerously addicting opioids. Much better bets are rehab exercises and mindfulness.

Psychiatry

Having a Severe Mental Illness Means Dying Young

Allen J Frances M.D. on December 29, 2014

People diagnosed with serious mental illness — schizophrenia, bipolar disorder, or severe depression — die 20 years early. Why?

People diagnosed with serious mental illness — schizophrenia, bipolar disorder, or severe depression — die 20 years early. Why?

Mental disorders have become a global commodity. A diagnostic fad heavily promoted first in the US now quickly spreads around the world. Parents must protect their kids from the drug company promoted flood of massive ADHD over diagnosis and over treatment.

I have known dozens of mothers who have lost children to suicide. None ever really got over it.

The Internet has reduced the price, and increased the convenience, of shopping for just every product in our economy- except medical care. Why not use comparative posted prices to empower consumers and reduce the monopoly power of providers.