Thursday, December 29, 2011

Dr Yao @ Blue Shield of CA: 999 refills of Suboxone

I just want to express my grattitude to Dr John Yao, MD, MPH, FACP, Senior Medical Director of Blue Shield of California, for his extraordinary generosity in authorizing Suboxone film with 999 refills for his subscriber in his "Authorization Confirmation Fax" dated 12/05/2011. The authorization is "valid from 12/5/2011 to 3/5/2012."

I am confused, however, as in the next paragraph Dr Yao writes, "The authorization has been entered with 99 refills to allow for titration purposes." Maybe that's 99 for titration AFTER the 999 are used up for a total of 1098.

Yay Dr Yao!

(If this was all a mistake at least I have another addition to my blooper collection.)

Thursday, December 15, 2011

What Would Psychiatry Be Without Psychoanalysis?

How might the practice of psychiatry have evolved without the close association with psychoanalysis? I don't know the history of how the two fields became so intimately intertwined, but I might imagine that at the time psychoanalysis gained acceptance it seemed to compare favorably with what little else we could offer those who suffered from mental disorders.

I would attribute several elements of the practice of psychiatry during the past 50 years or more to the influence of psychoanalysis:

  • The term "shrink," short for head shrinker, probably generalized from psychoanalysts to all psychiatrists. 
  • Likewise the practice of referring to psychiatrists as "therapists" probably would not have occurred without the nearly universal incorporation of this modality into psychiatric practice. 
  • Psychoanalytic/psychodynamic theory probably continues to form the basis of psychotherapy training in most residency programs. 
  • Then there is the 50 minute hour. What other medical specialty has fostered an expectation that so much time would be spent with the patient at each encounter? And what other medical specialty refers to these encounters as "sessions?"

What other medical specialty emphasizes "getting to know" or "understanding" the patient? Did this not originate with psychoanalysis?

Had it not been for psychoanalysis would other psychologies or psychotherapy methods have taken hold in psychiatry to the same extent? Keep in mind that many of these evolved out of or in reaction to psychoanalytic theories.

Will psychiatric practice some day return to what it might have been as the impact of psychoanalysis diminishes over time? Will that impact eventually disappear entirely? In the end will we say that psychoanalysis has damaged psychiatric practice or enhanced it?

Thursday, December 8, 2011

Hands Free Mic for VR

Having to don the headset has always tended to discourage me from using voice recognition software like Dragon Naturally Speaking even when the software performs well, so when I purchased a tablet PC with phased array mics a few years ago the completely adequate performance was like a breath of fresh air. This year though I put together my own desktop, so I reverted to the dreaded headset that came with my new(er) version of the software. I could hardly believe a mic costing less than $40 could handle the task, but the Andrea Array 2-S convinced me otherwise.

I mounted the mic atop my monitor, and my Web cam atop the mic. It recognizes my speech as well as any headset I have used, and works well with Skype, too.

You plug the mic into an included USB sound card. I plug my speakers into the card too. I still do not understand how to use the audio software that comes with the package, but neither do I seem to need it.