561. The political science of psychiatric diagnosis, a moral defense of the DSM (1:01:15)

Date:
2014-02-26
Main contributors:
University of Virginia. School of Medicine
Summary:
The Diagnostic and statistical manual of mental disorders (DSM) is perhaps the most contested document in American medicine, vital for the organization and funding of psychiatric research and mental health care, yet perennially criticized both from within and behond the mental health community. Heated debate accompanied the 2013 publication of the manual's fifth edition, DSM-5. Critics charged that the new edition masks political interests (e.g. interests of psychiatrists and pharmaceutical companies) under the guise of science at patients' expense. DSM-5 defenders championed the inclusiveness and transparency of the review process and evidence-base behind the manual's diagnostic decisions. In this Medical center hour, psychiatrist and theologian Warren Kinghorn argues for a mediating alternative: that the DSM may be best understood as neither an apolitical "encyclopedia" of psychopathology nor a political cloak for psychatric power, but rather as a working document of a living moral tradition. In this case the tradition-constituted discourse allows for appreciation of the DSM as a useful scientific document that reflects the moral assumptions and convictions of the communities that created and continue to sustain it. Co-presented with the History of the Health Sciences Lecture Series

565. The primary care physician, an endangered species? (1:02:15)

Date:
2012-09-19
Main contributors:
University of Virginia. School of Medicine
Summary:
With the aging of our nation's practicing physicians and the recent, steep decline in medical graduates choosing careers in primary care for adults, U.S. patients today are hard pressed to find a primary care doctor. And the already impressive gap between supply and demand of primary care physicians will likely widen once more than 30 million people gain access to health insurance under the Affordable Care Act. The urgent shortage of primary care physicians compounds this country's already significant health care challenges regarding access, delivery, and cost of care. In an era when all of health care is undergoing potentially transformative change, what will be the role of primary care doctors? For patients, what will be the "value added" of having a primary care M.D.? What roles will other primary providers (physician assistants, nurse practitioners) play? Is the primary care physician an endangered species, or a key participant in a newly configured primary care team? How can we devise, model, deploy, and teach new ways of delivering primary care that are team based, interprofessionally collaborative, effective, and satisfying to patients and practitioners alike? In this Medical Center Hour, family doctor and medical journalist Susan Okie draws on her recent Perspective article in the New England Journal of Medicine to explore the prospects ahead for the primary care physician. Two of UVA's primary care physicians: one a mid career family medicine physician and teacher, the other a medical student planning a primary care career offer their perspectives as well. Co-presented with the Generalist Scholars Program in observance at UVA of Primary Care Week