During a particularly hectic day, Janeni Nayagan, MD, a first-year resident in the department of psychiatry and behavioral health at Cooper University Hospital, Camden, N.J., was taken aback – but not surprised – by a patient’s comment.
Dr. Janeni Nayagan
In the middle of an emergent situation, she overheard a patient say that Dr. Nayagan wasn’t a “real doctor, she’s a psych doctor.”
“When it happened, I wasn’t particularly angry. It was something I knew I would hear eventually because I’d heard of others experiencing it,” Dr. Nayagan said in an interview. “Psychiatry is one of the fields of medicine that is often questioned in terms of legitimacy, and I knew that when I applied for psych residency,” she said.
Nevertheless, she wrote a post about the incident on Twitter, and she discovered she was far from alone. She posted her original tweet at the start of a night shift and was surprised by the number of responses when she opened her account the next day.
So far, Dr. Nayagan’s initial tweet has garnered 86 replies, 960 likes, and 35 retweets. Some clinicians reported similar experiences from both patients and colleagues, and others offered advice on how to handle such slights.
“There were a lot from people within mental health, but I also received responses from pathologists, radiologists, and others. I didn’t realize how much this experience pervaded through medicine, where a certain specialty would be told: You’re not a real doctor. So it was nice having that support,” Dr. Nayagan said.
Dr. Nayagan noted that psychiatrists encounter “specialty bias” to a greater extent than other medical professionals, and it can be a deterrent for medical students when considering psychiatry as a career path.
“It is something that has been around for a while, but it’s surprising that it’s still prevalent in 2020,” Dr. Nayagan said.
‘Busting the myth’
This type of bias is real, agreed Kaz Nelson, MD, associate professor of psychiatry and behavioral sciences and vice chair for education at the University of Minnesota, Minneapolis, and former director of the psychiatry residency program at the school for 8 years.
Dr. Kaz Nelson
She said there is “discrimination” toward psychiatrists, but noted that the problem is improving.
“I think we’re better now than 2 years or 5 years or 10 years ago, so we’re heading in the right direction. But ,” Dr. Nelson said in an interview.
“Psychiatrists have the same robust biomedical training as all specialties. They completed medical school and have this additional specialty and in some cases subspecialty training that is comprehensive of biology, psychology, and social components. We call that using a biopsychosocial model,” she said.
However, she noted that, when talking with students about the field of psychiatry, there’s an awareness “that perhaps we aren’t wearing a white coat” or a stethoscope around the neck.
“That gets translated as, You are giving up medicine – you got this medical training, and you’re not using it. And I have to bust that myth and convey that it really is a privilege to be able to integrate these aspects of knowledge and expertise. It’s in no way giving up medicine – we’re practicing medicine every single day,” said Dr. Nelson.