Scott Alexander explores two contrasting attitudes in psychiatry, discussing their merits and pitfalls, while reflecting on his own tendency to favor a more straightforward approach. Longer summary

Scott Alexander discusses two contrasting attitudes in psychiatry: Attitude 1, which takes patients' requests at face value, and Attitude 2, which seeks to unravel underlying complexities. He provides examples where Attitude 2 is clearly beneficial, but also highlights its potential for misuse. The author admits to leaning towards Attitude 1, partly due to personal preferences and social pressures. He expresses uncertainty about whether this approach is always correct and worries about potentially missing important underlying issues. The post reflects on the challenges of balancing these approaches in psychiatric practice. Shorter summary

Scott Alexander explores the nuanced ways pharmaceutical companies influence doctors, arguing that their tactics are more subtle and ethically complex than simple bribery. Longer summary

Scott Alexander discusses the complexities of pharmaceutical company influence on doctors, using personal anecdotes and hypothetical scenarios. He argues that pharma companies use subtle tactics beyond simple bribery, such as providing free lunches or drug samples, which can be difficult for even ethical doctors to resist. The post also touches on a community dinner sponsored by a pharmaceutical company, which highlighted tensions between different healthcare professionals. Scott emphasizes that pharmaceutical companies are 'sneaky' in their approach to influencing medical practitioners. Shorter summary

Scott Alexander critiques standard psychiatric responses to psychotic patients and proposes more honest, nuanced alternatives based on individual patient circumstances. Longer summary

Scott Alexander discusses his experience at the Michigan Psychiatric Society conference, focusing on how psychiatrists should respond to psychotic patients who ask if they are believed. He critiques a prestigious psychiatrist's standard response as condescending and potentially enraging to patients. Scott then explores alternative responses he'd like to give, emphasizing honesty and acknowledging the patient's perspective. He also addresses the common question 'Do you think I'm crazy?', suggesting that the standard answers aren't always helpful and proposing more nuanced responses based on the patient's situation and personality. Shorter summary

Scott Alexander discusses a study suggesting communication skills training for doctors may be ineffective, and shares personal observations on the nuances of doctor-patient communication. Longer summary

Scott Alexander discusses a study from the Journal of the American Medical Association that suggests intensive communication skills training for doctors may not improve patient outcomes and could even have negative effects. He relates this to his own experiences in medical training, sharing an anecdote about an attending physician with excellent communication skills who used an unconventional approach when delivering a cancer diagnosis. The post critiques the effectiveness of formal communication skills training in medicine and suggests that some aspects of effective doctor-patient communication may be difficult or impossible to teach. Shorter summary

Scott Alexander examines the limitations of empathy training in medical education and shares his experiences learning to express empathy effectively as a doctor. Longer summary

Scott Alexander reflects on the teaching of empathy in medical school and its application in real-world doctor-patient interactions. He describes the awkward role-playing exercises used to teach empathy, which often result in stilted, scripted responses rather than genuine human connection. Scott explains that this approach is driven by the need for standardized, legally defensible assessment methods. He then shares personal experiences as a new doctor, highlighting the challenges of expressing empathy appropriately in emotional situations. The post concludes with insights on how Scott has learned to better navigate these interactions, emphasizing the importance of focusing on the patient's needs rather than demonstrating one's own empathy. Shorter summary