Electronic Spring 2022 | Issue 50

Behaviorist vs. Psychiatrist: Reflections from Past IPS President

By: Alex Spadoni, MD

An alarming trend appears to be occurring in Illinois and throughout the country: replacements of words psychiatry and psychiatrist with behavior disorders.

Departments of psychiatry have now become departments of behavioral sciences. Hospital psychiatric units are now behavioral units. Outpatient clinics are now behavioral resources.

When did schizophrenia, bipolar illness, depression, and anxiety become behavioral problems? One could make the case that diabetes, cancer, and cardiac illnesses are behavioral. This blurring of terminology is causing confusion among patients and referral sources. Just as the stigma of psychiatric treatment was fading, behavioral has now eliminated stigma but caused confusion.

Elimination of the words psychiatry and psychiatrist will have implications for medical and psychiatric education. Medical schools will have to revise their curriculum and clinical rotations; and are four years of residency training necessary for the limited roles of diagnostics, psychopharmacology and somatic techniques, delegating traditional psychotherapies to less trained “therapists”?

These changes will be a bonanza for malpractice attorneys and confusing for insurance companies. Thus, it is important that IPA and APA address this issue.

As for next steps going forward, discussions with council members regarding this issue can ensue, with possible considerations of developing a resolution to condemn the practice. Perhaps this issue could be brought to the APA for their consideration and response. Every psychiatrist in Illinois should express their concern to hospital CEOs, medical directors, unit chiefs, heads of clinics, and solo practitioners. Furthermore, ISMS could be very helpful in this venture.