AN OPEN LETTER TO THE AMERICAN PSYCHIATRIC ASSOCIATION

To whom it may concern:

I am writing to express my extreme displeasure (i.e. anger) at the system you have set up for the DSM-V. As far as I can tell, the publication of this volume is nothing but a money-making scheme.

I am an APA member and have been one since residency, a good 25 years now. You have received thousands of dollars of my money over the years. I purchased the DSM-V as soon as it came out (in paperback, as the hardcover version was prohibitively expensive). I now re-purchased it as an e-book, for the only reason of being able to copy and paste diagnostic criteria for inclusion in forensic evaluations. Yes, I am well aware of the limitations and cautions of using the DSM-V in a forensic setting. I am a board-certified (and re-certified - yet more $$$$) forensic psychiatrist.

So after I spent an additional $120 on the electronic version of this relatively uninformative and useless book, which bears minimal resemblance to daily life in the office of a working psychiatrist, I now find that I cannot copy/paste the criteria. I have to TYPE them out as if I were in typing class in seventh grade. I also note that the electronic version of the DSM-V is not even clickable, so in order to get to a certain section I have to scroll through hundreds of unrelated pages, and it is quite difficult to reach the page I want. I tried the "bookmark" feature but all my bookmarks disappeared when I closed the application. Perhaps I am technologically stunted. That's okay. I studied psychology, and then medicine, not computers. I also note that the time I spend typing is not really billable as expert time.

Meanwhile, your organization, of which I am a less-than-proud member (I do it only for the fact that the courts, in their infinite naïveté, expect membership in professional organizations) has done NOTHING to help psychiatry and psychiatrists. We have more mass murderers than ever before. Insurance companies don't cover medications. Patients don't want to take responsibility for their own treatment or recovery. Medicaid, now a big deal under Obamacare which you supported, pays a whopping $7 per outpatient visit. My 17-year-old earns more making food deliveries on his bike. We have to farm out psychotherapy to social workers to who tell our patients to "smell your food" and instruct girls to pretend-cut themselves with ice cubes instead of razor blades. These same social workers like to tell their patients that psychiatrists don't know how to do therapy and also tell them that all we are good for is writing prescriptions, so they should specifically ask for Wellbutrin (the only medication with its own rabbi) or Lexapro (the one that causes total post-synaptic burnout in five weeks). Do you guys even know that this is happening? We have a parody of parity, in which we are paid a fraction of what other specialists are paid to work much harder, to try to cram therapy and suicide prevention into 15-minute hours every three months. And I can't even include diagnostic criteria in my reports without spending an hour typing them over? You must be kidding me. The APA is a useless organization that has done nothing for its members let alone for the millions of mentally ill in this country.

Don't bother sending a fake response. Take this email to some committee. I invite any one of you people whose salaries I and my colleagues pay to come sit in with me for a day and see what life is like in the trenches. The APA and its love affair with big Pharma and the insurance industry disgusts me. Sadly, I will have to laugh when a psychotic psychiatrist comes to your office to act out his rage.

Sincerely,

The 90-word-per-minute typist psychiatrist