254 Steve Daviss

[00:00:00 ]Brett: [00:00:00 ] [00:00:00 ] This week’s guest is Dr. Steve Davis. He’s a consultation liaison psychiatrist. Hi Steve.

[00:00:07 ] Steve: [00:00:07 ] Hey, Brett. Uh, thank you for a vitamin onto your show.

[00:00:11 ] Brett: [00:00:11 ] Oh, absolutely. Uh, tell me what a, uh, consultation liaison psychiatrist does.

[00:00:18 ] Steve: [00:00:18 ] Uh, that’s a great question. Um, so. Uh, consultation, liaison psychiatrist. Uh, the words in that phrase, essentially refer to psychiatrists who work in typically medical settings. Um, often hospitals emergency room. Sometimes it might be nursing homes, um, and. Uh, the focus is really, I’ve got somebody here with some sort of problem, and I need a psychiatrist to, uh, evaluate and see if they have a psychiatric problem that might be contributing or, uh, the person has [00:01:00 ] psychiatric symptoms.

[00:01:01 ] We think it might be XYZ, depression, bipolar disorder, schizophrenia, uh, alcohol withdrawal. Um, but we know we want a second opinion. So that’s, that’s really what we do. We work in hospital settings generally. Um, and that’s where I spent most of my career, I guess, working in either hospital settings or other kind of primary care setting.

[00:01:24 ] It’s like a FQHC federally qualified health center or primary care offices. Um, so that in essence is what a cl psychiatrist, uh, does. Uh, I’m also, uh, an addiction psychiatrist, um, frankly, It’s hard to do psychiatry without also doing addiction. Uh, and I’ve done a lot of, um, uh, work around addiction. In fact, I’m currently the president of the Maryland DC society of addiction medicine, which is a chapter of the larger national main addiction [00:02:00 ] organization, which is a, or the American society of addiction medicine.

[00:02:03 ] Brett: [00:02:03 ] So you do a lot more, um, uh, consultation than actual long-term seeing of patients, at least in your capacity as a consultation liaison, then.

[00:02:14 ] Steve: [00:02:14 ] Um, I had been, um, my career has kind of, um, O taken a winding path. I, you know, I started off doing, uh, actually frankly, schizophrenia research way back in the day. Um, and. Uh, I wanted to go into, uh, research, uh, primarily because it that’s what attracted me to psychiatry and medicine in the first place. I, um, uh, growing up, I had a, um, uh, family members who developed schizophrenia at a young age in their teens, uh, which is oftentimes when it develops and the.

[00:02:54 ] Uh, just to see, you know, these loved ones of mine transform [00:03:00 ] with hallucinations and seeing numbers floating in the air. And it just kinda made me made, you know, I was younger than them. I was probably 11 or 12 and made me wonder how does the brain do this weird stuff? Um, and I was kind of a geeky kid to begin with.

[00:03:15 ] Uh, so that just was something to focus on and, um, I never let go of it. I mean, that’s really, what’s driven my. My, my career is how does, how does it happen that the brain gets broken like that and how to fix it?

[00:03:32 ] Brett: [00:03:32 ] do you think it’s a typical fo it surprises me that you’re still fascinated now by what you were fascinated by when you were 12.

[00:03:43 ] Steve: [00:03:43 ] yeah, well it reminds me of, um, you know, so I, so I went into. Uh, kind of a research research career. I actually started out as an MD PhD candidate. Um, and then, uh, [00:04:00 ] Uh, when I was driving around to, um, residencies, you know, you go to four years of medical school after college, four years of medical school, then internship and residency for psychiatry, which is, uh, uh, typically four years.

[00:04:15 ] Um, and then maybe a fellowship or, or start your career. And as I was driving up to Dartmouth, um, and New Hampshire, um, for my interview on the radio, Um, there was an NPR, a story about how they found the gene for schizophrenia. And, um, I remember kind of shouting, you know, and exclamation as I’m driving. Um, Oh, this is great.

[00:04:42 ] And then my next thought was, Oh, well, I guess they solve that problem. Maybe I won’t go into research. Um, as we know, it’s never as simple as it seems. Uh, there are, you know, a bazillion genes that seem to. I have something to do with, uh, schizophrenia and, um, [00:05:00 ] it remains, uh, mental health in general, um, remains, uh, to me a very interesting, challenging area.

[00:05:09 ] Um, although over the years, my interest have gone from research, you know, causes it, how to treat it, um, to more mundane, but probably much more important things like, uh, we know what good care looks like. We sometimes don’t know how to get it to people. You don’t know how to get it to them, where to get it to them, how to make it affordable, how to make it effective.

[00:05:36 ] So a big part of, um, psychiatry nowadays is often, uh, uh, implementation research, how to. Get people, the care that they need, it’s a little sad, um, that it is like that. Cause we don’t seem to have as much trouble getting diabetes treatment to people and blood pressure treatment to people. Uh, but it continues to be a problem.

[00:05:57 ] Brett: [00:05:57 ] Do you, I think that, uh, I mean, there’s been a lot of [00:06:00 ] talk over the last couple of years about mental health, especially mental health in America. Do you feel like things are changing, uh, that there actually is more of a light being shined on those problems?

[00:06:12 ] Steve: [00:06:12 ] I do. Um, you know, it’s been something that’s been changing, I think over the years, but, um, over the past, I would say five, eight years or so there seems to be an increasing. Recognition of the centrality of mental health and by, and when I say mental health, I mean like mental health and addiction, I, I, a lot of people split those two things separately.

[00:06:39 ] I think of them, many of us think of them as, as together, it’s all brain stuff. Um, and so, uh, the, uh, th the recognition that if you don’t. Address those issues, then somebody’s health, physical health suffers as well. And so you’ve got to [00:07:00 ] do both and if you don’t do both, you’re not going to do a good job.

[00:07:04 ] If you’re just focused on physical health, like diabetes, you won’t do a great job with that, unless you’ve got the mental health stuff under your control.

[00:07:12 ] Brett: [00:07:12 ] So you talked about, uh, genes for schizophrenia and I, over my life, heard a lot about, you know, the various mental illnesses being passed on genetically has, has that kind of research resulted in any, um, actual therapies? Um, it does knowing that it’s genetic help in treatment.

[00:07:36 ] Steve: [00:07:36 ] um, it, it’s not a direct answer to that. Um, overall, you know, a blunt answer would be, um, not greatly, uh, but, uh, there’s more nuanced answers. So. Um, knowing that the target of the gene. So what does that gene do, you know, does it code for, uh, a certain neurotransmitter receptor [00:08:00 ] or, um, some other piece of the receptor, uh, ecosystem?

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