Most of our brain cells are glial cells, once thought to be mere support cells, but now understood as having a critical role in brain function. Glial cells in the human brain are markedly different from glial cells in other brains, suggesting that they may be important in the evolution of brain function.
We have to remain humble about our understanding of the brain, because even our most powerful tools remain pretty blunt instruments for decoding the brain. In fact, we still do not know how to decipher the basic language of how the brain works.
With the implementation of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, more people will have insurance coverage and, in principle, be eligible for more care.
My philosophy is really based on humility. I don't think we know enough to fix either diagnostics or therapeutics. The future of psychiatry is clinical neuroscience, based on a much deeper understanding of the brain.
I trained in psychiatry in the 1970s, and much of our training was about what was then psychoanalytic theory, with a little bit of theory from Jungian psychology and a few other places.
We need to ask whether, in the long term, some individuals with a history of psychosis may do better off medication.
Nearly every business collects metrics on inventory, sales, and workplace process. Health care has been slow to measure these kinds of outcomes. Increasingly, general medicine, via either managed care or large practice settings, is improving by collecting data through electronic records and refining practice based on what works.
