18.1 How We Should Be Practicing Psychiatry with Cara Hoepner, PMHNP

Join me with Cara Hoepner, a San Francisco-based PMHNP, to discuss how we SHOULD be practicing psychiatry. This is a 2-part series and in this first part, we will talk more about Cara's background that led her into psychiatric practice, then discuss the inherent problems with the DSM's massive over-expansion of psychiatric diagnoses and the major inherent limitations in modern psychiatry. We discuss how the "guidelines" for psychiatric practice DO NOT promote individualization of treatment, critical thinking skills, and DO NOT typically address the root causes of illness. Cara discusses her number one motion to DO NO HARM, causing her hesitance with using SSRIs and promoting the belief that SSRIs may be contributing to or causing a more rapid cycling between depression, mania, and euthymia (normal mood) in bipolar disorder (formerly manic-depressive illness) patients. We talk about addiction treatment and how our rapid tapers lead to protracted withdrawals, how addiction services create cookie-cutter treatment regimens they try to apply to every patient that walks through the door, regardless of individual factors of duration and amount of use and giving their brains and bodies time to adjust to lower doses of illicit and licit drugs/medications in their treatments. Lastly, we share a disagreement on industry's influence on our current malfunctioning system. Cara points out how the relationship between doctors/providers and industry representatives has shifted over time, and I emphasize the idea that if I don't promote that there are major problems with how industry operates and its lack of enforced regulations, then how will the system ever change? Hope you enjoy!

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Disclaimer, this podcast is for informational purposes only. The information provided in this podcast and related materials are meant only to educate. This information is not intended as a substitute for professional medical advice. While I am a medical doctor and many of my guests have extensive medical training and experience, nothing stated in this podcast nor materials related to this podcast, including recommended websites, texts, graphics, images, or any other materials should be treated as a substitute for professional medical or psychological advice, diagnosis or treatment. All listeners should consult with a medical professional, licensed mental health provider or other healthcare provider if seeking medical advice, diagnosis, or treatment.

In more than a decade of training and clinical practice as a psychiatrist, I've become increasingly disillusioned by the American healthcare system. It prioritizes profit over progress at the expense of OUR health. The average American spends almost twice as much on healthcare as the next highest spending country, yet our life expectancy drags four years behind other industrialized nations and ranks OUTSIDE the top 50 in the world. The system is a disaster, yet it's broadcast as 'the greatest healthcare system in the world.' Renegade Psych wants to return medicine's focus to PROGRESS OVER PROFIT, and limit the influence and power of the pharmaceutical industry and big business entities, whose primary motivations are financial in nature.

This conversational podcast is released monthly via SERIES on particular topics. There are 8-12 SEGMENTS, or episodes, per topic. I interview internationally-recognized experts in their fields AND relatively unknown, up-and-coming healthcare providers. Hopefully, we can educate patients AND providers about our medical system (especially mental health), so they can make better and more informed healthcare decisions.

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• Latest episode: 2025-12-02
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