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I appreciate the opportunity to respond to Dr. Scott Waterman's comments in your May 15, 1998, issue on my earlier article on "Who or What Is a Psychopharmacologist?"
First, contrary to Dr. Waterman's assertion, I did not "concede" that members of a specialty could designate themselves as subspecialists; that designation has a particular meaning in medicine which recognizes accredited subspecialty training, examination and the need for the public to be protected exactly from self-designation. There is no subspecialty as "psychopharmacologist" in psychiatry and Dr. Waterman's analogy to medical subspecialties exactly makes my point.
Further, I did not, as Dr. Waterman claims, assign "nefarious motives" (defined by Webster as "wicked or impious") to those who self-designate, but I did express concern that the various implications and inferences which could be drawn from such a self-designation could be misleading and/or have negative consequences for our field.
Finally, in a flight of rhetorical exuberance, Dr. Waterman describes me as "theorectically incoherent and demonstrably false", when I suggest that splitting psychotherapy and pharmacotherapy off from each other represents splitting off mind from brain, and that does not well serve efficient, effective, and economic patient care. He accuses me of ratifying "dualistic fallacies", but it is exactly those who establish and defend the self-designation of "psychopharmacologist" who ratify the dualistic mind/brain fallacy. Or else I missed something in my Philosophy 101 course.
Dr. Waterman and I do agree that "the way psychiatry defines itself. . .and the influence that managed care exerts over these questions. . ." are important topics to attend to.
Jerry M. Wiener, M.D.
Washington, D.C.