Medicine, as an applied science, consists of a spectrum of fields between areas that are largely ‘engineering’ and areas that are largely ‘art’. Surgery, for the most part, is something more like engineering/science, where we have most of the answers and don’t have to modify practice too much in response to new knowledge; Psychiatry is still largely art. Frankly, making an argument for the failings of medicine based on psychiatry is like blaming a 2 year old for not being toilet trained.

I agree that people are drawn to alternative medicine when they can’t get answers from doctors. And I am a vocal advocate both inside and outside of medicine for the failings of the system. For example, if I turn up to the GPS office and sit in a room of sick kids with paint peeling off the walls to be seen by a disinterested doctor for 15 minutes who sends me away without giving me a deifinitive answer to my questions/concerns; then later go to an alt-Med quack with a water fountain in the waiting room, incense burning and she spends 45 minutes with me listening to my problems, who am I going to come back to, especially if I derive benefit (there are studies showing that practitioner engagement and active listening are for many common ‘modern’ presentations highly effective)

Part of this is the modern world has produced people who are so healthy and generally well off compared to our forebears that the moment they develop an ache or pain they fear the sky is falling and demand an answer.

And medicine doesn’t have answers, or maybe not the answer these people want, because most of these things are just the process of growing old in and of itself - people are externalising their existential angst on a system that was designed to treat sick people, not the walking well.

For example, of the 17 patients I treated in the emergency department on my last 2 shifts, 9 of them should have never even turned up to the department. They had nothing wrong with them, or nothing that staying at home, resting and using some common sense wouldn’t have fixed. Yet there they are demanding answers to questions that our forebears would have considered part of life; and which in any regard we can’t fix anyway.

I don’t work in the US but the system there is so fucked that I wonder how long until it contributes to a broader breakdown in society; healthcare is a basic human right and you’re right the wealth transfer aspect of it is disenhartening and concerning.

> Psychiatry is a case study in ideological capture resulting in iatrogenic illness. My girlfriend was misdiagnosed, but since they use the courts to force her to take the drugs that actually make people suicidal (common result of anti-psychotics) and die of liver failure (my aunt's friend), there's no way for her to escape.

Psychology is kind of a special case, since there's often no physical evidence of the condition. You're just going by what you see and hear from the patient. Add to that the replication crisis, which is especially bad in the field of psychology, and you'll get a lot of things you think are proven but really aren't. And of course then there's the added issue of the justice system in your case. While already being punitive in general, they also use forced therapy and institutionalization as a punitive measure rather than a protective one used only in emergencies. Other fields of medicine don't have these problems (except for the replication crisis to some extent).

> The tragedy of Psychiatry is that the physiology of the conditions are largely understood, but this understanding didn't reach the practitioners working with patients.

That's also one of the problems. Practitioners aren't required to keep up with new research (maybe in some jurisdictions they are? I'd be interested to know), so many work on obsolete knowledge. I'd assume that many very specialized doctors like brain surgeons do keep up somewhat, but GPs most likely don't. It probably depends on their workplace as well. This one is common to all fields of medicine.

> Medicine is great when it works, but sometimes it causes the diseases they supposedly treat.

I'd say that's usually not the case (i.e. vaccines won't give you the disease they should protect you from), but psychology is special once again. With psychotherapy, patients can feel pretty vulnerable, and a bad therapist can make things worse by exacerbating existing mental disorders or even inducing new ones. Psychiatry works with lots of double-edged medications. A good psychiatrist will work with their patients to find the right medication and dosage, but a bad therapist may just prescribe whatever they think is right and disregard the patients opinions.