I have worked with psychiatrists who are well known in the Los Angeles community on both sides of the fence and even a few who attempt combined treatment. I have adapted my style to reflect the knowledge I garnered from a range of practitioners, but I remain very frustrated. My concern and difficulty with learning combined treatment has left the vast majority of my colleagues and mentors unimpressed. Everyone agrees that the current combined approach is adequate. So I tried to wear two hats in two different settings and learned several things. Both approaches demand relentless focus to eradicate illness and constant alteration in strategy to do so; however, the structural framework for decision making in each is incompatible. As a psychopharmacologist, I assessed symptoms to determine if a patient had reached a threshold for illness, then I treated to decrease symptom severity. As a therapist, I identified behavioral, affective, or cognitive templates that disrupted patients’ lives and tried to alter them through awareness, analysis, education, and exposure. As a biopsychosocial psychiatrist, I saw no way to integrate a threshold model of illness with a template model. The combined practitioners explained how to switch hats in mid-session, but how can one treat patients expertly when combining two incompatible clinical methods? Similarly, why cannot one approach suffice when both approaches aim to treat similar conditions? I beg to differ with Drs. Gabbard and Kay, who compared learning these approaches to understanding that light can be both particle and wave because no such proof exists to force us to compromise. Instead, why not see these approaches as classical physics and quantum mechanics before physicists understood that the theories described the same phenomenon?