This is not just psychiatry, its also the other doctors who pass the patients on to psychiatry. Doctors often call patients like this "heartsink" patients, because they cannot help and they feel bad about it. How they handle this is however an issue in medical training ... failed training. Uncertainty is a big issue in medicine. Not knowing what is going on or how to fix people is an issue. When the patient has chronic illness and does not die its a long term issue. Doctors need to be prepared to say they do not know, but will do what they can to help. That is, show concern without pretending to knowledge. The issues here are deep and complex, and its all muddled up with how doctors are frequently taught to deal with things. I do not doubt there are doctors who figure out their own solutions, but most don't seem to.