Psychiatrists' views of managed care and the future of psychiatry.
Managed care aims to insure the health of a population rather than that of an individual. This paper compiles opinions of psychiatrists and others on managed care and lists ways managed care potentially affects psychiatry. Managed care reverses the economic incentives indemnity insurance gave doctors to prolong treatment. It encourages psychiatrists to spend less time on empathic discussion and to use more standardized, less costly treatments. Many psychiatrists feel distressed about how managed care has changed their practices. Capitation care will change it further. Current trends suggest the U. S. will use and train fewer psychiatrists. Psychiatrists will spend less time with individual patients and more time planning and guiding the treatment of severely impaired patients. Many more psychiatrists will likely have unprecedented changes imposed on their careers.
Regestein
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Division of Psychiatry, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
D004992:Ethics, Medical; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration* / Q000639:trends; D008605:Mental Health Services / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D011570:Psychiatry / Q000191:economics / Q000193:education / Q000458:organization & administration* / Q000592:standards / Q000639:trends*; D011639:Public Opinion; D014481:United States