Magazine article Clinical Psychiatry News

Psychiatrists Celebrate Their Coping Skills. (Finessing Managed Care)

Magazine article Clinical Psychiatry News

Psychiatrists Celebrate Their Coping Skills. (Finessing Managed Care)

Article excerpt

PHILADELPHIA -- Amid packed sessions on pharmacotherapy and speeches warning of the challenges facing the specialty, attendees at one workshop at the annual meeting of the American Psychiatric Association heard what an audience member called "a celebration of psychiatry."

In a session titled Practicing Psychiatry in 2002, psychiatrists--with private practices from New York to Oregon--took turns discussing the nuts and bolts of their practices, their efforts to provide psychotherapy to as many patients as possible, and their tricks for winning the managed care battle. One after another, the panelists ended their talks the way Dr. Brian Crowley of Washington, D.C., did: "I'm having a good time, I think I'm doing good work, and I know I'm making a difference."

Dr. Ronald D. Abramson, who practices in Wayland, Mass., a Boston suburb, was one of the many panelists making an impassioned case for psychoanalysis.

"For many mental health clinicians, psychoanalysis and psychoanalytic psychotherapy do not now credibly exist, or, if they do, they exist only as an obsolete niche practice for self-indulgent wealthy people," Dr. Abramson said. "In the current climate of triumphant biologic psychotherapeutic reduction, it seems almost paradoxical that still most patients in mental health treatment receive some kind of psychodynamic psychotherapy."

Dr. Abramson decried what he called the managed care model of "patch them up, move them out" that emphasizes medication instead of therapy, rather than medication in conjunction with therapy. In Massachusetts, he said, this has discouraged young psychiatrists from trying to get on managed-care panels and set up private practices, leading to a shortage of psychiatrists in the area.

On a typical day in Dr. Abramson's practice, he sees 14 patients in 50-minute sessions beginning at 7:10 a. …

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