Future of group based mental health (or mental health in general)

[Manicsleep]

I was wondering how psychiatrists who work in the real world have experienced the world around them change in the last couple of years.
I have noticed some pretty dramatic changes that, although I had been hearing would happen, never materialized until this year.

I have a job as a psychiatrist in a somewhat large group. The physicians took themselves out of the administration aspect to a great degree an hired a psychiatric nurse with an MBA and proven leadership experience. She has made some pretty dramatic changes and we have seen the changes ripple out into the community as others have followed our lead.

We have hired psych techs, MFTs, LCSWs, 2NPs and let go of several psychologists. We have 4 psychiatrists and 2 psychologists now. 2 years ago we contracted with or had full time 12 psychologists. We actually have 3 more staff now and are doing better financially. Even our "consumer/client driven" customer satisfaction surveys are up.

However, I still think with the "patient" paradigm and don't necessarily agree with giving the patient the "purple pill" just because its on TV or because they asked for it. This model is seriously flawed because it takes out the expertise, in this case of some excellent psychologists and replaces it with marketing.

Just wondering what other physicians feel about this
How have you fared in your own practices
What do you believe the future holds with all these changes

---

Members don't see this ad.

 

[whopper]

I'm still not anywhere close to certain. I've noticed psychiatry practice is highly variable depending on the locality. There are still several areas where there are no psychiatrists and they are highly needed. There are areas where there is no shortage of them.

The issue I'm dealing with now is I'm wondering how on the state level if states will be able to maintain the pay of a psychiatrist (among other doctors in state hospitals) when several states are deeply in the red. California for example, will they still pay prison psychiatrists 200-300K for 40 hours of work in the face of their budget crisis?

 

[Manicsleep]

I'm still not anywhere close to certain. I've noticed psychiatry practice is highly variable depending on the locality. There are still several areas where there are no psychiatrists and they are highly needed. There are areas where there is no shortage of them.

The issue I'm dealing with now is I'm wondering how on the state level if states will be able to maintain the pay of a psychiatrist (among other doctors in state hospitals) when several states are deeply in the red. California for example, will they still pay prison psychiatrists 200-300K for 40 hours of work in the face of their budget crisis?

Well, I think that CA probably needs to utilize extenders and maybe some telepsychiatry but it is my understanding that they have a mandate from a court case.
200k is pretty low for CA if in private practice for a couple of years although you do work closer to 45-50 hours a week. But you must offset that with having that population, all the restriction (i moonlighted there when the contractor rates were really good).
Someone is going to say why I hate psychologists again BUT I don't see why they have so many psychologists in the prisons doing the job that a half asleep psych tech can do. Even the social workers are over qualified for the "case manager" position that they are paying 100k per psychologist. 100 patients per 90 days is absurd, especially when no therapy is involved.