Thursday, April 17, 2014

Psychiatrists' Role in the Brave New World of Health Care

APA President Jeffrey Lieberman, M.D., is using the Psychiatric News Alert as a forum to reach APA members and other readers. This column was written by Dr. Lieberman and Grant Mitchell, M.D. Please send your comments to

Health care reform has been a long time coming. Although many date the start of the health care reform process with the passage in 2010 of the Affordable Care Act (aka Obamacare), the economic and social forces that are driving it have been building for decades. (Think Medicare, Medicaid, HMOs, managed care, Hillary Clinton, and Harry and Louise [see here]). However, even now, many health care providers, and physicians in particular, would prefer to deny the inevitable: the transformative changes that will occur in the U.S. health care system.

It is true that we don’t know whether this change will be a gentle set of waves or a tsunami, and we don’t know into what form the health care system and the roles of its providers will ultimately be reconfigured. We just know that a comprehensive transition is looming.

In a previous column (“Change, Challenge, and Opportunity: Psychiatry in the Age of Health Care Reform,” Psychiatric News, October 4, 2013), Howard Goldman and I discussed the health care reform process from the macro health policy and economic perspectives. In this article, Grant Mitchell and I discuss how this will impact individual psychiatrists.

The goal of a transformed health care system is to expand care, improve quality, and lower costs. These goals may seem antithetical. Indeed, this is especially concerning to patients with mental illness and limited resources who have historically had limited access to care. Psychiatrists know firsthand this frustration, and that of their patients and their families, with the current models of care and financing: limited payments and visits, with silos between physicians that contribute to fragmented care. And although it’s gratifying that timely and ongoing treatment of psychiatric disorders is finally being recognized as critical to controlling health care costs, we are waiting for stronger policies that will remove the barriers to access to care and payment for such care.

Read more here.

You can follow Dr. Lieberman on Twitter at @DrJlieberman.