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Uneven Supply

In the Lone Star state there are 2484 psychiatrists practicing today. Ninety-one of those physicians are D.O. trained, the vast majority being M.D. trained. Becoming a psychiatrist in the state of Texas is no more or less time intensive than most other states. It requires a four year undergraduate degree, a graduate degree in medicine (usually four years), and the successful completion of a psychiatry residency program which usually lasts around four years as well. These up and coming psychiatrists, as well as those practicing today, are faced with many challenges that are also facing the entire medical community as a whole. Among these are an uncertain employment climate, a weakening economy, and healthcare reform in addition to the ever-changing face of the field.

Psychiatrists are not spread Across the country evenly. Across the country, the psychiatrist per one hundred thousand inhabitants ratio is about 16.5 per one hundred thousand. That statistic, which reaches its high in the new england state of Massachusetts. at 31.1 per 100,000, bottoms out at 4.6 per one hundred thousand in Idaho. Counter-balancing the five states with the highest ratios MA, New York, Pennsylvania, California, and Texas are the five states with the lowest ratios: Idaho, Wyoming, South Dakota, North Dakota, and Alaska. The Western states have the lowest per capita supply.

Health insurance

Another factor to the predicament are the vagaries of coverage providers practices and public health care programs. Some psychiatrists will only see patients with personal insurance policies. Others, who are employed by regional behavioral health organizations, may only provide services for individuals on the states Medicaid program. Arizona Health Care Cost Containment System will not see patients who have private insurance. And, there are some psychiatrists who will not accept any coverage plans.

Many private health insurance plans will only pay for a restricted amount of mental health care. Mental health troubles are singled out by insurance providers, and continuing care may not be allowed despite persistent need. If a patient is still in need of coverage for depression, for instance, but their plan only allows for no more than 3 mental care visits anually, they are forced to either discontinue care or pay for the care on their own. This is a very important concern for physicians in Arizona who deem that mental illnesses should be covered by insurers just like any other disease. For example, insurers usually will pay for as many outpatient visits and inpatient care needed to efficiently handle a diabetic patient, but the same insurer will limit their coverage despite the requisite for lasting care for patients who indeed have a mental health problem.

While some of the mental health requirements of patients can be taken care of by psychologists, some patients may be too ill and in need of an MD or DO who can prescribe medicine, something a psychologist is not able to do. Over the years, doctors and mental health advocates have strongly lobbied for mental health parity that insurance companies treat mental illnesses like any other medical condition, thus leading to a greater availability of services for people with mental health problems.

Cost

The internal costs of mental sickness is immeasurable, but the monetary one is not. According to a report by the U.S. Surgeon General's office, in 1996 the United States spent more than 99 billion dollars for the direct treatment of mental disorders. In 1990, the most recent year for which estimates are on hand, the indirect cost of all mental illness was at seventy nine billion USD, with most of that amount coming from loss of productivity due to premature death, incarceration and time spent by family members caring for the ill.

Primary Care Alternative to Psychiatry

Primary care physicians are trying to compensate for the insurance coverage void by learning how to care for such patients themselves. Because those primary care service providers know they don't have anywhere to send such patients, and the individual is presumably going to keep coming back to them for care anyway, it behooves the doctors to expand their skills to cover these kinds of problems. However, many insurers refuse to reimburse primary care physicians for mental health services and only cover such services if provided by a psychiatrist.

Even with the health bill finally signed into law its effect on our health care is not recognized. By 2014 there will be an escalation in the enrollment into health care insurance programs. This boost when, shared with the long term aging of the populace, should push demand for services and therefore cost higher. However, no one yet knows what will happen to remuneration rates from Medicare and this new program. The question is will there be a cut of reimbursement amounts for different specialties by Medicaid and this new program that may contrarily become a decreasing factor of the income of all specialties including Psychiatry, its related specialties, and subspecialties.

Ad Listed On: Nov 05, 2012

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Location: Sioux Falls Sioux Falls GQ