Number of Psychiatrists Providing Psychotherapy Continues To Slide

Reported in Psychiatric Times:

The number of psychiatrists who provided psychotherapy to all of their patients declined from 19.1% in 1996-1997 to 10.8% in 2004-2005. From 1996 through 2005 psychotherapy was provided in 5597 of 14,108 office visits to psychiatrists lasting longer than 30 minutes, but the percentage of visits involving psychotherapy declined from 44.4% in 1996-1997 to 28.9% in 2005-2006.

Several predictors were associated with a greater likelihood of receiving psychotherapy.

Patients who pay out-of-pocket are more likely to get psychotherapy from psychiatrists than those who have private insurance, said Mojtabai. Patients with personality disorder or dysthymia are more likely to receive psychotherapy from their psychiatrists, whereas patients with schizophrenia are less likely.

Regional differences also were apparent, Mojtabai told Psychiatric Times. Patients in the Northeast (46.4%) are more likely to receive psychotherapy from their psychiatrists than those in the South ( 23%).

Among patients less likely to receive psychotherapy from psychiatrists are those who are black, Hispanic, or younger than 25 years and those who have public insurance such as Medicaid.

The trends identified in the analysis “highlight a gradual but important change in the content of outpatient psychiatric care in the United States and a continued shift toward medicalization of psychiatric practice.”

H/T: The News Junkie

Comments

[Dennis]

what do you think about proposals to provide 2 years of post doc training to psychologists, allowing prescriptive privilege in a manner similar to that of Physician Assistants?

Dr X replies: I don't really have anything to say that hasn't already been said by others. I'm not particularly pro or anti-prescription privilege, but personally, I wouldn't pursue certification if the opportunity arose in Illinois.

But, a friend I went to graduate school with is a licensed psychologist-prescriber in Louisiana. If he were practicing locally (not possible in Illinois), I wouldn't hesitate to refer to him. That said, I don't know if the proposed training is sufficient, but I'm assuming that what you're asking about is the concern some have that clinical psychology would turn into psychiatry. My friend still does extensive testing and psychotherapy and he runs a clinical practicum and a pre-doc internship, so he still operates within the traditional discipline. Medication has been an adjunct in his work. But, if prescribing privileges became widespread, I'm not so sure he would be typical or that it would be a positive development for the field. I could imagine many who would reduce practice to prescribing medications. That would be a troubling development for clinical psychology as a discipline.

[libhomo]

We are a nation of drug addicts and Big Pharma are the biggest pushers.