The article regarding capitated psychiatric care in Connecticut [contains the quote] "This is brand new. This is the wave everyone predicted." With capitation rates of $3 to $5 a month, God help us if this is the wave of the future.

This appears to be the same type of "corporate practice" that we see in any other for-profit mental health carveout company. Unless the Connecticut group has a utilization guideline that empowers the patient in the therapeutic alliance with the therapist, one is likely to see the same destruction of the doctor-patient relationship as we have seen in all other carveouts. If PsychCare has indeed made a change in utilization management, I sincerely hope its psychiatrists would be willing to publish their utilization management policies and procedures so that our long-suffering patients can finally benefit from quality utilization review.

Unfortunately, I remain a skeptic of the corporate practice of medicine. Whether the CEO of the corporation has an M.D. or an M.B.A., financial profits will drive the values of the corporation.

Stephen J. Burns, M.D.

Shrewsbury, N.J.

(Psychiatric News, January 3, 1997)