What Must Be Done

A recent statement by the Group for the Advancement of Psychiatry (GAP) cites several major steps that psychiatrists should take to fight the infringement of managed care on psychiatric practice (see story). Titled "What Must Be Done," the steps are excerpted in part below.

1. Psychiatrists must hold firm to certain guiding principles.


1. We are physicians committed to our patients.


2. The biopsychosocial approach must guide our work.


2. Psychiatrists must be more assertive in defining the practice of psychiatry.


1. We must base the practice of psychiatry on the best interests of our patients, not primarily on the economic demands of those who consider economic factors to be primary.


2. Psychiatrists are the qualified clinicians to do initial evaluations for many patients.


3. Psychotherapy is an essential treatment for many patients. Performed by psychiatrists, it becomes uniquely valuable when coupled with other treatment modalities which only a physician can provide.


3. Psychiatrists must insist upon quality care for our patients; quality care requires that:


1. Medical decisions must be made by treating physicians in collaboration with their patients, with minimal interference by third party representatives.


2. Confidentiality, an essential element of quality care, must be protected to the greatest extent possible.


3. We support the American Psychiatric Association's work to establish published treatment guidelines for specific psychiatric disorders.


4. Outcome studies must be supported.


5. It is our duty to identify and address patterns of poor patient care wherever they occur.


4. Psychiatry as a profession must address these issues now.