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"Anyone who wants to see a psychiatrist ought to have his head examined!" This old gag is also a perfectly correct maxim.
Patients continue to resist treatment, social stigmas persist, and primary physicians often do not detect mental illness or make psychiatric referrals. So when a decision to see a psychiatrist is finally made, managed care should not impede. Shouldn't managed care have the burden of proof that a psychiatric referral is frivolous or harmful?
The January 16 issue's report titled "Managed Care Denies MH Care at Lower Rate Than Expected" is seriously flawed not only as noted in the March 20 issue in letters to the editor by Dr. Lawrence Kline and Dr. Harold Levy, but also in its basic premise. Managed care should out-reach more and rarely deny.
Lets modernize the gag/maxim to "Anyone who wants or needs to see a psychiatrist ought to have his/her head examined and treated!"
Harvey Fernbach, M.D.
Lanham, Md.