Biomedical subjects
Publications and source records attributed to D Van Buskirk.
Psychiatric residents training in a health maintenance organization (HMO) rapidly encounter the conflict between high demand for services and limited supply of time. In one HMO setting, the Harvard Community Health Plan, supervisors assist trainees in managing their practices to recognize their avoidances and conflicts and to respond therapeutically in keeping with the setting.
The Massachusetts Mandatory Mental Health Insurance Act requires all health insurance plans in the state to cover mental illness. Because of their concerns that this law might be taken as a national model, the authors describe the problems encountered in implementing it and the conflicts between the insurance carriers and psychiatry. The authors attribute the problems to some insurance carriers' failure to deal directly with organized psychiatry in obtaining screening guidelines, the absence of psychiatrists on the carriers' central committees, and psychiatrists' generally indifferent and hostile attitudes toward the carriers. The authors describe recent improvements and recommendations based on 10 years of experience.
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