PubMed Health⌕ Search

Biomedical subjects

Steven S Sharfstein

Publications and source records attributed to Steven S Sharfstein.

11 recordsLinked to original sources
PubMed2006

The tipping point from private practice to publicly funded settings for early- and mid-career psychiatrists.

OBJECTIVE: Practice settings for American psychiatrists were examined for recent trends. METHODS: Surveys were conducted in 1996 (N=970) and 2002 (N=917) among members of the American Psychiatric Association. RESULTS: Between 1996 and 2002 the percentage of direct patient care hours in publicly funded settings increased from 40 to 50 percent for early-career psychiatrists and from 29 to 44 percent for mid-career psychiatrists. By 2002 the percentage of direct patient care hours was higher in publicly funded settings than in solo office practices for early-career psychiatrists (50 percent versus 17 percent) and mid-career psychiatrists (44 percent versus 29 percent). CONCLUSIONS: The popular image of the psychiatrist sitting in a private office does not conform with current survey data, which show that psychiatric practice is increasingly taking place in publicly funded settings. Because it extends to mid-career psychiatrists, the shift from private office practice to publicly funded settings is not just a manifestation of early-career psychiatrists' earning a salary while building up their private practices but is a more enduring change in the landscape of psychiatric practice. The authors discuss the implications of these findings with regard to professional identity and training of psychiatrists.

Capital Financing↗
PubMed2002

Ethics in managed care.

The current era of managed costs and care create ethical dilemmas based on economic constraints and incorporation of principles of distributive justice. Traditional ethical concerns related to confidentiality, conflicts of interest, double agentry, and honesty are complicated by interference in the doctor-patient relationship caused by intrusive utilization management. National health reform must take these issues seriously to ensure that the cure promised by such reform efforts is not worse than the disease. The challenge for psychiatrists is to adapt to these constraints without losing sight of traditional ethical medical positions. If the ethics become diseased, then no cure may exist at all.

Adult↗
PubMedDate not supplied

Psychiatry and the consumer movement.

We agree that consumers' perspectives have had a limited impact on major policy shifts but note that they have resulted in important changes in the role of patients and families in all aspects of mental health treatment. In addition, we take issue with the use of "consumer" and "survivor" as one combined term because of the words' very different connotations. The field of psychiatry and the consumer movement may still differ in their views on the need for involuntary treatment but are now generally allied around the need for more effective and better-funded psychiatric services.

Coercion↗