Biomedical subjects
Publications and source records attributed to T E Bittker.
Prepaid psychiatric practice offers a number of cost-effective approaches to treating approximately 90% of the world's population. After reviewing the goal of prepaid psychiatry--to provide high quality medical care to a defined population at an affordable price--the author presents an overview of the fundamental components of this type of service delivery.
Physician surpluses and escalating medical care costs have fostered an alliance among government, corporate America, and health insurers that has inspired medicine's industrialization. These same forces will transform psychiatry into an industry where prospective payment, automation, salaried employment, and central control of clinical activities threaten to become the dominant form of medical practice. Emerging trends suggest that both patients and health professionals will gravitate to various forms of alternative provider organizations in an effort to shield themselves from the economic uncertainties of seeking and providing care. The chronically mentally ill and others requiring extensive treatment risk exclusion from this new system, where cost consciousness may supplant compassion.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors describe a prepaid mental health program affiliated with a Phoenix-based health maintenance organization. Challenged by the need to limit financial risk and by high outpatient utilization rates, this prepaid health plan, developed a policy of service delivery which could both satisfy patient and consultee demands and conserve costs. Staff philosophies, services, administrative characteristics and client population are described. Key concepts in the delivery of service are outlined. The authors conclude by reviewing some of the ethical and financial dilemmas confronting the prepaid mental health professional.
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Explore the source record for details and available documents.
The authors describe a prepaid mental health service program in which outpatients referrals were 34.7 per 1,000 members per month, the hospital admission rate was .80 admissions per 1,000 members per year, and the average length of hospital stay was 5.03 days. They offer several explanations for their finding that the costs for mental health services in this program appear lower than those in fee-for-service programs.
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Many of the character traits that contribute to physician success can become risk factors to depression when amplified. Only reluctantly do some physicians attend to and express personal needs. The preemptory desire to satisfy the demands of his patients and colleagues may further subvert self-awareness and appropriate self-indulgence. Ultimately, frank depression emerges. Too often, depression remains unrecognized or untreated until the physician's self-destructive pattern compromises his capacity to care for his patients. The author discusses clues to the early recognition of depression as well as strategies in the prevention and treatment of the depressed physician.