Thiele Jonathan S, Doarn Charles R, Shore Jay H
1University of Colorado Anschutz Medical Campus, Aurora, Colorado.
2Family and Community Medicine, University of Cincinnati, Cincinnati, Ohio.
Telemed J E Health. 2015 Jun;21(6):510-3. doi: 10.1089/tmj.2014.0159. Epub 2015 Mar 12.
There is a national shortage of psychiatrists, and according to nationally available data, it is projected to get worse. Locum tenens psychiatry and telepsychiatry are two ways to fill the shortages of psychiatric providers that exist in many areas in the United States. Employment and salary data in these areas can be used to illuminate current trends and anticipate future solutions to the problem of increasing demand for, and decreasing supply of, psychiatrists in the United States.
A search was conducted of the literature and relevant Web sites, including PubMed, Google Scholar, and www.google.com , as well as information obtained from locum tenens and telepsychiatry organizations.
There is a dearth of data on the use of locum tenens in the field of psychiatry, with little available prior to 2000 and few published studies since then. The majority of the data available are survey data from commercial entities. These data show trends toward increasing demand for psychiatry along with increasing salaries and indicate the utilization of telepsychiatry and locum tenens telepsychiatry is increasing. The published academic data that are available show that although locum tenens psychiatry is slightly inferior to routine psychiatric care, telepsychiatry is generally equivalent to face-to-face care.
One can anticipate that as the national shortage of psychiatrists is expected to accelerate, use of both locum tenens and telepsychiatry may also continue to increase. Telepsychiatry offers several possible advantages, including lower cost, longer-term services, quality of care, and models that can extend psychiatric services. If current trends continue, systems that demand face-to-face psychiatry may find themselves paying higher fees for locum tenens psychiatrists, whereas others may employ psychiatrists more efficiently with telepsychiatry.
全国范围内精神科医生短缺，根据全国可得数据预测，情况还会恶化。临时聘用精神科医生和远程精神病学是填补美国许多地区精神科医疗服务提供者短缺的两种方式。这些领域的就业和薪资数据可用于阐明当前趋势，并预测未来解决美国精神科医生需求增加而供应减少这一问题的办法。
检索了文献及相关网站，包括PubMed、谷歌学术和www.google.com，以及从临时聘用和远程精神病学组织获得的信息。
关于精神科领域临时聘用情况的数据匮乏，2000年之前几乎没有可用数据，此后发表的研究也很少。现有多数数据是商业实体的调查数据。这些数据显示出精神科需求增加、薪资上涨的趋势，表明远程精神病学和远程临时聘用精神科医生的利用率在提高。现有的已发表学术数据表明，虽然临时聘用精神科医生略逊于常规精神科护理，但远程精神病学总体上等同于面对面护理。
可以预计，由于全国精神科医生短缺预计会加剧，临时聘用和远程精神病学的使用可能也会继续增加。远程精神病学具有若干潜在优势，包括成本更低、服务期限更长、护理质量以及能够扩展精神科服务的模式。如果当前趋势持续下去，需要面对面精神科服务的系统可能会发现自己为临时聘用精神科医生支付更高费用，而其他系统可能通过远程精神病学更高效地聘用精神科医生。
