Sharfstein S S, Beigel A
Sheppard and Enoch Pratt Hospital, Baltimore, MD 21285.
Am J Psychiatry. 1988 Jun;145(6):723-7. doi: 10.1176/ajp.145.6.723.
The private practice of psychiatry is being transformed by the new economics of medical care. Patients are paying more out-of-pocket for necessary care (demand-side cost sharing), and health care providers are being asked to assume part of the risk of treatment through prospective payment (supply-side cost sharing). Specific survival strategies for psychiatrists in private practice include development of a balanced practice, expansion of referral networks, participation in alternative delivery systems such as health maintenance organizations and preferred provider organizations, active involvement in utilization and claims review, participation in outcome studies, and expansion of patient care advocacy and community involvement.
精神病学的私人执业正被医疗保健的新经济模式所改变。患者需自掏腰包支付更多必要医疗费用（需求方成本分担），而医疗服务提供者则被要求通过预期支付承担部分治疗风险（供给方成本分担）。私人执业精神科医生的具体生存策略包括发展均衡业务、扩大转诊网络、参与诸如健康维护组织和优选提供者组织等替代服务体系、积极参与利用情况和理赔审查、参与结果研究，以及扩大患者护理倡导和社区参与。
