Knesper D J
Arch Gen Psychiatry. 1978 Jan;35(1):19-24. doi: 10.1001/archpsyc.1978.01770250021001.
A shortage of psychiatrists continues to exist in state mental hospitals (SMHs), and Public Law 94-484 is likely to aggravate this problem. A telephone survey was done of 50 state departments of mental health to collect data about (1) the number and kinds of SMHs in each state;(2) the percentage of psychiatrists in SMHs who are foreign medical graduates; and (3) strategies for attractiing psychiatrists to SMHs. States with SMH residency training programs employed significantly more psychiatrists and paid significantly lower salaries than did states without these programs. Nine states reported no or few problems obtaining psychiatric staff. These nine states employed more psychiatrists and had a smaller proportion of foreign medical graduates than the remaining 41; salaries were similar. Sets of strategies for obtaining psychiatrists were identified for all 50 states. The strategies of competitive salaries, university affillation, and incorporating the SMH into an interdependent network of quality mental health care delivery systems are examined in detail.
州立精神病院（SMH）持续存在精神科医生短缺的情况，而公法94 - 484可能会使这一问题更加严重。对50个州的精神健康部门进行了电话调查，以收集有关以下方面的数据：（1）每个州SMH的数量和类型；（2）SMH中外国医学毕业生担任精神科医生的比例；（3）吸引精神科医生到SMH工作的策略。设有SMH住院医师培训项目的州比没有这些项目的州聘用的精神科医生明显更多，支付的薪水也明显更低。九个州报告在获取精神科工作人员方面没有问题或问题很少。这九个州聘用的精神科医生更多，外国医学毕业生的比例比其余41个州小；薪水相似。为所有50个州确定了获取精神科医生的一系列策略。详细研究了竞争性薪资、大学附属关系以及将SMH纳入相互依存的优质精神卫生保健服务系统网络等策略。
