Summergrad P, Herman J B, Weilburg J B, Jellinek M S
General Hospital, Boston 02114, USA.
Gen Hosp Psychiatry. 1995 Jul;17(4):251-9. doi: 10.1016/0163-8343(95)00048-v.
This paper describes the impact of managed care on an academic medical center department of psychiatry. Like the pioneers before us, academic medical centers have often traveled wilderness paths, training new generations of psychiatrists and providing research about and new understandings of psychiatric illness; under assault from powerful competitive forces, we have all too often circled the wagons in an attempt to survive what we perceive as an onslaught. We describe the ways in which our academic medical center department of psychiatry has responded to managed care forces, in particular, the impact of managed care on residency training, inpatient services, outpatient psychotherapeutic and psychopharmacological care, and faculty morale. We describe how we have worked closely with our medical colleagues, formed new committees, and initiated forays into capitated arrangements. Despite difficult external circumstances, we have been able to survive, regroup, provide leadership, and continue with renewed purpose.
本文描述了管理式医疗对一所学术性医学中心精神病学系的影响。和我们之前的先驱者一样，学术性医学中心常常在艰难的道路上前行，培养新一代精神科医生，开展有关精神疾病的研究并提供新的认识；在强大竞争力量的冲击下，我们常常严阵以待，试图在我们所认为的猛攻中存活下来。我们描述了我们学术性医学中心精神病学系应对管理式医疗力量的方式，尤其是管理式医疗对住院医师培训、住院服务、门诊心理治疗和精神药物治疗以及教职员工士气的影响。我们描述了我们如何与医学同事密切合作、成立新委员会并着手参与按人头付费的安排。尽管外部环境艰难，我们仍得以存活、重新组织、发挥领导作用并带着新的目标继续前行。
