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Comments and Controversies

Insidious progress

Vol. 10, No. 08 / August 2011

I love Dr. Nasrallah’s editorials, but none more so than his commentary in the June issue, “A skeptical view of ‘progress’ in psychiatry” (From the Editor, Current Psychiatry, June 2011, p. 18-19), in which he deftly highlights factors hindering the advancement of our profession. Clearly, his arguments come from the heart and speak directly to many psychiatrists’ concerns about what is happening in clinical settings.

I believe managed care has contributed to the proliferation of irrational polypharmacy. This is a consequence of clinicians who find themselves under unrealistic time pressures and cost constraints to come up with an expedient, “magical” treatment for acute hospitalized patients.

In reference to the comments about the phrase “behavioral health,” I have always objected to the pejorative term “providers” to refer to physicians. The designation “behavioral health providers” lumps psychiatrists and all other workers in the mental health field under the same umbrella, blurring the roles and identities of the different professions. Insurance companies further dismiss our psychiatric follow-ups as “medication management,” which ignores the broader, more specialized nature of our work with patients for the purpose of slashing fees. We often take these terms for granted, accepting them as nothing more than semantics or corporate jargon, but they are not so innocuous. We all should be aware of how these labels limit psychiatric practice and allow us to be subjugated by parties with financial motives.

On behalf of all of us who see the insidious side of the so-called progress being made in psychiatry, thank you for this insightful, well organized, and well written editorial.

Radwan F. Haykal, MD
Clinical Professor of Psychiatry
University of Tennessee Health Science Center
Memphis, TN

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