Top Paper: 45,000 More Psychiatrists, Anyone?

by Nancy Wilson | February 05, 2011 6:02 PM EST

I recommend the following paper as well: Shortage of Child and Adolescent Psychiatrists in Texas by Emilie A. Becker, MD; Brian King, BA; Alan Shafer, PhD; and Christopher R. Thomas, MD. Accessed 02/05/11 at

http://www.hhsc.state.tx.us/medicaid/HB2163/App-E.pdf 

Dr. Carlat, please accept my apologies for misspelling your name in my previous post.

by Nancy Wilson | February 05, 2011 5:28 PM EST

Dr. Carlet is right about the shortage of psychiatrists in Texas. In September 2010 there were 1,687 psychiatrists working in the state (6.6 per 100,000 citizens). Most counties did not have a psychiatrist. 

Source: http://www.dshs.state.tx.us/chs/hprc/tables/10Psych.shtm

by Carlos Contreras | February 05, 2011 2:50 PM EST

My understanding is that psychiatry has problems getting medical graduates going into psychiatry due to the supposed average starting salary being around $140,000.  With growing medical school debt, training 45,000 more psychiatrist might affect the supply and demand of psychiatrist and thus drive medicare reimbursement lower due to the fact that there would then be enough psychiatrist.  As you know the government uses any excuse to cut reimbursement. 

by Ronald Pies | February 04, 2011 3:34 PM EST

• I very much agree with Dr. Weissman that the much-touted "evidence"that psychologists are safe and effective "prescribers" is, in fact, not credible evidence at all. It consists largely of anecdotal observations and a lack of reported adverse events. (Consider the obvious conflict of interest in reporting such events). No drug would ever be considered "safe" simply on the basis of a lack of reported adverse reactions--yet a number of psychiatrists continue to claim that this standard of evidence should suffice vis-a-vis the psychologists. This is really inexplicable to me. If anyone wants to make the case for safe and effective practice, the kind of evidence we need is systematic evaluation of prescribing practices on the part of psychologists, or any other kind of mental health professional. I also agree with Dr. Weissman that we have a serious mal-distribution of psychiatrists in the U.S.. I believe we need to address this via various incentives to encourage demographic shifts to under-served areas. --Ron Pies MD