William M. Glazer, MD

Should we accept the analysis of a journalist who has not treated a patient or implemented a study and reaches conclusions that run counter to well-established practice guidelines?

As a consultant and educator for various stakeholders in the delivery of managed mental health services, I see confusion, skepticism and demoralization in the mental health professions about the direction health care is taking. Many doubt their ability to achieve the objective of the managed care mantra: Better care at less cost. To the clinician delivering care, it feels as if there is no stable ground to stand on, or, in the words of a 1960s female R & B group: "Nowhere to run to baby, nowhere to hide." Our profession seems to be either frozen in fear or disorganized in struggle, not grounded and coordinated in response to the changes that are upon us.