In Medicine, as Elsewhere, What Pays Is Usually What Gets Done

LevinDonaldPsychiatrist2011-06-05.jpg “”I had to train myself not to get too interested in their problems, and not to get sidetracked trying to be a semi-therapist.” Dr. Donald Levin, a psychiatrist whose practice no longer includes talk therapy.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A1) DOYLESTOWN, Pa. — Alone with his psychiatrist, the patient confided that his newborn had serious health problems, his distraught wife was screaming at him and he had started drinking again. With his life and second marriage falling apart, the man said he needed help.

But the psychiatrist, Dr. Donald Levin, stopped him and said: “Hold it. I’m not your therapist. I could adjust your medications, but I don’t think that’s appropriate.”
Like many of the nation’s 48,000 psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient. So Dr. Levin sent the man away with a referral to a less costly therapist and a personal crisis unexplored and unresolved.

For the full story, see:
GARDINER HARRIS. “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy.” The New York Times, First Section (Sun., March 6, 2011): A1 & A21.
(Note: the online version of the story is dated March 5, 2011.)

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