The general public has recently made demands for continuity of care in psychological services from outpatient settings to inpatient facilities and back. These demands plus three economic and structural modifications within our nations' health-care arena, including the incursion of for-profit health-care corporations into the health delivery industry, the 1985 JCAH decision to include nonphysician providers on hospital medical staffs, and the 1990 California Supreme Court Decision (CAPP v. Rank) ensuring full medical staff participation by California psychologists, have opened the doors to the independent practice of psychology in hospitals, rehabilitation centers, nursing homes, and day treatment facilities. This article presents current professional realities for psychologists in hospitals and health-care settings and reviews the work of the American Psychological Association in support of hospital independent practice.Professional psychology is steadily being drawn into the maelstrom of the crisis in American health care. Today our nation spends more on health care than any other nation in the world, and we are the only industrialized nation, other than South Africa, to have not enacted a comprehensive national health-care program (Mitchell;. Recently, both the Bush Administration and the U.S. Congress have entered into the beginning stages of a truly national debate regarding what type of program would most effectively meet the needs of our nation (DeLeon, Wedding, Wakefield, & VandenBos, 1992). With the report by the Administration that even though current healthcare expenditures already represent approximately 13% of our Gross Domestic Product (GDP)-up from less than 6% only 3
Hospital practice has become increasingly important for psychologists over the past decade. However, expanded opportunities for practice require training for competency. The authors propose developing a comprehensive, systematic, and flexible program of training for hospital practice in psychology including graduate course work, supervised practicum experience, and opportunities for retraining. Recommendations for certification in hospital practice, credentialing and privileging, and continuing education are included.
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