The dismantling of our health system: Strategies for the survival of psychological practice.

Cummings, Nicholas A.

doi:10.1037/0003-066x.41.4.426

Cited by 101 publications

(132 citation statements)

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“…In fact, recent studies have shown a medical offset of mental-health service. Sixty percent of patient visits to physicians are accounted for people who are not medically ill. Medical offset refers to moving these patients out of the medical system, into the psychological system, thus reducing medical costs and addressing the cause of patient problems (Cummings, 1986(Cummings, , 1992. Overall, the hesitance of third-party payers to support mental-health services is not based on empirical data, but on unwarranted concerns about the efficiency of mental-health services under a managed-care system.…”

Section: Accountability: Empirically Supported Therapies Outcomes Amentioning

confidence: 99%

Cognitive therapy: Looking backward, looking forward

Dobson

Khatri

2000

J. Clin. Psychol.

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Section: Accountability: Empirically Supported Therapies Outcomes Amentioning

confidence: 99%

Cognitive therapy: Looking backward, looking forward

Dobson

Khatri

2000

J. Clin. Psychol.

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“…However, unable to write DRGs for psychiatry, it turned the problem of out-of-control costs for mental health over to the private sector, and managed behavioral health organizations (MBHOs) were created almost overnight. Foreseeing the birth of MBHOs, Cummings (1986;see also Cummings & Fernandez, 1985) created a model whereby practitioners would still determine the course of behavioral care. Called American Biodyne, its tremendous success as a practitioner-driven MBHO was rejected as unnecessary by psychology and psychiatry.…”

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confidence: 99%

The Financial Dimension of Integrated Behavioral/Primary Care

Cummings

O’Donohue

Cummings

2009

J Clin Psychol Med Settings

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There are two reasons why mental health, now more appropriately termed behavioral healthcare, is declining: (a) a lack of understanding among psychotherapists of healthcare economics, particularly the intricacies of medical cost offset, and (b) our failure as a profession to see the importance of behavioral interventions as an integral part of the healthcare system inasmuch as the nation pays for healthcare, not psychosocial care. This paper will briefly describe the rapid changes in the economics of healthcare during the past 75 years, including the post World War II enthusiastic espousal of psychotherapy by the American public which was followed by a precipitous decline as our outcomes research in behavioral care remained ignorant of financial outcomes, leaving it to the government and managed care to arbitrarily curtail escalating mental health costs. At the present time psychology is on the cusp of becoming part of the healthcare system through integrated behavioral/primary care, renewing the primacy of financial considerations such as return on investment (ROI) and medical cost offset, as well as an urgency that we avoid the mistakes that are emerging in some flawed implementations of integrated care.Keywords Healthcare economics Á Medical cost offset Á Integrated behavioral/primary care Very few people do anything creative after the age of 35. The reason is that very few people do anything creative before the age of 35.

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“…According to Sarason (1981, p. 833) clinical psychology has become, like psychiatry, &dquo;exclusive, money oriented, a lobbying force, supersensitive and super pious about upholding standards and monitoring credentials, and tolerant but not respectful of the research endeavor.&dquo; Increasingly, practice and marketing potential go hand in hand (Austad & Hoyt, 1992;Cummings, 1986). Managed care, advocacy for hospital, (Enright, Resnick, DeLeon, Sciara, & Tanney, 1990;Zaro, Batchelor, Ginsberg, & Pallack, 1982), and prescription privileges (Brentar & McNamara, 1991;DeLeon, Fox, & Graham, 1991) define a center around which practice increasingly collects (Schneider, 1990).…”

Section: Opinionsmentioning

confidence: 98%

The Case Against Licensing Health Professionals

Gross

1998

Sex Abuse

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In the interest of full disclosure, I am a licensed psychologist. Yet I oppose licensing. I remain licensed because I wish to continue to practice my profession. My opposition to both general and specialty licensure is the subject of this paper.To understand my position requires knowing that state governments, under the umbrella of their police powers, grant licensing to a profession to protect the welfare of the public. The licensing act reserves either a title (i.e., psychologist) or a practice (i.e., psychotherapy) to persons who meet particular requirements approved by the state. Doing so creates a monopoly which in turn grants certain economic advantages to licensees. The history of licensure is replete with evidence that economics, not protection of the public, drives licensing. In fact, with rare exceptions (i.e., stockbrokers, detectives), professions have sought licensing-the public has not demanded it.My review of the empirical research shows no substantial relationship between licensing and quality of service measures. Evaluations of the work of licensing agencies also show they do not protect the public (Gross, 1984(Gross, , 1986:(a) Assessment of initial competence relies on invalid criteria, emphasizing credentials and cognitive skills over performance and person over context.(b) Monitoring of ongoing professional competence has not progressed beyond the questionable mandating of continuing education.

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The dismantling of our health system: Strategies for the survival of psychological practice.

Cited by 101 publications

References 1 publication

Cognitive therapy: Looking backward, looking forward

Cognitive therapy: Looking backward, looking forward

The Financial Dimension of Integrated Behavioral/Primary Care

The Case Against Licensing Health Professionals

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