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Recent developments in antitrust: challenges to medical autonomy.

R D Miller

    New Directions for Mental Health Services
    |January 1, 1989
    PubMed
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    Psychologists are increasingly providing mental health services at lower costs, challenging psychiatrists' dominance. Market forces and legal decisions will determine the quality of care from non-physician providers.

    Area of Science:

    • Health Economics
    • Mental Health Policy
    • Professional Practice

    Background:

    • Antitrust scrutiny removal has enabled economic arguments against psychiatrist hegemony in mental health.
    • Psychologists have gained traction by offering comparable services at lower costs than psychiatrists.
    • The less overtly medical nature of psychotherapy facilitated psychologists' market entry.

    Purpose of the Study:

    • To analyze the shift in mental health service provision away from psychiatrists.
    • To examine the role of economic factors and legal precedents in this shift.
    • To anticipate future trends in non-physician mental health provider roles.

    Main Methods:

    • Analysis of legal decisions and legislative actions.
    • Examination of economic arguments in mental health service delivery.

    Related Experiment Videos

  • Review of industry trends, including health maintenance organizations (HMOs).

    • Main Results:

    • Courts, legislatures, and insurers increasingly favor psychologists and other non-physician providers.
    • Cost-containment efforts are driving the utilization of nondoctoral providers.
    • Psychiatrists have initiated legal challenges against the use of lower-cost providers.

    Conclusions:

    • The market, peer review, and tort litigation will increasingly validate the quality of care from non-physician mental health professionals.
    • Licensed non-physician providers will seek legal and consumer recognition for their services.
    • Increased access for non-physician providers brings greater public scrutiny and malpractice liability risks.