Earn-as-you-go pressures in academic psychiatry

The future of academic psychiatry may be seriously jeopardized by recent funding cutbacks at federal and state levels. Hospitals and departments of psychiatry are having to function as businesses, and full-time faculty are increasingly concerned with profits, with less time for teaching. Shrinking departmental resources make it necessary for faculty to assume the new responsibility--in addition to their administrative, educational, and teaching roles--of generating large portions of their own salaries from private patient care revenues. Residents' opportunities to work with psychotherapy patients are being compromised by financial considerations. Other actual or potential consequences of the fiscal dilemma include decreased teaching of medical students and lessened scholarly productivity.