Am J Psychiatry 1985; 142:149-154
Copyright © 1985 by American Psychiatric Association
The industrialization of American psychiatry
TE Bittker
Physician surpluses and escalating medical care costs have fostered an
alliance among government, corporate America, and health insurers that has
inspired medicine's industrialization. These same forces will transform
psychiatry into an industry where prospective payment, automation, salaried
employment, and central control of clinical activities threaten to become
the dominant form of medical practice. Emerging trends suggest that both
patients and health professionals will gravitate to various forms of
alternative provider organizations in an effort to shield themselves from
the economic uncertainties of seeking and providing care. The chronically
mentally ill and others requiring extensive treatment risk exclusion from
this new system, where cost consciousness may supplant compassion.
