Comparison of psychiatrists and psychologists in clinical practice
Comparison of psychiatrists and psychologists in clinical practice
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DOI：
10.1176/appi.ps.53.8.977
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发表时间：
2002-08-01
影响因子：
3.8
通讯作者：
West, JC
中科院分区：
文献类型：
--
作者：
Pingitore, DP;Scheffler, RM;West, JC
目的：作者比较了来自加州精神病学家和心理学家的数据，以确定在引入管理式护理和精神服务提供的其他变化后，临床实践中长期存在的差异是否仍然存在。研究方法：从执业临床医生在，加州谁参加了1998年全国调查的精神病学实践和2000年加州调查的心理实践进行了比较，对病人的病例，实践概况，保险或报销安排有关的项目。结果：97名精神科医生和395名心理学家的数据可用于研究。精神科医生报告说，他们在实践的大多数方面花费的时间都比心理学家多，每周工作的总时间也比心理学家多。精神科医生报告的每周病例数中，因精神病接受治疗的人所占的比例高于心理学家报告的病例数。心理学家报告说，他们每周的工作量包括更大比例的人治疗焦虑症，人格障碍，和其他疾病。精神科医生报告说，他们从公共保险中获得的服务平均报酬更高，心理学家报告说，他们治疗的没有保险的病人平均百分比更高。在收入来源和费用安排方面存在显着差异，精神科医生的净收入比心理学家高出近80%。结论：尽管管理式护理人员安排和治疗策略简化了两个提供者群体的做法，但精神科医生和心理学家之间在临床实践模式上仍然存在长期差异。精神科医生和心理学家之间的显着收入和工资差异可能部分是由于心理健康劳动力的供应动态，对心理学家产生不利影响。
Objective: The authors compared data from psychiatrists and psychologists in California to determine whether long-standing differences in clinical practice remain after the introduction of managed care and other changes in mental service delivery. Methods: Responses from practicing clinicians in, California who participated in the 1998 National Survey of Psychiatric Practice and the 2000 California Survey of Psychological Practice were compared on items related to patient caseload, practice profile, and insurance or reimbursement arrangements. Results: Data from 97 psychiatrists and 395 psychologists were available for the study. Psychiatrists reported spending more hours on most aspects of practice and working more total hours per week than psychologists. The weekly caseloads reported by psychiatrists included a greater percentage of persons treated for psychotic conditions than did the caseloads of psychologists. Psychologists reported that their weekly caseloads included a greater Percentage of persons treated for anxiety disorders, personality disorders, and other disorders. Psychiatrists reported receiving a greater average payment for services from public insurance, and psychologists reported treating a greater average percentage of patients who did not have insurance coverage. Significant differences in income sources and fee arrangements were observed, and the net reported income of psychiatrists was nearly 80 percent greater than that of psychologists. Conclusions: Long-standing differences in clinical practice patterns remain between psychiatrists and psychologists despite managed care staffing arrangements and treatment strategies that streamline the practices of both provider groups. The significant income and wage differences between psychiatrists and psychologists may be partly due to supply dynamics of the mental health workforce that adversely affect psychologists.