A possible solution to the 'shrinking' workforce
I would like to offer another pragmatic, easy, and quick solution for dealing with the shrinking psychiatrist workforce (The psychiatry workforce pool is shrinking. What are we doing about it? From the Editor. Current Psychiatry. September 2016, p. 23,24,95).
The United States is short approximately 45,000 psychiatrists.1 Burnout—a silent epidemic among physicians—is prevalent in psychiatry. What consumes time and leads to burn out? “Scut work.”
There are thousands of unmatched residency graduates.2 Most of these graduates have clinical experience in the United States. Psychiatry residency programs should give these unmatched graduates 6 months of training in psychiatry and use them as our primary workforce. These assistant physicians could be paired with 2 to 3 psychiatrists to perform the menial tasks, including, but not limited to, phone calls, prescriptions, prior authorizations, chart review, and other clinical and administrative paper work. This way, psychiatrists can focus on the interview, diagnoses, and treatment, major medical decision-making, and see more patients.
Employing assistant physicians to provide care has been suggested as a solution.3 Arkansas, Kansas, and Missouri have passed laws that allow medical school graduates who did not match with a residency program to work in underserved areas with a collaborating physician.
Because 1 out of 4 individuals have a mental illness and more of them are seeking help because of increasing awareness and the Affordable Care Act, the construct of “assistant physicians” could ease psychiatrists’ workload allowing them to deliver better care to more people.
Maju Mathew Koola, MD
Associate Professor
Department of Psychiatry and Behavioral Sciences
George Washington University
School of Medicine and Health Sciences
Washington, DC
References
1. Carlat D. 45,000 More psychiatrists, anyone? Psychiatric Times. http://www.psychiatrictimes.com/articles/45000-more-psychiatrists-anyone-0.Published August 3, 2010. Accessed November 11, 2016.
2. The Match: National Resident Matching Program. results and data: 2016 main residency match. http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf. Published April 2016. Accessed November 11, 2016.
3. Miller JG, Peterson DJ. Employing nurse practitioners and physician assistants to provide access to care as the psychiatrist shortage continues. Acad Psychiatry. 2015;39(6):685-686.
Concerns in psychiatry
The August 2016 editorial (Unresolved questions about the specialty lurk in the cortext of psychiatrists. Current Psychiatry. p. 10-11,19,19A) was absolutely, right on the mark. It is heartening to realize how consistent our concerns are through our profession. Although I try to put my shoulder to the wheel to seek answers, it can become frustrating.
Denis F. Darko, MD
CEO
NeuroSci R&D Consultancy, LLC
Maple Grove, Minnesota