For some time now we have been insisting in the formation of a Caucus of Psychiatrists Working with Managed Care Patients in the American Psychiatric Association,. Why? Because as individual clinicians we have been feeling quite lonely and helpless dealing with the big MCO corporations.

Is this a good idea? We are not sure. Some have said that by moving in this direction we are legitimizing these organizations, and that the only way to deal with them is to refuse to be credentialed into their panels. We see the rational for this, especially when we realize how difficult, if not impossible has become for us to work with patients under their constraints and restraints. Let us be clear that we are not talking about money. We are talking about being able to do the work that we used to love when practicing our noble profession.

What is our vision? To have a Caucus for a group of clinicians, psychiatrists who are not interested in becoming entrepreneurs, CEOs, administrators, medical directors, reviewers or managers. Instead they like to continue to treat patients in their offices, and up to the time that managed care arrived, were making a decent living and deriving great professional satisfaction from their work.

Of course we could be wrong in trying to form the group within the APA.  If we are, this movement will not prosper. But we are supposing that there are many members like us who will  like to meet in this special interest group, a Caucus, to share experiences, concerns, suggestions and, above all, to have a voice at a national level when fighting for our clinical profession and our patients.

There are so many things we can do as a group. Starting with the nagging question if should we sign or resign as providers for these corporations, we can share information on how they operate in different States, how to best organize our offices to deal with their demands while at the same time making sure that we work in an ethical and clinically efficient way. Hopefully, as we grow as a group our voice, up to now mute, will be heard.

We are grateful to the American Psychiatric Association for giving us this space. We are also thankful to Dr. Thomas Allen and Bruce Hershfield the Assembly Representatives who presented the action paper proposing the Caucus. We are also thankful to the Assembly and the Board of Trustees for making the Caucus a reality. We acknowledge the support from many APA officers and members of the Board of Trustees as well as "Psychiatric News", "Psychiatric Care and Managed Care" and the members of the APA List Serv, Mem2Mem.

The rest will be up to us. With the help of Karen Sanders from the APA Staff we hope to grow. We already have a List Serv and scheduled meetings at the APA Annual Meeting and the Psychiatric Services Meeting.  Time will tell if our vision will turn into reality or if there will be new and better ways to deal with this enormous threat to our noble profession. We hope that you will join our Caucus. To do so contact Karen Sanders at ksanders@psych.org.
 

Marcio V. Pinheiro MD
mvp1@ix.netcom.com
wefp.bh@terra.com.br