supervision sessions at Community Counseling we are advised to place the least invasive diagnosis on an individual’s chart for fear of “labeling stigmas” in the future. Will this jeopardize their chance for insurance coverage? With some companies it may—is this ethical? To whom are my loyalties and obligations? Hopefully I can say with conviction--the patient.With regards to the cost effectiveness of managed care, we need to consider the results found in a study by Winegar who showed that in the year 1991 mental health costs rose from $4.25 million to $4.8 million. These figures hardly demonstrate an increase in savings. Empirical research on managed care also fails to show an improvement in the quality of care and decrease in cost (Dudley, R.A., Miller, R.H., Korenbrot, T.Y., Luft, H.S. 1998).Although managed care is here to stay, it requires revision. Professionals are entitled to salaries commensurate with their education and scope of knowledge. Denying patients the right to choose someone based on whether or not they are on a certain list is almost as bad as censoring freedom of speech—everyone should be able to pick their medical or mental health provider.It would not be fair to ignore the fact that some physicians or therapist have milked the system. If a policy included a 28-day stay for inpatient treatment, then they stayed 28 days whether is was warranted or not. Managed care has eliminated this practice and made a difference in inpatient costs. The old “fee for service” system also encouraged too many sessions. However, a dishonest or conniving therapist will find a loophole in any system. Therapists must advocate for what is best for their patients. This is an ethical and moral obligation of the profession. Failure to provide services to a patient of a recognized standard of care is unethical and clearly violates trust.In conclusion I view managed care as accepting the ...
