The title of the article “Lack of Psychiatrist Creates an Access Problem in Oregon” caught my eye. I sat down to read it and the following paragraph “Pincus said the undersupply of psychiatrists could be due to a number of factors. For one, psychiatry is one of the lower-paying physician specialties. According to the American Association of Medical Colleges, the starting salary for a general psychiatrist is $185,300. Neurologists started at $250,000 and neurosurgeons topped the list at $475,000. That’s in part because the health-care system tends to reward doctors for doing procedures, like surgeries, rather than spending time talking to a patient” Those salaries stunned me (No wonder my students thought I am wealthy). I do believe providers and clinicians should be paid a livable wage that matches their discipline, but these annual salaries clearly show our health care system is steeped in the fee for service model instead of value health care.
I am confident it is trickling down to patients’ co-payments and insurance plans. It upsets me that we live in a society where doctors are rewarded for doing procedures like surgeries, but therapist and clinicians like myself are not honored and rewarded for spending time with mentally ill patients to help them return to their base line, so that they can live their best possible life. It leaves me wondering, “Why we are NOT treating the whole person?”. The article goes on to say “A quarter of U.S. adults report a mental-health issue at any given time, and about half will incur a mental illness at some point in their lives. Most of those conditions are treated by primary-care physicians, who can prescribe an increasing number of psychiatric medications to treat basic behavioral-health conditions.”
I was stumped why this analysis did not consider the supply of other types of behavioral health providers; such as psychologists, psychiatric nurse practitioners, behavioral-health counselors, and social workers. Then I kept reading and was informed “In most parts of the country, those practitioners provide the majority of mental-health care but don’t have the training to deal with the most complex cases and not all can prescribe medications.” I call bullshit as a clinically licensed social worker; no, I am not able to prescribe medication. I applaud my profession on this, as medication is not always the answer. My mental health training is solid, as I graduated from one of the best schools in the county. I am qualified to diagnose and treat a mentally ill person (Even Texas state figured that out). My graduate program provided extensive classroom training, and I chose two intense practicums where I racked up over a thousand hours of clinical experience. Post graduate school I had go through a plethora of clinical steps and supervision, which you can read about in this post. It is my hope that Oregon, like Texas, begins to see the value of clinicians like myself. Those who work in the social service sector and whom are licensed under fair conditions should be able to be seen as an asset in the mental health field.