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Essential Roles for Psychiatry in the Era of Managed Care

Mark Olfson, MD, MPH; John F. Gottlieb, MD; Myrna M. Weissman, PhD
Arch Gen Psychiatry. 1997;54(3):206-208. doi:10.1001/archpsyc.1997.01830150024003.
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DURING THE past few years, managed care has moved aggressively from inpatient to outpatient psychiatric care and from the private to public sector.1 One consequence of these developments is that psychiatrists are now at risk of losing several of their traditional clinical roles to less highly paid nonmedical mental health professionals. Some psychiatrists have responded by emphasizing their professional roots within medicine and their intellectual roots within biology and the neurosciences. In this issue of the ARCHIVES, the prescription urged by Detre and McDonald2 that psychiatry should join neurology as a single discipline carries this response to its logical extreme.

See also pages 201 and 212

We question the wisdom and necessity of such a union. We believe that the future of psychiatry will be best served not by merging with neurology but by concentrating on the assessment and treatment of patients with major psychiatric disorders who


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