Winter 1995, Vol. 4, No. 2

Psychiatrists need to tout strengths, contributions to potential clients

By Brian L. Grant, M.D.

These are challenging times for health care as many basic assumptions have been challenged and changed by forces of consumers, payers and government.

We psychiatrists are no strangers to such change, and long in advance of others in our profession, we have had to contend with challenges to our expertise, access to patients, and even our right to exist in certain quarters. For any still asleep or in denial, the basic shift has taken place and there is no turning back to those days of plenty, when health care was controlled by physicians and hospitals, with cost-plus budgeting and little fiscal restraint or accountability.

We have entered into the competitive realm long experienced by other businesses. To succeed in a competitive environment we must not only have a needed service to offer, but those who are in the position to benefit from the services must know about them, and be able to make educated decisions about the need and value of the service. Our patients have many choices; they can do without any mental health services, or seek help from others who purport to do as good a job as us for less, or better work than us at any price.

As occupational psychiatrists, we need not take on the whole health care system. I suggest that we do some careful questioning and exploration about ourselves and our work. First, we must ask ourselves if we have something of value to offer to individual workers, companies and organizations that we wish to serve. If the answer is yes, we must assess the relative value of the competition and determine if we are taking sufficient steps to communicate our value to those who need us.

To date, this writer knows that we have a long way to go on many levels. As a field of study and practice we have some history over the past decades, but few adherents. Membership in our new organization is less than 200, though there are other practitioners in the field who are not yet members. Our publications are few but excellent, and our course offerings are increasing in number and attendance. But there are other mental health practitioners who are far more established in the workplace and aggressive in maintaining and increasing their position.

This was reinforced at the recent conference several AOOP members attended in Washington, D.C. The conference on "Work, Stress and Health", was jointly presented by the American Psychological Association (APA), National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration (OSHA) and Office of Personnel Management (OPM). At the opening reception and plenary session, the current and growing alliance of psychology and policy makers was clear.

However, in reviewing the actual scientific content of the sessions, it was clear that in terms of bringing understanding to organizational dynamics or to individual suffering and pathology, we have a great deal to offer that is not available from occupational psychologists. Among those in mental health, we psychiatrists are best trained and qualified to embrace and integrate the individual as we consider their impact on organizations and how organizations affect the person. Companies and organizations care about and pay for results, and want their employees and systems to function well.

To reach these organizations we must work with our APA, and aggressively and repeatedly communicate our unique attributes and strengths to business, government and organizations. Psychiatrists should devote more effort to learning, consultation, teaching and publishing on organizational issues. We must learn to speak the language of and understand business and groups as well as we know individuals. We must remain open-minded and eclectic, by avoiding jargon or unitary theories as we do our work. We may work with and learn from others, including psychology and social work.

We must recognize, take pride in, and communicate to ourselves and our patients our unique abilities to make a difference.

 
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