Psychotherapy Finances

Primary care physicians have steadily drained business away from behavioral health care providers over the years by prescribing – often without evaluation by a mental health professional – pharmaceuticals to their patients suffering from depression, anxiety and other disorders.

This trend has been maintained despite evidence that a combination of talk therapy and medication is often most effective for mental health treatment.

Now, The National Alliance of Professional Psychology Providers (NAPPP) has hired a Washington, DC public relations company to help make a case that physicians should not be able to provide behavioral health services unless “they can specifically demonstrate that they have had and passed the requisite education, training, supervision, and testing.”

That’s according to John Caccavale, one of the NAPPP founders, writing in the organization’s June issue of The Clinical Practitioner newsletter.

“Most primary care physicians, while well meaning, simply do not have the skills or training to evaluate and diagnose serious behavioral disorders,” Caccavale said. “As a result, patients are not receiving the appropriate standard of care that they require and healthcare resources are being misused and squandered.”

There are no limits to a physician’s scope of practice, and that’s wrong, NAPPP argues. “There is a fairly simple remedy: Medical licensure boards should subject physicians to the same limited licensing that every other healthcare professional provides services under,” said Caccavale.

NAPPP hired the firm M+R Strategic Services to orchestrate “a campaign to educate the public” about the issue and “to require physicians to obtain an evaluation and appropriate diagnosis before medications are prescribed.”

But can the ant really move the rubber tree plant? The American Medical Association has one of the most powerful lobbies in the country, and any effort to tinker with physicians’ scope of practice would have to clear some very heavy political machinery.

M+R specializes in “grassroots mobilization,” as well as direct lobbying. “We work with clients to employ creative staging tactics – rolling out a series of events, media tours or other activities around the country (and on the Internet) – in order to build toward bigger events in the country’s major media markets,” according to company’s promotional material.

One of their recent clients was the American Civil Liberties Union (ACLU) in 2007, “a time when the fundamental freedoms that the organization protects were under attack by the Bush Administration.

“M+R helped plan and promote a national ‘Day of Action to Restore Law and Justice’ to raise awareness of the situation within the Democratic Congress and pressure them to act.”

But scope of practice isn’t exactly a hot button issue with the American public, and it will be interesting to see what a Washington lobbyist does with it.