Psychiatry must respond to rapidly shifting paradigms in approaches to care, he said, many of which are driven by market demand for alternative types of treatment. Managed care continues to drive a number of these developments, as practitioners of psychiatry and medicine in general compete to establish more effective and efficient treatments. One particular paradigmatic change confronting psychiatrists is that managed care institutions that authorize treatment are shifting away from an emphasis on diagnosis to an emphasis on functional impairments generated by a patient's diagnosis. For their part, patients are demanding that psychiatrists continue to make varied and acceptable treatments available. In an ever more competitive marketplace, the patient will want to receive benefit from every appointment.
Psychiatrists also are likely to find themselves called on to provide time-limited therapies.
Clinical practice will require that psychiatrists stay abreast of developments in treatments that go beyond psychopharmacology. Practitioners will no longer find themselves with singular role definitions. The Eisenberg study, Yager said, suggests that a substantial market segment wants treatments unavailable through conventional medicine. Relaxation training and imagery techniques were among the top 10 treatments sought by patients. New mental health plan models need to consider this information about consumers, in terms of their interests and willingness to pay for treatment.