Big Pharma threatens the future of psychotherapy
Advances in medical science – and in the marketing of that science to consumers – have led to the belief that nearly every ailment there is, be it physical or mental, can be solved with a pill. These days, it seems almost everyone is taking a pill for something.
In no field of medicine is this obsession with drug-based “solutions” more prevalent than in psychiatric care. New research shows these “wonder drugs” are putting psychiatrists out of business. According to research published in the Archives of General Psychiatry, fewer and fewer psychiatrists entering the field are either specializing in or being trained for psychotherapy.
The reason for this downward trend in psychotherapy is both the increasing dominance of Big Pharma’s products and the fact that managed care insurance plans are now less likely to cover it. And let’s be honest: while most health care is prohibitively expensive these days, it’s not easy to try to convince someone to pay outrageous hourly sums for the privilege of just talking to someone about how you feel.
Full disclosure: at best, I think psychotherapy is a sketchy course of treatment. At worst, it’s downright quackery. But either way, it’s vastly preferable to drug treatment.
The study showed that between 1996 and 2005, the percentage of patient going to therapy fell from 44.4 percent to 28.9 percent. During this same period, there were significant shifts in managed care reimbursement policies, as well as a flood of new (and trendy) psychiatric medications. This period also coincided with a boom in pharmaceutical TV advertising, and many of the ads that saturated (and continue to saturate) the airwaves are for mood altering antidepressants.
“Thanks to the advances of managed care, psychotherapy was basically devalued from the perspective of psychiatry,” says Dr. Christopher Colenda, a psychiatrist at the Texas A&M Health Science Center College of Medicine. “All that we were supposed to do was diagnose and consult for pharmacology. A lot of incentives for wanting to be in psychiatry were essentially removed by managed care.”
As much as I’m not a fan of psychotherapy, I’m disturbed that so-called “advances” by Big Pharma and the insurance industry can effectively do away with an established medical practice. Whether I happen to agree with the medical practice in question or not is entirely beside the point. This disturbing trend shows that the expediency of the bottom line and the convenience of prescribing pills have become preferable (and more profitable) than actual medical care.
You know how I’m always telling you to follow the money? It’s especially true when it comes to the decline of psychotherapy. The bottom lines of both the insurance companies and Big Pharma are hammering the practice. What’s more, the psychiatrists who offer the service tend to have clients who pay out of their own pocket for the treatment, rather than relying on managed care coverage.
And the money issue comes from the doctors’ side, too. Dr. Colenda says that, in his experience, “Some of the residents that I trained with have basically dropped out of insurance plans and are taking cash-only business where they can provide comprehensive services [including psychotherapy].”
But while Big Pharma keeps selling drugs and managed care companies keep a higher percentage of those premiums they collect, and the doctors flee the managed care systems how are the patients faring? Not so well. Colenda thinks that there could be a marked decline in the recovery of patients.
“We know that, for depression, the combination of psychotherapy and pharmacology leads to better outcomes,” Colenda says.
But it’s looking like the welfare of patients will have to take a back seat to the bottom line, doesn’t it? And we can thank Big Pharma and the insurance industry for that. No matter what I think about psychotherapy, you all know what I think of those other two.
