The Institute for Spirituality and Health
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Spirited Words

See below for a collection of reflections, writings, essays, poems, and other contributions that the ISH community has submitted over the years. We hope you enjoy.

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On Psychiatrists Being Taught How to Increase Revenue

By John Graham

April 2nd, 2014

I was recently saddened to receive an email inviting psychiatrists to attend a course so they could learn how to increase their revenue by increasing patient load, etc.  Small wonder psychiatry is rapidly becoming “psychopharmacology,” writing prescriptions in a 20-minute office visit,  and all-too-often ignoring the underlying psychosocial and spiritual problems that cause a patient’s symptoms in the first place. 

In that email here is what the course promised: 

“Attend our conference, where after only two days with our experts you’ll  walk away with proven strategies you can implement the day you return to your  practice, such as:

  • Enhance scheduling techniques to accommodate  more patients without driving staff crazy
  • Isolate key metrics to look for in your P&L  to determine areas for improvement to reduce overhead and increase revenue
  • Identify important documentation you’ll need to  improve your daily coding work
  • Analyze Relative Value Units (RVUs) to increase  practice compensation
  • Techniques to identify and remedy collection  problems, both hidden and obvious”

This makes me angry.  But, that is where psychiatry is headed, full-steam ahead.   Several years ago I completed a  two-year psychotherapy fellowship at the Houston Psychoanalytic Institute.  While there, a member of our faculty said, concerning psychoanalysts, “We are the ‘dinosaurs’ of our profession, a dying breed.”   I hated to hear that, but my professor is probably right. 

Dying breed or not, during my training we were taught to create a safe space for our clients in a healing environment and a block of time set-apart week-after-week to be with our patient.  We were taught that being with our patient and listening to his or her story would allow our relationship to develop the level of trust required to form a “therapeutic alliance.” 

A therapeutic alliance.  I love the term — an alliance that is therapeutic — one that can bring about healing, given enough time.  That cannot happen in twenty minute visits, once a month, or, even worse, with six or twelve-month appointments, to adjust medication levels. 

Soon psychiatrists will no longer need a couch.  After all, two straight back chairs facing each other will do just fine and encourage the patient not to interrupt while you write your prescription.

They offered a course to increase revenue for psychiatrists.  What about a course to increase the quality of patient care?  

John K. Graham, M.D., D.Min., President

Sara Moore