Posted by garnet71 on May 14, 2009, at 21:46:40
In reply to What are our alternatives?, posted by SLS on May 14, 2009, at 15:58:37
I should probably mention I have a lot of hope for the future. Now that it has become standard for health insurance companies to pay for mental health care, and more people are getting treatment to improve life quality, it seems drug companies have had more incentives to create drugs that work. (Should we thank drug company lobbyists for that? - maybe) Not to mention more disposable income with dual-income families that have grown since the 70s (though that can be certainly be argued right now). I still do believe that mental health research is a late evolver because of past stigma involved.
But there are still a lot of people who do not think ADD/ADHD exists--and educated people. There are still a lot of people who think depression or anxiety is something you can cure yourself, and that there is nothing biological about it, again, educated people. It's pretty surprising considering that 25% of the population has a mental illness in any given year, and that major depression is the leading cause of disability.
There are increasing health policy managemetn programs at universities, which brings in outside influences, and from a policy perspective, rather than only relying upon what doctors are taught at med school. Doctors are most likely not trained to run businesses from an economic or efficiency perspective, and do not specialize in management. They probably don't have time to train for political science and business to understand the dynamics of how businesses and government policies effect health care. I was considering getting my master's in health care management, but changed my mind at the last minute. I think it would be too frustrating to deal with politics, especially when so much changes every 4 or 8 years with presidential administrations. It would be back and forth.
Plus how many doctors have time for advocacy? I had one amazing psychotherpist who spent much of his free time doing advocacy work. He belonged to associations-but was actively involved, not just a memmber; spoke at events, wrote letters to the editor of newspapers on a regular basis....and more. A true gem. Unfortunatley, he was taken by pancreatic cancer.
More and more companies are allowing open access to information and increasingly engaging in collaboration to solve problems. I wouldn't be surprised if research would be handled this way in the near future.
Still, follow the incentives and you can pretty much derive a lot of implications that result.
For example, did you ever contact a dermatologists office to get a skin cancer screening, and found out the wait is 3 months? That's because every teenager in the city is there for acne treatment--it is covered by most insurances now. Incentives. Only 2 decades ago, only teens with severe acne went to the dermatologists. Maybe some of this could be treated OTC. There are lots of incentives for specializing in dermatology, and less incentives for general practice. Psychiatrists, if this rank still stands correct, are the 2nd most likely to be sued for malpractice after OB/GYNs. This alone has lots of implications, some possibly lead to offering less effective treatments, or denial of off label/experiemental treatments. Incentives...That's where policymakers come in to solve problems. Unfortuantley, education usually isn't as important when it comes to what it takes to get elected. So, in many ways, it's our own fault--the people we choose to elect to run our government and make our laws....it's systematic. At any rate, everything unspirals to one thing--money.
poster:garnet71
thread:895787
URL: http://www.dr-bob.org/babble/20090505/msgs/895861.html