Managed care in America has created a new landscape for how
patients receive care. In other countries there is a
deprofessionalization of care, but that could be from shortages in
doctors or in a remote area (Epstein, 2014). In America it is because
managed care has been promed by health insurance companies as a
better way for them to save (make) money and for doctors to be free
from mundane visits. Health insurance companies have created
standards of care that must be met when a patient comes for a visit
(Epstein, 2014). Those standards of care have now been streamlined
across all companies and can now keep a patient from receiving the
additional care that they may need. Managed care keeps a patient
from easily obtaining second opinions because that follow-up visit
may now be accomplished by a mid level provider or in some cases
an RN. A complex medication may be explained by a tech who is
following the directions properly but does not have the same
experience as a pharmacist in explaining the proper usage (Epstein,
2014).
Even in mental health deprofessionalization is a cause for concern. If
a patient is suicidal a fast medicine change will not truly address the
situation (Ware et al., 2000). The push for medication and then
therapy can cause bigger issues if a person's mental health is not
addressed quickly at times. There are also issues with insurance, how
many visits to a PCP need to be had before a patient can be referred
to a therapist or psychiatrist and is a PCP truly able to help the
patient without the intensive training that others receive in properly
treating mental health (Ware et al., 2000). Deprofessionalization is
good for some parts of health care, but it should never be used at the
expense of the patient's body being in its best possible health.
Epstein, R. A. (2014). Big law and big med: The deprofessionalization
of legal and Medical Services. International Review of Law and
Economics, 38, 64–76. https://doi.org/10.1016/j.irle.2013.09.004
Ware, N. C., Lachicotte, W. S., Kirschner, S. R., Cortes, D. E., & Good,
B. J. (2000). Clinician experiences of Managed Mental Health Care: A
rereading of the threat. Medical Anthropology Quarterly, 14(1), 3–
27. https://doi.org/10.1525/maq.2000.14.1.3
