Psychiatric Times Vol 14 No 5

Daniel Chaffin, M.D., says he has never been at the top of the physician pay charts. That's why the solo practitioner in San Rafael, Calif., decided long ago to pay close attention to his finances. He dutifully put money in a retirement plan each year, avoided speculations, and focused his attention on growth-oriented stocks and stock mutual funds. The result: A seven-digit retirement account, additional investments on the side and, in short, financial security for himself and his wife as he nears his 70th birthday.

Like most other medical specialties, mental health has its share of unscrupulous providers who choose to break the rules and often end up learning lessons the hard way. The federal False Claims Act, a civil remedy, along with a myriad of other criminal statutes, have evolved into powerful weapons in the hands of federal and state prosecutors who have made health care fraud a national priority.

What Z has done is momentarily lift the veil that conceals...another veil. Thrilling because he is doing in public what I do in private. Stripping the professional illusion that psychiatrists are invisible machers, not just real friends and enemies, creditors and debtors, parents and partners, but detached angels. An illusion fostered by a xenophobic profession carefully cultivating the illusion of transcendental social levitation.

Project for Psychiatric Outreach to the Homeless Inc. (PPOH) is an award-winning program through which volunteer psychiatrists help agencies treat the homeless mentally ill started by psychiatrist Katherine Falk, M.D. "Up to this point I could walk by people living in cardboard or over gratings, shrug my shoulders and say 'at least they get taken to Bellevue,'" Falk recalled. "But what I found out is... they weren't taken to Bellevue or anywhere else."

After a decade of diminishing control and exclusion from provider panels, psychiatrists are developing strategies to regain some control of health care. With the help of consultation services like those provided by the American Psychiatric Association, they are learning to survive and prosper in this era of managed care.