Re:

12/31/13

To the editor:

Most people would choose to avoid a relationship experienced as adversarial and borne of mistrust.  Such is the predicament of the psychiatrist, especially if talk therapy is involved, in relation to the insurance company.  Letters come informing us, for example, that on average patients are seen for eight visits or less.  Not a subtle message.  On the surface 'medical necessity' as a factor in determining ongoing coverage seems inoffensive and unobjectionable. But it is often used as a weapon to deny care when intensive treatment is taking place. The practicing psychiatrist must insulate himself from the background threat with which he and his patient are confronted in order to listen carefully to his patient.  

Yet insurance companies are entitled to know what they are paying for and cost containment is a legitimate concern. What reforms does Helen Farrell suggest to remedy this situation?

Respectfully,

Larry S. Sandberg