This article will present ethical considerations of the ACA for psychiatrists. For the most part, ethical dilemmas for psychiatrists will occur in the quality and efficiency improvement category. Particular areas of concern are new innovations to improve quality and bring down costs, integrated health systems, linking payments to quality outcomes, payment bundling, and paying physicians based on value rather than volume.
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The largest and fastest-growing subset of Social Security Disability (SSDI) beneficiaries is patients with psychiatric diagnoses, even as the federal SSDI Trust Fund diminishes. In 2005, the Social Security Administration authorized the Mental Health Treatment Study (MHTS) to test the hypothesis that a comprehensive, team-based, supported employment program would increase the likelihood that beneficiaries would find work.
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Most medical journals (as well as TCPR) require authors to disclose their affiliations with pharmaceutical companies or other for-profit entities, to help readers assess for any evidence of bias.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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