The United States is facing a shortage of psychiatrists, and the situation only appears to get worse as many psychiatrists are older and nearing retirement.
Part of the reason is that fewer physicians are choosing to specialize in psychiatry. While the total number of physicians in the country increased by 45% from 1995 to 2013, based on data from the American Medical Association, the number of adult and child psychiatrists over that same period increased just 12%, to 49,079 from 43,640.
Meanwhile, a recent survey from the Association of American Medical Colleges found that almost 60% of psychiatrists are aged 55 or older. That makes psychiatry the fourth oldest medical profession of 44 specialties in terms of practitioner age.
Compounding the problem is that as there are fewer psychiatrists entering the field, the U.S. population is growing and many more people are eligible for mental health services thanks to the Affordable Care Act.
One of the reasons why few physicians are becoming psychiatrists is that many medical students believe that psychiatry doesn’t pay as much as other medical specialties, American Psychiatric Association President Renee Binder, MD, told the Associated Press. Indeed, federal data indicates that the average annual wage for a psychiatrist is $182,700, just below the mean for primary care physicians and 28% below for some surgeons.
Binder added that the immense amount of paperwork required by Medicare and private insurers takes away from time psychiatrists, who often work solo, can spend with their patients.
Another issue is stigma surrounding mental health, even among practitioners, and a perception that psychiatry isn’t as highly regarded as other specialties given that “psychiatry is devalued by some in the medical profession,” Darrell Kirch, MD, president of the Association of American Medical Colleges, told the AP.
One of the ways to address the shortage is greater adoption of telepsychiatry, which would allow psychiatrists to treat more people in rural areas, or patients who would have difficulty making it to the doctor’s office, through the use of two-way video.
Another is to promote greater use of collaborative care, where psychiatrists provide greater consultation to general practitioners. Along these lines, there are also calls for primary care physicians to have more mental health training.
A more controversial move would be to allow psychologists, with appropriate additional medical training, to prescribe psychiatric medications to patients. Only Illinois, Louisiana and New Mexico, allow this, but efforts to do so in other states have face strong opposition from psychiatric groups.