Damian Sendler Research

DR. DAMIAN JACOB SENDLER RESEARCH ON EFFICIENCY OF PSYCH CARE

Dr. Sendler seeks to understand the efficiency of psychiatric care in terms of cost. One idealized form of therapy would be splitting treatment into two parts: initial in-office assessment at higher payment rate, and follow-up care at home provided via internet.

Dr. Sendler research on Psychiatry and Sexology

Dr. Damian Jacob Sendler: In one of the most recent research papers I have explored, what are the factors that would allow people to have better access to psychiatric care in the context of online therapy? The most important question that was asked during the study was to evaluate the relationship between the cost and quantity of treatment provided to patients. There are different ways of looking at the affordability of psychiatric practice. But one unexplored area of psychiatric research is to look at how we can combine clinical psychiatric care provided in the provider's office and then some supplementing that with follow up care provided through other means such as online platforms.

Combining Clinical and Online Therapy

Dr. Damian Jacob Sendler: Some people might wonder what the utility of combining online clinical care with follow up therapy, provided through the internet, is. The main reason is cost. If we actually would allow people to see a psychiatrist in person to coordinate the care they need to receive prescriptions, and also have someone to talk to about their very personal sources of distress, we are continuing to provide standard mental health treatment. Unfortunately, the cost of treatment is high because a lot of insurance companies, at least in the United States, do not support or pay for psychotherapy. [Did you know that Damian Sendler examines topics related to health promotion and psychology. Read on to find out more]. And the most common way of seeing patients is by providing them with medications, and to then schedule follow-up care to make adjustments to those medications if they are not as efficient as initially desired.

So in an ideal world, these patients, especially those who are treatment-naive, which means that they are receiving psychiatric care for the first time, might need extra guidance, including guidance on how to take medications and to recognize possible side effects that come with medication treatment. Unfortunately, the cost is the limiting factor here, and a lot of people either do not participate in psychiatric therapy due to the cost of treatment.

In an ideal situation, I've envisioned that patients would be able to continue their care on a low-cost treatment track. The inexpensive path, in my mind, would be something that could be designed in the form of online therapy or online, systematic follow up where patients do not necessarily have to see their psychiatrists regularly t follow up care in their office. This approach facilitates decreasing the average cost of care per visit, but that they would be in a way under constant monitoring of the health care provider, should they experience any concerns or have any additional questions. From a cost standpoint, psychiatrists, just like any other medical provider, are typically compensate either per visit or per hour of treatment. And those costs can quickly accumulate for people that might require more expensive therapeutic attention.

Therefore, the idea here would be for psychiatrists to reduce the cost of treatment for patients by mostly overlooking their treatment progression remotely. They can then use the time that is available in their clinical practice to see other patients who can afford to pay their treatment costs or who are new patients and require specialized mental health treatment.

This is all sort of like developing an iteration of treatment planning based on capitation service, where health care providers are paid a fixed amount of money each month so that they commit to seeing patients from a particular company or group of businesses under the joint agreement. In the United States, this is called HMO, and the idea here is that typically employers pay a fixed amount of money per each employee. Those employees can receive treatment under a particular medical provider group. This approach makes the cost of treatment to go down because those patients that are typically healthy will not utilize the services as often as those that have more chronic issues. And the same can be true of psychiatric care. There is no specific initiative to advance this type of schedule and to provide this type of service. And therefore, it is essential first to explore what are the priorities that both psychiatric providers and prospective patients are looking for in terms of not just reducing the cost, but also improving the delivery of care. The obvious issue here is that the care is being split into office and outpatient online follow-ups, and that might make some patients and providers uncomfortable.

Online Therapy Versus Clinical Psychiatry

Dr. Damian Jacob Sendler: There is no question in my mind that clinical psychiatry is going to be a predominant form of therapy for most patients experiencing psychiatric distress. There is a growing number of people that do require counseling or short term treatment due to a stressful life event that might have put them on edge with their mental health well being. Or who might be going through some other sorts of trauma due to employment or past experiences, and want to get together with a healthcare provider and resolve those issues? And therefore, it is essential to look at different cost-effective alternatives to providing just inpatient treatment.

I remember that when I was in medical school, I saw a lot of patients that were returning patients due to specific problems like substance abuse and schizophrenia. These individuals would be typically seen in the clinic for initial stabilization and scheduled for follow up care. The issue patients would eventually face running out of money on their insurance accounts, and the hospital would not be able to provide continued care unless it was an emergency. Therefore, I certainly understand the need to think about alternatives and to think about how we can hook these individuals up to treatment programs. At the same time, we need to think about decreasing the cost of delivery of care and decreasing the overhead costs for providers, so that that incentivizes them to take on more patients at any given moment.

The advantage of this most recent research is that providers might be seeing, let's say a hundred patients as per the roster that they officially carry, but in practice, they might be seeing about, you know, one-third of those patients in clinical practice and the rest, through online follow-ups with those individuals. There are a lot of different significant developments happening now in how e-therapy can be delivered. Therefore, it is crucial to consider those alternatives and to educate physicians that they can effectively provide care through different modes while also saving money on the cost of maintaining their private practice, office supplies, and office support.