Cost-Effectiveness of Psychiatrists

To the Editor: Dr. Dewan demonstrated by simple addition that one more than one equals two: that health plan fees for combined psychotherapy and pharmacotherapy by a psychiatrist cost less than split treatment by a pharmacologist and a nonpsychiatrist psychotherapist. This elegant and clever brief report deserves acclaim, given the paucity of research on this topic. Psychiatry must broaden its literature to ensure its economic survival (1). The American Psychiatric Association’s Commission on Psychotherapy by Psychiatrists seconds Dr. Dewan’s call for the clinical trials that are now desperately needed to supplement his accounting. This research should assess not simply cost (cf. Goldman et al., 1998) but also the quality and associated outcomes of treatment: remission of patient symptoms, restored or enhanced function, and better quality of life.