Child Psychiatry

The April 20 issue carried an article on the great need for child psychiatrists. I am a healthy, vigorous child psychiatrist, well trained in Boston. One of the reasons I retired from practice in March 1999 was because I was unable to acquire sufficient patients to maintain a private practice. Prior to the reign of managed care, this was not the case. Since the 1980s, however, the ability of families to afford private treatment for their children has diminished to the point of nonexistence. Remember, most young children need to be seen more than once a week, and one or both parents also need be seen at least occasionally. This certainly puts most families beyond the range of affordability without the previously existing aid of insurance coverage.

So what is the point nowadays of the extra training in child psychiatry, no less the strain of taking board exams, if one does not have access to child patients? The workforce recommendations cited in the article hardly seem practical in the current economic climate.