Retraining the Practicing Psychiatrist

The psychiatric community has been profoundly affected by managed care, but its response has been largely passive and defensive. Because many practicing psychiatrists have failed to adapt, they lack the skills and attitudes required to function effectively in the current and coming environment, and they will need to learn new ones. The academic health center may be one site of such learning, if the trainers themselves have first been trained. This article explores the nuances of the challenge and suggests a two-step process for addressing gaps in practice performance.