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Wanted: Indiana psychiatrists

Friday, November 9, 2012 - 12:01 am

Try scheduling an appointment with a psychiatrist in Fort Wayne and you may find yourself waiting a month - or more - to get in. If you are looking for a child psychiatrist, it could be even longer.

According to Teresa Hatten, board president for the National Alliance on Mental Illness, Indiana ranks 41st per capita in the country for psychiatrists. Currently there are 7.1 psychiatrists for every 100,000 people, while in Canada there are 12 psychiatrists to every 100,000.

“There are counties in the state that have none, and they (patients) travel long distances to get to a psychiatrist or rely on family doctors,” Hatten said.

According to Eric Looper, the CEO of St. Joseph Hospital, if the hospital could find two more psychiatrists to hire, they would do so tomorrow.

St. Joseph has been conducting a search for over a year and simply isn't finding people willing to come to Fort Wayne. Looper said it is a combination of factors: Fewer people graduating as psychiatrists and the sellers' market the demand has created. Increasingly, the practitioners can pick and choose where they want to go.

The adult psychiatric unit at the hospital has 14 beds, something Looper would like to see expanded, but without the staffing their hands are tied.

The unit is frequently full. Although they never turn anyone away, it means patients might have to be housed in a different unit while waiting for a bed, or the hospital has to look around the area to find another place for treatment.

In addition, psychiatrists who are in Fort Wayne tend to be aging, with several practicing only part-time because they are semi-retired.

“Half the psychiatrists in Indiana are 55 or older,” Hatten said. “We are going to have a big problem in a few years.”

Dr. Barbara Gelder, a local practicing neuro-psychologist, said the psychiatrist she refers her patients to is one of the few child psychiatrists in the city, Dr. Sylvia A. Manalis. It can be a two-month wait for an appointment.

More troubling: Gelder said it is not profitable for psychiatrists to take Medicaid patients as the amount of paperwork has increased while the rate to treat has not followed suit in 20 years.

“We are balancing the budget on the backs of our kids,” Gelder said, in referring to healthcare program cuts in the Indiana State budget.

Manalis said 50 years ago, psychiatry was very popular and a lot of people were graduating in that field. Now, she said, there are very few. Manalis is not sure why it has lost its appeal but said the focus in psychiatric treatment now is not analysis therapy.

Instead doctors use psychiatric drug treatment and follow up. It is counselors and psychologists who now do the bulk of the therapy.

Paul Wilson, CEO at Park Center, said the pay for psychiatrists is not much more then a general practitioner makes, which could explain why more people are opting for lucrative careers in medicine as cardiac specialists or orthopedic surgeons.

Currently, Park Center has seven psychiatrists on staff, but not all of them are full-time and all of them are older. They also have three nurse practitioners who can help with psychiatric evaluations. Wilson said that has been one way they have been able to keep themselves in a comfortable staffing situation.

However, he is concerned that as the staff ages out, he will have a hard time finding replacements.

“There aren't enough people graduating locally to fill the need,” Wilson said.

Hatten said IU Medical only had two graduates in psychiatry in the 2010-2011 school year.

Hatten who has a close family member with a mental illness said it has been a struggle over the years finding a psychiatrist, let alone the right psychiatrist. She wishes local foundation or our legislators would offer loan forgiveness to medical students with the understanding they must spend time working in Fort Wayne as a psychiatrist when they graduate.

Thirty years ago, Hatten received funding for her nursing education with the understanding she would work in Fort Wayne after graduation, which at that time was seen as an underserved area.

Also a problem: With fewer and fewer doctors willing to take Medicaid patients, people who don't have private insurance go untreated. Without mental institutions, should these people break laws, they wind up in jail or prison.

“They are the new mental institutions,” Hatten said.