Too Few Symptoms to Diagnose? A Managed Care Ethical Dilemma
Item
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Title
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Too Few Symptoms to Diagnose? A Managed Care Ethical Dilemma
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Identifier
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d_2009_2013:2732c7c4013c:11349
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identifier
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11713
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Creator
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Racanello, Amy Michael,
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Contributor
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Georgiana S. Tryon
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Date
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2012
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology | Clinical psychology | ethics | ethics and psychology | managed care | managed care and APA ethics | professional ethics
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Abstract
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Managed care rations health care to populations by using gate keeping methods to counterbalance cost. Subsequently, managed care dictates treatment decisions made by practitioners. Managed care has been implicated in damaging relationships within the clinical practice of psychology that unethical and fraudulent practitioner behaviors, and undesirable the client-practitioner relationships. The present study built on the design and results from the pilot study. It was an attempt to explore the relationship between managed care and psychologists' unethical behaviors, and understand the characteristics, specifically empathy and narcissism, of psychologists who behave unethically when assigning diagnosis required by managed care companies. Of particular interest to this research was an examination of individuals who report incongruous personal ethical personal standards and behaviors. The pilot study revealed a sample of the participants who reported that they acted ethically and abided by professional ethical standards all of the time. These same individuals also reported that they would incorrectly diagnose a client who did not meet diagnostic requirements to receive payment for services through managed care. Participants included 101 mental health practitioners. Data were collected with an online survey, that included measures of personal characteristics, professional ethics, empathy (Spreng et al., 2009), narcissism (Corry et al., 2008), motivated reasoning, and diagnostic decisions. Correlational analyses indicated that personal and professional characteristics are positively related to practitioners reporting that there are reasons to assign unmerited diagnoses to clients. Conjoint analysis, using logistic regression, indicated that practitioners who reported that there are reasons to assign unmerited diagnoses to clients and unwavering adherence to the APA ethics code most frequently assigned unmerited diagnoses to fictional clients. A sub-group of the participants from the current work again reported that they acted ethically and abided by professional ethical standards all of the time but demonstrated unethical behavior. This finding and practitioner individual differences related to diagnostic behavior are both topics for fruitful future research.
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Type
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dissertation
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Source
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2009_2013.csv
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degree
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Ph.D.
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Program
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Educational Psychology
