Date of Award

Spring 5-1-2004

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Michael Murphy

Second Advisor

June Sprock

Third Advisor

Virgil Sheets

Abstract

Recent surveys have provided support to the frequently asserted opinion that managed care has negatively impacted psychologists in independent practice. Many recommendations have been made by professional organizations to address the negative impact and most have been directed at guiding practitioners to adapt to changes in health care delivery. However, there is little data on how private practitioners evaluate these recommendations or if they are using these strategies to adapt to the changing practice environment. The focus of this dissertation was to assess the extent that psychologists in independent practice have adopted the recommended strategies. By establishing a representative sample of psychologists in independent practice as part of an ongoing research network for data collection over the Internet, this project evaluated current practitioners' attitudes regarding managed care, identified trends suggestive of adaptive responses, and evaluated the relationship between select demographic variables on practitioners' opinions and practice patterns. One hundred and thirty-nine members of the American Psychological Association Division of Psychologists in Independent Practice responded to a survey. The data collected raised issues associated with use of the Internet as a means for data collection in terms of response rates. Data also indicate that psychologists maintain strong negative opinions of the impact of managed care on practice patterns, consistent with findings obtained seven years ago. Adaptive responses appear to be associated with changes in business structure factors, e.g., development of group practices, while remaining in traditional mental health care service delivery. Finally, participants' theoretical orientation, population size of their practice location, and proportion of managed care lV clients seen in practice appear to be important factors when evaluating business and clinical practice patterns. Recommendations for the use of the Internet for data collection and an ongoing research network are discussed.

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