Psychiatrist, Advocate for Patient Care

Chapter 1: Focus on the Patient


​What is the best way to deliver and pay for medical and mental health care in the United States? Is there a single model that can deliver affordable services effectively and efficiently to everyone?


What is the best definition of “value” when providing medical or mental health care? How do we decide when the care systems deliver “value” for each dollar spent? How much does “value” rely on a point of view; that is, what does value mean to the patient, the physician, the third-party payer, the premium-payer, the politicians, and the regulators that oversee it all?


The holy grail of medical care is said to pursue these three goals: 1) high quality care, 2) elivered when and where it is needed to everyone who seeks it, 3) at affordable prices. Is this a definition of value?


I believe there are answers to these questions that can lead us to a better and continuously improving system of medical and mental health care. As a result of more than 42 years of medical practice, most of it in psychiatry, and my active engagement in numerous national
and state policy-making bodies and professional associations, I am qualified to present informed ideas and opinions. What this book presents is the result of my professional experience, my research, my interaction with patients and other professionals, as well as a great deal of contemplation.


I have a bias. My point of view begins and ends with a single, primary concern – the patient comes first.


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