Tuesday, February 21, 2012

The American Psychiatric Association scam

The American Psychiatric Association (APA) is in danger of losing the little credibility it still enjoys.

The organization is chasing medical insurance company reimbursement money by empowering “working groups” to invent whole new diagnoses by committee.

This is bad form for an association of professionals whose life work is supposed to be pursuit of the truth.  And it comes at the worst time:  When Americans have about had it with ploys to pump up revenues and profit from the public till.

According to sources familiar with the content of the official Diagnostic and Statistical Manual V—under development by the APA and slated for publication this year—people who are grieving and people who are shy will be labeled with “disorders.”  So, too, will some people who rape children or adults.  Hoarders—who, heretofore, might have qualified for obsessive-compulsive disorder—may get their own special diagnosis, too.

Hey, why not?  There’s a reality TV show about that.  Why not a diagnostic code, too?

Meanwhile, conditions which psychiatrists are used to diagnosing—like schizoaffective disorder and gender identity disorder, may be phased out.  Those seem to have been unpopular, I guess.  Bipolar disorder, which has been considered a mood disorder, could be reclassified as a psychotic disorder.

All in all, more human beings struggling with their emotions will be classified as sick, leading to more diagnostic codes that fit their supposed “disorders” and more money billed to Medicare, Medicaid and private insurers.

This unhealthy contamination of science by economics has a long tradition at the American Psychiatric Association.  The whole idea of promulgating more and more diagnoses, with codes like 300.23 and 309.81 and 307.44, Recurrent, was always partly a scheme to wrench the rich tradition of understanding and healing people’s psyches into the dictates of medical model billing.  It also fits neatly with the Continuing Medical Education monies routed to the APA by pharmaceutical companies whose medicines get FDA indications for particular diagnoses.


The more diagnoses, the better.  Everyone gets one.  Everyone gets billed.  Everyone leaves with a prescription.

The only trouble is that, under this system, the high art of empathy and life story analysis has been left to wither from disuse, like a beggar outside a bazaar.

What other medical specialty arrives at an official list of diagnoses by committee, then creates a bestselling book with the resulting codes (that nets the APA untold millions)?  Can you imagine groups of endocrinologists getting together to coin terms like “Excessive Urination Disorder of High Blood Sugar, With Attendant Social Disruption?”  How about cardiologists coming up with “Pain Over Sternum Associated with High Fat Diet, Despite Adequate Exercise?”