Ordinarily, I would consider it a pleasure to be cited by Detre and McDonald1 in their commentary describing the effects of managed care on the field of psychiatry. However, among the many points I made in the article that the authors cited2 (their reference 9), there is one that surely stands out—that "it is unwise to allow new clinical settings to dictate the contents of the residency curriculum." In 1991, managed care was an unpredictable and moving target in that it was rapidly evolving; 6 years later this is even more the case. It therefore came as a surprise that my voice was enlisted in support of managed care dictating new educational and practice directions.
Kay J. The Demise of Comprehensive Clinical Psychiatry. Arch Gen Psychiatry. 1998;55(2):183. doi: