A specialty in psychiatry, for example, typically earns about $90,000 annually, or about $7,000 per patient.
A specialty of psychology, on the other hand, typically makes about $70,000, or $4,200 per patient, a psychologist at a major hospital in Virginia said.
That could change based on changes in the federal government’s “mandate to make a $20,000 cap” for specialists, said psychologist and author David Stuckey, a professor of psychology at Georgetown University.
The Centers for Medicare and Medicaid Services (CMS) in October announced a $50,000 limit on a number of new specialized specialists.
In a separate report, the CMS noted that more and more Americans are seeing a doctor that is not a psychiatrist or psychologist.
This means that some doctors will no longer qualify for a waiver for a speciality, Stucker said.
In addition, many doctors will need to see a clinical psychologist before they can prescribe opioids, Stuker said.
Some of these doctors may not be aware of their specialty, he added.
“If a patient sees a psychologist and says ‘I want to use a narcotic, I need help,’ they might be the one to ask for the waiver,” Stucke said.
The problem is that the waiver is not always automatic, he said.
“A lot of the people who have the waiver will have a problem in their job and might not want to go back to a place that has a psychiatrist and a psychologist.”
The cost of a specialty of psychiatry is especially high in the south, where mental health is more stigmatized, Stuckerman said.
For example, a specialty in obstetrics and gynecology can cost up to $100,000 for a specialty that typically includes about 100 patients.
Stucking, a member of the National Association of Behavioral Health Specialists (NABSHS), an association of specialty mental health and addiction specialists, noted that in Texas, a state that has one of the highest rates of opioid-related deaths in the nation, about 40 percent of the state’s mental health providers are psychiatrists.
“There are probably more than a thousand mental health professionals in Texas right now that are not psychiatrists,” Stuckermansaid.
“And some of them are specialists.”
The issue of specialty pays also plays a role in the rising number of opioid overdoses in the United States.
According to a 2015 analysis by the Substance Abuse and Mental Health Services Administration, about 6,600 people died from an overdose of opioids in the U.S. in 2017.
“I would say the rate of opioid overdose in Texas has doubled in the last decade, but there is a huge difference between the number of people that are taking opioids and the number that are dying,” Stucker said.
He added that more doctors are prescribing opioids than ever before, but some specialists have not been trained to deal with the rising rate of overdose and addiction.
“It is a little bit of a puzzle because they need to teach the new doctors how to do the job,” Stuccksaid.
The new federal guidelines on the waiver program were issued by CMS in October, a move aimed at helping mental health practitioners and their patients to get the necessary training to continue their work.
“While there are many factors that may affect a specialist’s willingness to continue practicing, it is important to remember that mental health specialists have the opportunity to practice under the waiver waiver,” said David Cohen, a physician who oversees mental health services at Stuckemans hospital in Anchorage, Alaska.
The American Psychiatric Association has long encouraged mental health clinicians to work with their patients and the government to reduce opioid overdose.
“We need to understand why people are using opioids, and we need to do more to prevent them,” said AMA president and CEO Michael A. P. Gerber in a statement.
“Many of these behaviors may be preventable, but it will take a coordinated approach that includes the health care providers and their staff who are responsible for these patients.”
A report by the National Center for State Courts released in October suggested that the federal waiver program could be a good option for many mental health patients.
It noted that some states have expanded mental health waivers to include addiction treatment and other services that are less expensive.
But the report also said that states may need to adjust the waiver programs to address other factors.
“These waivers are not the only way to help mental health care professionals,” said Dr. Sarah P. Welsch, president of the American Psychiatric Nurses Association.
“They can be helpful, but they need more work to ensure they are providing the best care possible to the patients they care for.”
The American Association of Clinical Psychiatry and the American Academy of Addiction Psychiatry are also calling on the government and mental health organizations to improve the waiver system.
“The waiver program is an important tool for mental health treatment providers,” said