The Big Chill

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Abstract
Even though concerns about managed care are a source of extraordinary distress among psychiatrists today, many residents are not being provided with adequate preparation and training to deal with those concerns. When young psychiatrists leave their training programs and enter practice, they are experiencing profound demoralization. Much of their dysphoria appears to be a result of the impact of specific aspects of the managed care system on the preexisting psychological characteristics of psychiatrists. Preventive strategies to minimize this impact are discussed.