James Baker, MD

James Baker is a child and adolescent psychiatrist.

States dropping Medicaid and the impact on patients

Health Policy

January 16, 2011

by James Baker, MD

Lawmakers in over a dozen states are considering getting out of Medicaid altogether as a way of dealing with the impact of the new healthcare law on already-bad state budget deficits.

I can understand the frustration with federal intrusion into state policymaking that would lead some Texas lawmakers to suggest that approach. In doing so, you’d be freed of all of the federal …

Healthcare costs cannot be controlled by only banning fee for service

James Baker, MD

Health Policy

November 18, 2010

by James Baker, MD

Once the recession is over (maybe that should be “if the recession is ever over”), it’ll be time to do something about the deficit.

The way to do that is to get healthcare costs under control.

But I don’t see how containing fee-for-service medical practice does the trick because, outside of family practice, I cannot see how to get away from fee-for-service, for the most part.

I think …

Mental health is affected by the poor economy

James Baker, MD

Health Policy

September 30, 2010

by James Baker, MD

All over the country, more people are seeking out mental health and developmental disability services from public clinics because they have lost their insurance.

Yet at the exact same time, those services have taken a big hit due to the poor economy, too. One survey says that 32 states have cut their public mental health services, and the average cut is about 5%.

That 5% may not …

Medicalization increases treatment and can harm patients

James Baker, MD

Conditions and Diseases

August 26, 2010

by James Baker, MD

“Medicalization” is the process of turning problems into diagnoses and people into patients.

According to Dr. Gilbert Welch, “It encourages more of us to be anxious about our health and undermines our confidence in our own bodies. It leads people to have too much treatment — and some of them are harmed by it.”

“Alcohol dependence” and “attention deficit hyperactivity disorder (ADHD)” are among the issues that …

Are antidepressant drugs better than placebo for depression?

James Baker, MD

Medications

July 26, 2010

by James Baker, MD

Clinical psychologist Irving Kirsch is selling a new book in which he argues that anti-depressants aren’t much better than placebo. He bases his claim on sophisticated statistical studies he has done that combine the results of antidepressant research trials from over the years.

The scary part is that he had to use the freedom of information act to get a hold of some of the studies.

His …

Local control can be used to empower patients

James Baker, MD

Physician

June 27, 2010

by James Baker, MD

In public mental health care, “local control” is the mantra that describes the desire to assure that mental health policy is dictated by local communities rather than by state or federal government.

I hope that folks who insist upon this are mindful that power-hoarding in the form of “local control” is no blessing in itself, except when it is used, in turn, to empower the people we serve.

I …

Can children really have bipolar disorder?

James Baker, MD

Conditions and Diseases

June 4, 2010

by James Baker, MD

Using the diagnosis “bipolar disorder” for children with problems in mood has been controversial ever since a surge in its use in the mid-1990’s.

A recent article in the Los Angeles Times gives the pros and cons on the use of “bipolar disorder” in children through the opinions of two psychiatrists on opposite sides of the controversy.

The problem with using “bipolar” is that it requires a too-loose interpretation …

James Baker, MD

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