Title

Future psychologists' perceptions of managed care

Date of Award

2008

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

William Wagner

Advisor Department

Psychology

Abstract

This study was designed to examine future psychologists' perceptions of managed care, as well as their managed care related training and work experience. Data for this project were gathered electronically via a specially designed website. Participants were 119 future psychologists completing predoctoral internships in university counseling centers (n = 61) and hospitals (n = 58). Variables examined included predoctoral interns' attitudes towards managed care and their perceptions of the importance of knowledge in three critical domains relevant to service provision in the contemporary marketplace (i.e., general reimbursement, risk management, misdiagnosis). One measure, the Demographic and Practice Information Form (DAPIF), was created specifically for this study. The DAPIF was used to gather basic demographic information as well as information regarding the extent of respondents' managed care related training and experience. The Practitioners' Appraisal of Service Delivery Environments (PASDE) was used to measure participants' attitudes toward managed care. Three subscales on the Practitioners' Perception of Work Setting (PPOWS) were used to measure participants' perceptions of knowledge and preparedness in general reimbursement, risk management, and mis-diagnosis. Experimental items were developed for use on PPOWS subscales 2 (i.e., risk management) and 3 (i.e., mis-diagnosis). The addition of the experimental items bolstered the internal consistency of the instruments; therefore, all experimental items were retained. Results of multiple linear regression analysis suggested that predoctoral interns' knowledge of both risk management and mis-diagnosis were significant predictors of their attitudes toward managed care, while their knowledge of general reimbursement was not. With one important exception, neither managed care experience, graduate program type (i.e., Doctor of Philosophy (PhD) vs. Psy.D.), nor managed care related coursework was significantly predictive of knowledge in the three domains related to contemporary service provision. Managed care related work experience, however, was significantly related to knowledge/endorsement of mis-diagnosis. Analysis of responses to individual items on the mis-diagnosis subscale of the PPOWS suggested that some predoctoral interns may be inadequately prepared to appropriately navigate commonly encountered managed care related ethical scenarios. Implications for graduate students in psychology as well as those in the crucial position of providing their training are discussed, and suggestions are provided for future research.