The Practice of Rural Medical Psychology

Ward M. Lawson


Rural and urban psychologists are increasingly being impacted by the Healthcare reform and the Affordable Care Act (ACA), which is redirecting the majority of care through the Primary Care and Community Hospital systems, utilizing an Integrated Care Model. This model increasingly breaks down silos, co-locates behavioral health and substance abuse professionals alongside physicians, mid-level providers and nurses, and seeks more comprehensive and long-term focused treatment rather than palliative and control-oriented treatment, e.g., psychotropics only approaches, or diabetes medications only, or hypertension only, etc. approaches to chronic illnesses with lifestyle components and causes.  The ACA emphasizes "scientifically validated interventions" as eligible for reimbursement, and performance-based “meaningful use” contracting that activates incentive pay for appropriate referrals to other specialists. Rural and urban psychologists alike will need to decide how they will position themselves in this new paradigm, within an integrated care practice or outside.

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