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The following article was published by the Deseret News on July 30, 2003: |
PROVO — The fish tank gurgles. The darting fish compete with a Disney movie for the attention of little children. Ragged magazines litter a table. Someone coughs and doesn't seem able to stop. Americans know the doctor's office — we make more than 800 million visits to physicians each year. But a lot of those trips are unnecessary and could be prevented by marriage and family counseling, according to a Brigham Young University study. A fraction of the population demands a lopsided share of medical attention, but members of that group reduce visits to the doctor's office by 53 percent after marriage and family therapy, says D. Russell Crane, director of BYU's Family Studies Center. "When we help families build on their strengths through therapy, it helps them to do better and be healthier," said Crane, who conducted the study. The study should encourage health insurance companies to provide more coverage for counseling, experts say. Crane examined "high utilizers" of health care — people who made four or more trips to a doctor during a six-month period. This oft-treated group raises costs for health-care companies and insurers in an industry that has seen insurance premiums skyrocket. National health-care spending reached nearly $1.3 trillion in 2000, according to the U.S. Centers for Disease Control. The new study was a follow-up to Crane's discovery in 2000 that the average person attending marriage or family counseling sees a 21.5 percent reduction in medical visits. His research on high utilizers is featured in this month's issue of the Journal of Marital and Family Therapy. "Docs can usually tell you who the top 10 percent of the utilizers are in their practices, and they know which ones don't need to be there," Crane said. "Unnecessary utilization is what we're trying to address." "This solidifies a niche for marriage and family therapy where we can bring health-care costs down," said Scott Ketring, a professor of human development and family studies at Auburn University in Alabama. "We can work as part of a hospital treatment team to bring costs down. This is good news for my profession, and it's good news for the medical industry." Crane's results do not surprise Dr. Michael Rhodes, director of the family medicine residency program at Utah Valley Regional Medical Center. "Patients are individuals, more than just a combination of physical symptoms," Rhodes said. Rhodes said most doctors aren't trained to look for mental-health issues or to recommend counseling. He champions a cradle-to-grave approach to family medicine that includes appropriate referrals to therapists. Crane said patients benefit from therapy in two ways. First, improved marital and family relationships reduce stress, which can lead to or exacerbate physical problems. Second, therapy results in increased support for patients from family members. "When families are supportive and nurturing, patients adhere to regimens better," Crane said. Crane found that it didn't matter whether the high utilizer attended family therapy as a "problem patient" or a tag-along. High utilizers who attended therapy for the sake of another family member saw a 57 percent reduction in medical visits. The numbers even surprised Crane. "I was stunned," Crane said. "You would not necessarily expect to find results of the magnitude we saw in our studies." He said results were seen by people who had as few as five visits to a therapist. Therapists and many doctors believe the studies underscore the effectiveness of marriage and family therapy on general health and that health insurance plans should increase coverage for counseling. "Mental health coverage in many health plans really is a joke," said Rhodes. "Health insurance coverage might be a better tree to bark up because it's probably easier to change benefits than to turn the U.S. medical system upside-down," Rhodes said. "We think we can justify increased coverage financially," Crane said. "The health insurance industry hasn't had this research because it's information that wasn't available before. A lot of plans include some coverage for therapy because they think it should be helpful." It turns out those companies were right, said Ketring, the Auburn professor. "It's one of those cases where what we knew intuitively or thought would be the case turned out to be true." |
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The above article was published by the Deseret News on July 30, 2003 |
