Ten mental health professionals team
up to form private referral network.
Dr. Darryl Goldberg, Dr. Baruch Brody, Dr. Raina Emstoff and Dr. Mark Diem see a
need for a metro Detroit Maimonides Society.
ernment grants to study ethics
in genetic research, outlined
what he called the Jewish and
Augustinian views on lying. St.
Augustine, a 4th-century Chris-
tian leader, believed it was al-
ways wrong to tell a lie. But St.
Augustine also said that some-
times it was OK to deceive by
telling the truth.
Dr. Brody gave an example:
You don't want the Jones family
to attend your dinner party, but
you don't want the Joneses to
know that you don't like them.
You carefully schedule the din-
ner for the night they'll be out of
town, and you send them an in-
vitation.
"That's Augustinian decep-
tion," Dr. Brody said.
The rabbis disagreed with St.
Augustine. Although they con-
ceded that sometimes a white lie
is necessary to avoid needlessly
hurting another person, the rab-
bis spurned Augustinian decep-
tion as a cruel method of "stealing
the mind" or "messing with the
head" of another human being.
Dr. Brody administered a few
tests to help doctors at the Mai-
monides Society meeting deter-
mine if they subscribe to rabbinic
or Augustinian thought. One of
these tests included a'hypothet-
ical case regarding "Sherri," a 15-
year-old girl whose mother
accompanies her to the doctor's
office.
"Sherri comes to the office one
day complaining of nausea and
fatigue," Dr. Brody explained.
The doctor ushers Sherri into
the examining room. Sherri's
mother remains in the lobby. In
secrecy, Sherri tells the doctor
that she's been sexually active for
a year. The doctor determines
she's pregnant.
Sherri begs him not to tell her
mother. Her mother, she says,
wouldinsist on keeping the baby.
But Sherri knows she can make
an anonymous visit to an abor-
tion clinic. The problem would be
solved in a matter of days, she
says.
.
What should the doctor do? Dr.
oody Allen and other Friedman, a social worker and
"CCO's purpose is not to at-
Brody offered his audience three
Hollywood stars might one of CCO's founders.
tack managed care," he says. "It's
alternatives.
have mainstreamed a
Therapists must report a pa- to provide an option. We want
1. Tell the mother about Sher-
trip to the shrink, but tient's progress to a health.plan the freedom to practice as we
ri's condition.
that doesn't lessen the embar- "gatekeeper," who in many cas-
2. Tell the mother that Sher- rassment for ordinary people es terminates or reduces insur- were trained."
With CCO, patients have the
ri did not want him to disclose who bump into friends, co-work- ance dollars the patient receives
the results, so mother and ers and bosses in the lobby of for additional help. Sometimes, option of using their insurance,
but they may choose to pay out-
daughter will have to talk about their psychologist's office.
when a patient demonstrates im- of-pocket. Private fees, based on
it themselves.
Ten local mental health pro- provement, coverage ends.
a sliding scale, are determined
3. The Augustinian alterna- fessionals want to reduce the
"I don't know anyone in the by each therapist. These fees are
tive: Tell the mother that Sher- chances of that happening.
ri's symptoms have been going Last spring, a team of psy-
around and are not uncommon. chologists and social work-
In fact, they'll disappear in a mat- ers created Confidential
ter of days.
Counseling Options, a pri-
As with all Dr. Brody's ques- vate referral network based
tions, a number of doctors in the in Southfield.
audience offered vociferous re-
CCO has no centralized
sponse.
clinic and no waiting room.
Patients access help by call-
ing a phone number, leav-
ing a message and waiting
for a return call from a CCO
therapist who schedules a
confidential appointment at
his or her private office.
Therapists specialize in
stress management, family
conflicts, depression, pho-
- "Sherri's my patient, not her bias, sexual problems and
mother," said one physician, who a variety of other issues.
opted for the third approach.
Founders say their net-
"But who's paying the bill for work offers patients "an al-
the doctor's visit?" said another. ternative to employment-
Pleased to spark debate, Dr. related mental health
Brody stressed the importance of plans," like HMOs and Paul Friedman and Dr. Karen Weiner helped establish Confidential Counseling Options.
discussing medical ethics and Ju- PPOs.
daism.
Health plans, they say, can
"If Maimonides societies are pose two problems: One, they're field who isn't a little bit ticked contingent on a patient's ability
truly going to function, they must not confidential enough. Mental off about this," says Dr. Karen to pay, not on an insurance com-
focus on what our tradition says problems become the business of Weiner, a Southfield-based li- pany's fee schedule.
No outside billing services are
about these cases," he said. "It's not only the patient and therapist censed psychologist who also
used.
one thing to say you should be but also the insurance company. helped establish CCO.
Dr. Weiner believes rationing
CCO therapists average 15
honest and it's another.thing to
Two, employment-related
determine in certain cases what health plans extend increasing- of treatment can put both a pa- years of experience. Though each
in the world that means. We ly limited coverage to their tient and therapist at risk. The has operated -an independent
patient, despite signs of im- practice, they have known each
need to reflect long and hard." ❑ clients.
provement, might require ongo- other for many years. They be-
CCO founders refer to a recent ing sessions to assure a lieve that forming a referral net-
Wall Street Journal article, which long-term recovery. And the ther- work will help them better
reported that more than half of apist does not want to sacrifice market themselves and each oth-
the Fortune 500 companies have his or her patient's health to er.
restricted mental health benefits monetary considerations.
"We've shared cases. We've
in an effort to cut costs.
"That basically goes against worked together," Dr. Weiner
"Within a year or two, very few the professional ethics of thera- says. "Some of us studied to-
patients
will be covered for tra- pists, who must not allow busi- gether. We have a mix of people
.
ness concerns to interfere with who are well-suited to treat a Al
treatment," Mr. Friedman says. broad spectrum of problems." ❑ it
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