Two Brattle Center (TBC) is a struggling for-profit private mental health clinic based in Harvard Square. Its founder, Dr. Joan Wheelis, is a nationally recognized practicing psychiatrist who has developed outpatient treatment programs based on Dialectical Behavior Therapy (DBT) for patients with borderline personality disorder (BPD). These patients, typically adolescent girls and young women, struggle with emotional crises and are prone to destructive behaviors such as cutting, excessive use of alcohol, taking drugs and suicide attempts. These patients are very difficult to treat and TBC has developed programs that make a noticeable difference to these patients. DBT requires teams of people with different types of expertise and so the original operating model developed by Dr. Wheelis was one in which TBC was staffed by a large number of part-time clinicians, the "affiliate model." However, changes in the health care environment, particularly the advent of managed care, have put very real pressures on this model and the company is now in a state of crisis. Dr. Wheelis is trying to decide whether and how to keep it going. The key decision is whether to shift to a "staffing model" based on a larger number of full-time clinicians. This will require a larger patient population to make the economics of greater fixed capacity viable. Another constraint is the poor state of its basic financial systems. Morale is low and thus staff turnover is high, with many clinicians taking patients with them into their private practice when they go. TBC is trying to decide whether to join the Blue Cross Blue Shield network, which would increase its patient population but at rates much lower than it currently charges by only taking private patients. Dr. Wheelis is also pondering whether to start a non-profit foundation as a way of getting money to support its teaching and training programs, or even making the company a non-profit itself.

【書誌情報】

ページ数：16ページ

サイズ：A4

商品番号：HBSP-408103

発行日：2008/1/29

登録日：2008/5/22