Introduction by Merrill Mathews, PhD

 The U.S. healthcare system has experienced dramatic changes since the 1960s, and Dr. Lee Beecher has seen them all. He entered medical school in 1961 and continued practicing psychiatry until he retired in 2014. He has spent the past few years writing this insightful book, which highlights and explores the many changes—and challenges—in the system.

Throughout his professional life, from its early days when doctors and patients partnered to produce individual healthcare outcomes, to today, when large healthcare “provider” systems predominate and often predetermine practice procedures, Dr. Beecher has remained committed to one critical theme: For the best possible patient outcomes in any medical or mental health system, the patient ultimately must take responsibility for his or her own care – this is especially true with psychotherapy.

The physician’s role, Dr. Beecher contends, is to help a patient understand his or her medical or mental health needs and then guide them to activate a successful strategy to reduce their pain and suffering. This physician’s role has increasingly been commandeered by third party payers and government regulators, contends Dr. Beecher.