[JamesVI]

All I’m saying is that the schedule of payments for medical care in the US is largely driven by what Medicare pays for each treatment code. The Medicare payment schedule is set by a board that is largely dominated by “procedural” doctors (surgeons). The only procedure in psychiatry is ECT, so a psych dept can charge a lot more for ECT than (say) a course of CBT.

I’m not trying to imply that psychiatry is coin-operated, but if ECT is “funding the department” there is an incentive to propose ECT, even if the science doesn’t support that.