Rich Daly's article about the drop in psychotherapy use in the January 7 issue was certainly consonant with my recent experience here in New York City in closing my practice as I retire. I've continued a pattern of practice established over 40 years ago of doing traditional, "long" talk-therapy sessions, including, sometimes, pharmacotherapy. More recently, in the last 15 years or so, "split" therapy became prevalent with the intrusion of managed care patterns, and I continued my old approach, in addition to seeing patients for medication management and "short" talk-therapy sessions of 30 minutes.

Now, many of my ending patients have been reporting to me that it's very difficult to find psychiatrists who will accept new patients with insurance; other psychiatrists will see them only out of network or for 15-minute med-check sessions, not for regular talk sessions.

I've had to delay retiring, briefly, I'm afraid.

HAROLD A. HAMER, M.D.
New York, N.Y.