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Should medical treatment be a business? It’s an age-old question that many people feel VERY strongly about. After all, is it ethical to “make money” off of human suffering? The obvious answer is “absolutely not,” which is why we conceptualize it differently. The forgotten question here is: “How do we create mechanisms to address human suffering?”

In all of the days (years!) of school and training to become a therapist, one thing is true: no one works for free. So how do we break this coconut open unless we start at the basics? First up: what is work? The dictionary definition is “activity involving mental or physical effort done in order to achieve a purpose or result,” or “a task or tasks to be undertaken; something a person or thing has to do.” 

In general, people want some form of return for expending energy. You burn calories to go to the fridge if there’s something there that’s rewarding. (Ice cream! Soda! Snacks!) Removing all judgment, wanting a return for some form of work (i.e., investment) is human nature. You reap what you sow, and you’ve gotta do some work to get anything in this world.

As mental health clinicians, we carry a unique burden. We are trained in beneficence and fiduciary responsibility while also balancing autonomy and maximizing the recipient’s perception of value. All of these put us in a tough position because treatment requires both the individual and the therapist to put in work. While the patient’s return on therapeutic work should be feeling better, what’s the therapist’s return for the time spent and expertise used? Payment.

Payment comes in many forms: money, gratitude, continuing education credits, RVUs, etc.  The purest form of payment is direct; Simply Psych encourages all of its clients to use a direct pay model for care because the transparency creates the strongest connection between the treat-er and the treated.

Using insurance to finance healthcare has made the patient-clinician relationship worse. People have been trained to pay a monthly premium (that most folks don’t see because it’s via their employer), then trained to pay a small copay (that is more symbolic than financially helpful to running a small business), and then expect unlimited access to the best and most comprehensive knowledge and skill of that clinician.  It’s a recipe that is doomed to fail.

Therapists who work for agencies that take insurance feel the pressure immediately. They are pushed to find the “right answer,” implement the fix as quickly as possible, and close that case within a limited number of visits. That’s not quality of care, nor any semblance of truly helping people. Discovering mental and emotional health will never be a quick and easy solution, but rather a continued investment of diligence, intentionality, and commitment. Finances are almost always where the problems start. Spoiler alert: therapist burnout is high.

Simply Psych encourages clinicians to go the direct pay route. By having a direct financial and fiduciary responsibility to the people they treat, clinicians “eat what you treat,” fully responsible for the care their patients receive.  Not only does this cut down costs (insurance companies are not into paying you your worth or giving money back to their policyholders), but it also restores your agency in running the practice you want (and freeing you from the #PAIN of prior auths.) 

Tying your livelihood directly to the people you treat builds deeper rapport and human connection. Yes, it’s scary. But improving quality of care requires authentic empathy; this automatically happens when you love your patients/clients (read more on loving them here). Let us help you facilitate a practice that you feel proud to be a part of, and that you would want to visit yourself as a patient/client. At Simply Psych, we are happy to help.

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