Mental Health Professionals – How Do We Survive the Crisis in Managed Care?

We all know there is a major crisis in health care in the USA.  I’ve been reading with interest discussions on list serves and blogs about how to better manage costs, redistribute funds and improve reimbursement rates.  Through my reading I have come to two conclusions.  1.) There is no easy answer and 2.) no one seems to agree on a place to start any reform.

Consumers blame doctors for making too much money, doctors blame consumers for not taking care of their health and requiring expensive procedures, mental health professionals seem very intent on blaming managed care companies themselves for hoarding profits.  And the truth is, all of those points have merit and I believe everyone must own a piece of reform. 

But let’s get down to brass tacks–these issues are very macro-economic. We need some serious number crunchers, economists, and policy wonks to address this.  A call to your legislator or a nicely written letter to your senator is not going to produce radical change.  I’m not saying that you should not do those things, and I do think that mental health professionals need to be a voice at the table when health care reform is discussed, but you and I are not going to move mountains and reform a system so much a part of our American economy and health care culture.

But I for one, still want to make a good living while helping people live more satisfying, emotionally healthy lives.  I also have only so any hours in my day to dedicate to work, family, my health and worrying about the greater economy. 

Now this may sound a tad self-preserving of me, but I feel a responsibility to tell it as I see it.  The time I spend in angst over the unfair practices of managed care is time I take AWAY from thinking creatively about building my practice.  Realistically I can do almost NOTHING about changing managed care in this moment.  However, I can do many, many things to develop my practice in this moment.  So I have two choices, use my “business thinking time” to worry, complain and  feel anger about the unfairness of it all, or plan to build and grow so I can offer my services to more people and make a better living for myself.  So how should you be spending your time?

Now maybe you already have an ideal practice and your have time to take on managed care, if so, my many thanks to you!  However, if you do not have your ideal practice then leave the policy development to your professional associations to whom you pay significant dues to take on such things (and if you are not a member of APA, NASW and your state association, it is time to do so, they advocate on your  and your clients’ behalf).  But if you do NOT have your ideal practice you will need to consciously determine how much energy you have to dedicate to taking on the macro-economics of managed care and how much time you dedicate to the micro-economics of your business and practice.

Now I can imagine a chorus of voices, “If we don’t change health care, we can do NOTHING to better our business!”  To which I say: not true! 

You see, we have become conditioned to rely on managed care to fund our practices and often succumb to a learned helplessness that we can only stand by and suffer whatever policies come down from the managed care pipeline.  Well, we know better than anyone that learned helplessness is a cognitive process.  Our thinking becomes our reality.

But what if you shift your thinking?  What if you do not have to do whatever MCOs dish out to make a living?  How would that improve your mood, your sense of well-being, your ability to be present with your clients?  What if you start to think that the skills and information you possess are needed by so many and you can share your knowledge and talents in a variety of ways, not just in the 50 minute hour paid by a third party? 

I submit to you that as psychologists, social workers, marriage and family therapists and licensed mental health counselors we must shift our thinking in this way because our reimbursement rates WILL NOT INCREASE—EVER.  Even if we wage the most comprehensive, strategic, aggressive battle known to the health care industry, we will not regain ground.  No medical group can expect this to happen, but we get stuck in this magical thinking that if only we could “convince” somebody of our worth they will pay us more. 

So use your energy wisely.  Try to promote your knowledge, gifts and talents to serve as many as you can while still valuing yourself and your contributions to others.  While it is easy to get stuck in helplessness, anger and frustration it is unproductive at best, destructive at worst.  And shift your thinking to one of a proactive private practice business builder, not a reactive, fearful, angry health care provider.  Trust me, you will get more good accomplished and benefit from less stress, more energy and good vibes surrounding you.

Looking for more information on building your ideal private practice and developing multiple streams of income? Visit Susan’s blog, The BizSavvy Therapist, for more information.

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