Thursday

Whoah Nelly

Four years ago, I had less wrinkles and brighter eyes.

The End.


.... I love doing that. Okay, not "The End." But that would be funny right? No?

I'm avoiding. Someone please stop me

Ahem.

Four years ago I sat down (as someone with more free time) and wrote an article detailing everything I wished I could tell people before they used insurance. I had sat on the phone far too many times that week, on hold, waiting to be forced to give personal information out on my clients... again. Just so they could get the money they were due.

Idealistic and younger me thought: "Don't you think if you were a client you would want to know this information?"
And I answered myself, "Yes! I would!"
Idealistic and younger me asked, "Well then isn't it like you have a moral imperative to educate the consumer here?"
And (full of hubris and naivete) I answered myself, "YES self! I do!"

And a blog post was born. No biggy. Like 10 people read it and I knew them all.

And I thought THAT was the end. Really.

Then I got clients a few months later (who actually thanked me for the post and said they chose me and chose NOT to bill insurance because of it). That's cool.

Then I got therapists a while later (who secretly said they agreed but would never post it). That should have been my warning sign.
But time passed and I forgot it existed.... until managed care became an even hotter topic. And somehow, due to the gods of google (or Bing, or Yahoo, or If-I-Knew-Why-I'd-Be-Amazing-But-I-Don't) I suddenly started getting eyes. Lots and lots of eyes. Over 3000 and counting to be exact.

And with the eyes, came the hate. Oh yes, lots of that. You're not new to the internet- you know this is something to assume right? Commenters will be harsh! Haters be hatin.... (anyone? no?).

So now I have a debate in my mind. Keep it up? Take it down? Does it help? Does it hurt? Is it relevant? Is it necessary?

And my words haunt me- I would want to know. So... for now it stays.

But geesh! I'm a therapisty type. It means I'm kind of sensitive. Get it? Yikes! Thank goodness for comment moderation.  So mostly, I'm whining here. My apologies! What was my point? Oh yeah, managed care.

2014 has become another huge shift. We don't have to be surprised there. It's on the news 24/7. No one can predict where this journey will take us. No one can even predict what mental health care will look like in 10 years- as there is still debate about what/if it is medical care or not. And since we don't know what medical care will look like... it is anyone's guess.

Articles like this one speculate that private practice therapists will be a thing of the past. They will become one more "office visit" as part of a large HMO or even a state-run institute. With tight time limits and quick diagnosis/treatment timelines.

Is this tragic? Or wonderful? I guess it depends on your view and how it turns out. But for now, I know that my clients and I are in this together. I am doing my darnedest to serve them while protecting the integrity of my care, and the confidentiality of their services. And I am thankful to say, that this has meant a full calendar for the last 4 years. Even though I am not on any insurance panels.

Being able to treat what my client deems important. Being able to treat with skills and tools my client feels are the most helpful. Being able to see a couple or a whole family when my client feels that is necessary... and being able to do all this without reporting it to a database... is so precious to me. That kind of freedom thrills me.

Why speak of this? Partly because I'm a nerd and find this kind of socio-political stuff fascinating. :)
Mostly because I believe you have a right to know. I would want to know. You have choices here. They are not easy ones, but they exist.

So what are your thoughts? Are you glad I told you all this? Would you rather know? Or not? I'm taking your comments!