| We all know there is a major crisis in health care in the | | | | and your clients' behalf). But if you do NOT have your |
| USA. I've been reading with interest discussions on list | | | | ideal practice you will need to consciously determine |
| serves and blogs about how to better manage costs, | | | | how much energy you have to dedicate to taking on |
| redistribute funds and improve reimbursement rates. | | | | the macro-economics of managed care and how |
| Through my reading I have come to two conclusions. | | | | much time you dedicate to the micro-economics of |
| 1.) There is no easy answer and 2.) no one seems to | | | | your business and practice. |
| agree on a place to start any reform. | | | | Now I can imagine a chorus of voices, "If we don't |
| Consumers blame doctors for making too much | | | | change health care, we can do NOTHING to better |
| money, doctors blame consumers for not taking care | | | | our business!" To which I say: not true! |
| of their health and requiring expensive procedures, | | | | You see, we have become conditioned to rely on |
| mental health professionals seem very intent on | | | | managed care to fund our practices and often |
| blaming managed care companies themselves for | | | | succumb to a learned helplessness that we can only |
| hoarding profits. And the truth is, all of those points | | | | stand by and suffer whatever policies come down |
| have merit and I believe everyone must own a piece | | | | from the managed care pipeline. Well, we know better |
| of reform. | | | | than anyone that learned helplessness is a cognitive |
| But let's get down to brass tacks--these issues are | | | | process. Our thinking becomes our reality. |
| very macro-economic. We need some serious | | | | But what if you shift your thinking? What if you do not |
| number crunchers, economists, and policy wonks to | | | | have to do whatever MCOs dish out to make a living? |
| address this. A call to your legislator or a nicely written | | | | How would that improve your mood, your sense of |
| letter to your senator is not going to produce radical | | | | well-being, your ability to be present with your clients? |
| change. I'm not saying that you should not do those | | | | What if you start to think that the skills and information |
| things, and I do think that mental health professionals | | | | you possess are needed by so many and you can |
| need to be a voice at the table when health care | | | | share your knowledge and talents in a variety of |
| reform is discussed, but you and I are not going to | | | | ways, not just in the 50 minute hour paid by a third |
| move mountains and reform a system so much a part | | | | party? |
| of our American economy and health care culture. | | | | I submit to you that as psychologists, social workers, |
| But I for one, still want to make a good living while | | | | marriage and family therapists and licensed mental |
| helping people live more satisfying, emotionally healthy | | | | health counselors we must shift our thinking in this way |
| lives. I also have only so any hours in my day to | | | | because our reimbursement rates WILL NOT |
| dedicate to work, family, my health and worrying about | | | | INCREASE---EVER. Even if we wage the most |
| the greater economy. | | | | comprehensive, strategic, aggressive battle known to |
| Now this may sound a tad self-preserving of me, but I | | | | the health care industry, we will not regain ground. No |
| feel a responsibility to tell it as I see it. The time I spend | | | | medical group can expect this to happen, but we get |
| in angst over the unfair practices of managed care is | | | | stuck in this magical thinking that if only we could |
| time I take AWAY from thinking creatively about | | | | "convince" somebody of our worth they will pay us |
| building my practice. Realistically I can do almost | | | | more. |
| NOTHING about changing managed care in this | | | | So use your energy wisely. Try to promote your |
| moment. However, I can do many, many things to | | | | knowledge, gifts and talents to serve as many as you |
| develop my practice in this moment. So I have two | | | | can while still valuing yourself and your contributions to |
| choices, use my "business thinking time" to worry, | | | | others. While it is easy to get stuck in helplessness, |
| complain and feel anger about the unfairness of it all, or | | | | anger and frustration it is unproductive at best, |
| plan to build and grow so I can offer my services to | | | | destructive at worst. And shift your thinking to one of |
| more people and make a better living for myself. So | | | | a proactive private practice business builder, not a |
| how should you be spending your time? | | | | reactive, fearful, angry health care provider. Trust me, |
| Now maybe you already have an ideal practice and | | | | you will get more good accomplished and benefit from |
| your have time to take on managed care, if so, my | | | | less stress, more energy and good vibes surrounding |
| many thanks to you! However, if you do not have your | | | | you. |
| ideal practice then leave the policy development to | | | | Looking for more information on building your ideal |
| your professional associations to whom you pay | | | | private practice and developing multiple streams of |
| significant dues to take on such things (and if you are | | | | income? Visit Susan's blog, The BizSavvy Therapist, |
| not a member of APA, NASW and your state | | | | for more information. |
| association, it is time to do so, they advocate on your | | | | |