Thursday, July 08, 2010

therapists on the beach

It's summer again.  You can tell because it is really hot.  Is it that Global Warming thing, or is it just hot?  You can also tell by the number of bugs that are flying around my computer screen and crawling across my keyboard.  I can't squish them into the keys because the screen will turn colors and flip pages.  I can only blow them away.  But then they think I'm a wimp and take advantage of my lack of power.

When it is summer I go down to the beach, especially when it's hot, like it was today.  Usually when I go to the local beach it is just full of vacationing families playing family games and splashing each other until the youngest kid begins to cry.  If I go to the bigger beach a half hour away there is a much greater chance of being surrounded by vacationing NY psychiatrists.

But today there were a couple of NY therapists on my beach.  I kind of knew one of them and he knew the others so we talked about our practices a bit and complained about insurance companies, and did some of the things that therapists do when they suddenly find themselves bunched together.

These guys are from NYC.  They charge a lot more than I do, and I think they get more.  They make their patients bill the insurance, and that way, since they don't sign contacts with insurance companies, they can charge what they want.  I am not too thrilled with that, but I understand that they play in a different market and they serve a population that can pay.  Rich people have problems too.

What does bother me is that they seem to see their clients two or three times a week, and they do so for months, and often for years.  Even for years and years.

Now it is rare when you read here that I am in favor of anything that insurance companies do, but if I kept getting bills for three sessions a week, and it continued for year after year, I would be upset too.

The basis for my being upset comes from the word "therapy."  If someone comes to me for "therapy: I take it to mean that I will treat them for something that is wrong, with the goal that it will get better, with the understanding that whatever is wrong, it can and will get better, or else there is no reason for treatment.

To me, endless treatment is not "therapy." It is hand-holding at a high price.  It also encourages dependency, while therapy encourages independence.

I guess the competition in NYC is great enough that therapists have time to see people three times a week.  I rarely see people twice a week, and when I do, it is to keep them out of the hospital, and I feel they are on the edge. If I saw someone three times a week, for more than two weeks, they would be in the hospital the next week.

I don't mind them having a different business model, but I do mind how it makes the whole profession look inefficient, and perhaps incompetent, AND at a very high price.  I mean, if you're sixty-two years old, how many years can spend talking about your mother. You only lived with her for eighteen, and you've talked about her for forty.  Let's get to the part where you grow-up and change your life!

3 comments:

Forsythia said...

You're right about therapy" with no endpoint in sight, but why did you take your laptop to the beach? Do you want to get sand in it? Do you want the NYC shrinks to think you are working on a paper for a fancy-schmancy journal? Serves you right if the bugs are bothering you. The bugs are trying to bring you a message: "Shut the laptop already."

Amanda said...

To me, endless treatment is not "therapy."

OMG - can we clone you? I promise we won't make too many of you, just a few 100.000 or so!

There are too many doctors who give the impression of wanting full appointment books rather than cured folks. I understand that people have to make a living (and pay their enormous educational debt) but there has to be a better way...

KathyA said...

I agree with you about about the dependence thing....
I also agree with Forsthia. Shut the damn laptop and relax - (she says as she throw her husband's iphone out the car window!