The end of private practice?

There has been a lot of talk in the health care field about the potential demise of private practice. Doctors are increasingly becoming employees of hospitals instead of self-employed practitioners. Several factors seem to be contributing to the change. Not the least of which are Medicaid, Medicare and insurance reimbursement practices. The ongoing implementation of the Affordable Care Act (ACA) along with the eventual requirement for electronic health records (EHR) are reported to be discouraging increasing numbers of doctors from working independently.

 

With the push for mental health parity, behavioral health providers are likely to experience similar pressures in the coming months and years. If doctors aren’t able to make it independently, will counselors fare any better? How will we navigate the maze of insurance requirements? Where will the referrals come from once hospitals get more involved in behavioral health? How will small practices afford to comply with the EHR requirements? I believe these questions are key to maintaining relevance in the behavioral health field in the years to come.

I would love to hear any thoughts or insights from those of you currently working in the behavioral health field.



5 thoughts on “The end of private practice?

  1. I have to say that I absolutely disagree with this idea and I think it is dangerous for us as therapists to promote the idea and/or buy into it. There are many therapists who feel extremely discouraged, and defeated trying to build a private practice, or even to hold on to one they have had for years. I feel like we need to encourage and be supportive and provide an alternate view.

    I have a full thriving fee-for-service practice in NYC and we do not take any insurance. I also coach therapists on how to do the same. The insurance industry is not only destroying the livelyhoods of mental health professionals, it is also taking away clients right to choose their own service.

    We as therapists have 2 major responsibilities here: 1) Educate ourselves enough on the business end of things so we can continually evolve, stay in business, diversify our services, and do good work and 2) educate clients that self-care, both physical and emotional, is an investment for their lives and the insurance industry is making it impossible for most therapists to provide good clinical work.

  2. Of course I wasn’t trying to promote the end of private practice. I have simply heard of significant shifts away from private practice in the medical field and wondered aloud if the same shift may impact behavioral health practitioners. I have been encouraged by some of the responses from others that those in private practice who choose to, will find a way to survive.

  3. Greetings! I know this one intimately. After 9 years of taking insurance and never really making any sort of profit, last August, I decided to go fee for service. I also now have a thriving private practice with as many clients as I can handle. Of course, these folks often have insurance and can get reimbursed themselves using the superbill I give them. After years of being discouraged with the insurance companies, I’ve found a renewed sense of commitment in private practice.

    1. Thanks for the insight. It’s nice to know about how others have managed.

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