Originally posted on BioPsychoSocial, here: https://www.biopsychosocial.net/single-post/2017/10/18/The-Actuary-and-the-Therapist-A-Love-Story
Monetary risk is something we all contend with when we take out our healthcare wallet —especially when it comes to investing in mental health. Whether you’re an individual consumer or a corporation contracting for benefits, it can be hard to measure the value of a medical endeavor. How can we make these choices in a sensible way? Although I see the value for people who have left my office with a successful treatment in their back pocket, for today’s blog I won’t plead the case for the intuitive gift of therapy. I will also leave questions for when to integrate both medication and talk therapy to a different time. Today I’m more interested in seeing what possibilities may exist between psychiatric treatment inclusive of talk therapy and the actuary. Could a cold hard look at the numbers be more warm than previously thought? Could it have more to do with the tender first steps of love?
The idea for this blog came up after a weekly therapy session with a woman who has been my patient for many years . I considered this patient’s treatment with me and began thinking of where she started . She was lost in the misery of a broken heart, leading a stagnant, reclusive life, unable to productively use her talents and skills. Her early life had not made it easy to address relationships in a healthy fashion, and she appeared to be on a trajectory towards greater isolation. Fast forward to this week….. she left our session happily embroiled in negotiating conflicts inside her successful company while simultaneously trying to figure out how these issues might be affecting her intimate relationship. How has she achieved this? My vote is “Aye” for treatment with me and “Nay” for the healing sands of time. Evidence for the success and realistic expectations of treatment are a separate topic to be addressed in a later blog.
A Brief Pause…. I want to take a moment and clarify a particular aspect of combined talk therapy and medication treatment. In this blog, I’m not attempting to correlate a patient’s level of need to how long (or short) the duration of his or her treatment. The relationship between these two factors is complex. In my practice, treatment length and termination are most often not determined by the therapist. Typically outside elements such as a job, location or insurance change might artificially end a treatment. Otherwise it is a more or less natural process of meeting treatment goals and reviewing with the person that characterize the ending of a treatment.
Back to the love story … Still I wondered, could I justify all those sessions as a cost-effective use of resources. Perhaps I thought, I should just avoid the question as she pays out of pocket and answers to herself regarding choice of treatment. Although it's a viable option for her, not everyone has the ability to insulate themselves from actuary-driven private insurance companies or payors. Many of my patients depend on coverage choices made by their insurance provider. In the end I knew that I wanted to take a closer look at the cost of a treatment with me. I wanted to focus on the actuarial dollar; the cost an employer or insurance company may use to determine where to spend their healthcare dollar. So, I closed my eyes and put my finger down on a random week’s list of appointments to explore. In other words, I went over my therapy cases for a single week. I tallied people who were in a consistent therapy and converted folks seen less than weekly to their weekly year equivalent. Keep in mind that these are rough sketch statistics. Here is what I came up with:
If you’re in Austin Texas and are seeking a psychiatrist in Austin, be sure to visit us. You can learn more about us on Google or find us here.
Pondworks Psychiatry & Psychotherapy
3636 Executive Center Dr G70
Austin TX 78731
(512) 371-9555
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