WHY I DON'T LET INSURANCE COMPANIES TELL ME HOW MUCH I CAN CHARGE FOR HELPING MY PATIENTS

Almost two years ago I decided to not accept the limitations that insurance companies place on what I charge.  Insurance companies reimburse psychiatrists for a brief "medication check."  This often translates into a 10 minute session during which there is discussion of how the person is doing in general, an evaluation of current symptoms and response to the medication, review of any side-effects to the medication, decisions regarding any dose changes or change to a different medication, and finally a plan for evaluating the response to the medication and possible side-effects.   That is a lot to cover in a short amount of time.  I do not believe that it can be done in 10-15 minutes.  It takes more time to cover all of these areas that are important for anyone taking medications.  I have found that this can not be rushed and that improvement is related to the time spent listening and interacting and coming to joint decisions regarding the treatment. This is true whether it is focused on medication or other forms of treatment.

I have also found that the time spent is important to be able to assess the level of stress each person is experiencing and then develop ways to help that person reduce their stress level.  This is very important to overall improvement and is a major factor in increasing positive responses to medication.

I also have seen the importance of making the treatment fit the individual person. This influences the type of medication that I prescribe and allows for a determination of the optimum dose of medication. One size does not fit all. Even if one can guess that based on statistics with large numbers of people a certain dose range is likely to be helpful for any one person, it still makes a difference to discover a specific dose that is helpful for each person.  

Individualizing treatment for each person is also important when evaluating some laboratory [blood test] results, especially those involving hormones such as the thyroid.

All of the above takes time and I will not compromise this to fit reimbursment limits from insurance companies.  I have found that even though it costs more initially to see me, the positive results and improvement lead to a significantly improved quality of life and is worth the investment.

For more about my philosophy of treatment, please see the "PHILOSOPHY" section of this website.