Psychiatrists paid more for doing less, if they do anything at all

Shrink Rap has an interesting insight of private practice shrinks

Many psychiatrists in private practice don't take insurance, or don't 'accept assignment.' They require the to patient pay them and then the patient can submit to his health insurance company and reimbursement is made directly to the patient. This often means that the patient, having gone Out-Of-Network, has a higher co-pay &/or a higher deductible, and the hassle of paperwork. Generally, if a patient sees an In-Network psychiatrist, they make a copay and the hassle of getting the rest of the money falls on the doctor.

Psychiatrists fresh out of school generally go into private practice, because that is where the money is. So how does this work out?

So how and why does any psychiatrist accept insurance? Basically, the insurance companies pay okay for short appointments with a psychiatrist. While there are time standards for coding psychotherapy appointments (25 minutes, 45-50 minutes), nearly everyone charges more per hour for a 25 minute appointment than for a 50 minute appointment, even many of the out-of-network docs. So a psychiatrist who sees two patients in an hour makes more than a psychiatrist who sees one patient in an hour, and often the insurance companies-- perhaps eager to encourage their policy holders to seek psychotherapy with a cheaper provider-- will pay a reasonable amount for a shorter session-- perhaps they make this worth doing. And "Med Management" 90862 for those of you who like CPT codes-- has no time restrictions on it. If a psychiatrist can squeeze four or five patients into an hour, he can do okay by the insurance companies.

So the psychiatric profit margin is in putting patients on drugs, rather than actually sitting down with them, talking things over, and doing something for the human being sitting there in front of them.

It is very easy to make the prediction that psychiatric profit margins will go up with drug usage, and most psychiatrist will develop a lack of interest in doing anything else for their clients except other then prescribing them some pills to pop.