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JD4010

$17.93 per minute

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12 minutes ago, CoolCat7 said:

Nobody should make that kind of money.  Nobody in the world.

True - but they do.... 

In this case I am sure some of it is going to the practice as a whole, paying salaries of underlings and electric bills, and etc. but still...

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53 minutes ago, myra_viveash said:

True - but they do.... 

In this case I am sure some of it is going to the practice as a whole, paying salaries of underlings and electric bills, and etc. but still...

I agree, breaking it down to a per-minute rate is misleading, it doesn't include any time spent on admin tasks and depending on the location rent may take a significant junk out of it. Then there's student loans which have to be paid back, malpractice insurance, various taxes, and if he/she takes insurance patients those will have to be made up for since insurance often pays very little. Many also take on a small number of sliding-scale or pro-bono clients. 

While a psychiatrist obviously makes way more than a blue-collar worker they're still paid less than someone in a white-collar managerial position so it's not THAT outrageous. $269 does seem to be on the high end though, I usually paid $150 but it was in the suburbs, city prices would most likely be higher. 

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23 hours ago, myra_viveash said:

Wow. Wish I was making that kind of money. I hope that is what they billed insurance and not you. Was this just a normal appointment?

Nope. Out of my pocket. The only "good" thing is that it counts towards my deductible. And yes, it was a normal med-check appointment.

Edited by JD4010

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I posted the "by the minute" rate because it would illustrate the humongous money that goes into our for-profit medical system here in the US. I think I'm done going to the shrink. I can't afford this kind of $$$.

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17 minutes ago, JD4010 said:

Mental health has become a luxury good.

So true. God, mental health medication management must be where the money is. When I was taking Adderall for my ADD, I had to go every month to get a new prescription, since it's a highly regulated drug. The appointments were always scheduled as 15 minute slots, though I was usually only there for about 5 minutes. And based on how crowded the waiting room always was, I wouldn't be surprised if he scheduled more than one person in the same 15 minute slot.

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Outrageous!!!!!! 

I pay $150 (no insurance price because my insurance is out of network) for 30 minute sessions, if I need an hour for whatever reason- I just have to tell them when scheduling and the price is the same! That's in the heart of Austin, Texas- city prices. That price is ridiculous, this person is "in network" with your insurance? Because something is not right. Regardless  if it accounts for your deductible or not. Psychologists/therapist don't even have the ability to prescribe medication. It's someone qualified to help you navigate your life. If you're employed, have you looked into EAP? Majority of employers covers so many visits and typically have a wide range of therapist you can talk to. I would be interrogating (nicely) the people that can explain that bill. They're probably charging the maximum they can... which still isn't right.

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3 hours ago, JD4010 said:

I posted the "by the minute" rate because it would illustrate the humongous money that goes into our for-profit medical system here in the US. I think I'm done going to the shrink. I can't afford this kind of $$$.

Well I don't take meds and I'm normal right?  Honestly I feel tons better since I quit taking them.

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Yep, this was an appointment with my psych doctor, and he's part of the network. Our deductibles have been going up rapidly over the past few years, as have our premiums. It's a complete and utter rip-off.

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Definitely want to be in network. The whole thing is a vicious circle. Between the pharma companies, hospitals, doctors. Each one ups the ante then so does the next. My personal belief is that we do need regulation but not socialist medicine.  Pharma companies are the worst of the bunch and make ridiculous profits. They work in the trillions of dollars. They buy and sell lobbyists and politicians and doctors by the truckload. They're as powerful as the big oil companies.

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I don't mind doctors making good money. But the pharma companies and the profit-driven insurance and HMO companies siphon most of our cash away. Single payer is the way to go...whether that be privately or publicly operated.

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On 5/15/2017 at 4:25 PM, JD4010 said:
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Just got the bill for my last appointment with the shrink. It was $269 for 15 minutes. That works out to almost 18 dollars per minute!

That's simply ridiculous.

 

Damn.  You're right.  Here's a note your psych should understand;  'that's insane.'

For about as long as I can remember, I have found the value that psychiatrists provide to be elusive and hidden.  I say it that way only because admittedly, I didn't study things like organic chemistry, or how to make a great living by colluding with pharmaceutical companies who sell mind-altering drugs no one understands.

I think you need to consider complaining, asking for an abatement, and/or seeking a new psych.  Medical billing is notoriously subjective and also usually open to modification.  Cash payment or partial immediate payment as you know can help, but bottom line to me, you just are not receiving the value of what you're being asked to pay.  It doesn't magically become different because it's a doctor or specialist.

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Let's be honest the drugs rarely work and when they do there is consequences they call side effects that are worse than the problem itself but oh they have another pill to fix that problem and the next pill causes a problem the pill after that can fix.  Before you know it you are on 10 pills and started out with one problem.  They are way more powerful than the oil companies.  At this time they run the whole world.  If I took all the pills they said I had to take I'd take about 20.  All I take is a vitamin in the morning and nothing else.  The world needs to wake up!

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11 minutes ago, sober4life said:

Let's be honest the drugs rarely work and when they do there is consequences they call side effects that are worse than the problem itself but oh they have another pill to fix that problem and the next pill causes a problem the pill after that can fix.  Before you know it you are on 10 pills and started out with one problem.  They are way more powerful than the oil companies.  At this time they run the whole world.  If I took all the pills they said I had to take I'd take about 20.  All I take is a vitamin in the morning and nothing else.  The world needs to wake up!

I basically agree with you...while at the same time of course, I never do or have discouraged anyone from using antidepressants where they do or may help them.

I take them sometimes and others I don't, but my experience pretty clearly mirrors what you've said, and by now, I have pressed and had 3-4 psychs candidly admit most of that, especially that they do not really have any understanding of how they work if they do, and that they absolutely cherry pick the studies to use.

Anyway, I too have found natural things that help MUCH more, albeit mine or not vitamins.  Pharmas or oil companies? I'll have to give that some thought.  

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Sadly, at least in this country, we are all about instant gratification. That comes in the form of pills when it comes to medicine. Let's face it. Most people go to the doc, tell them what hurts, then expect a prescription and be on their way. While pills are a big part of modern medicine they should not be the panacea that they are for everything that ails you.

I would argue that not taking meds for depression is the right answer for everyone. There are a good number of people who come out ahead, all things considered, like side effects etc. I do agree with @sober4life though that every pill comes at a cost and usually that is another pill that covers the side effect. Left without any push back on the doc you could easily be on 5 meds for 1 problem. It is not just depression that this happens. Have heart problems and watch how many pills they can find for you to take... 

I'm with @JD4010 on the insurance companies. They are dictating what and how your doctor can treat you if they want to play in network with the insurance companies. So your doc will go for the cheapest and easiest way to get you out of their office if they have to deal with major insurance carriers unless they are willing to go to bat for you. Each year you get less support and at more cost per month and copay regardless of how big your employer is. They are cutting corners everywhere because medical benefits hit them hard. They tell the insurance company their rates are too high and need to lower them. So they cut back and cut corners to lower their bid. You end up getting good to mediocre depending on your company. Great coverage is pretty much a thing of the past.

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4 hours ago, gandolfication said:

I basically agree with you...while at the same time of course, I never do or have discouraged anyone from using antidepressants where they do or may help them.

I take them sometimes and others I don't, but my experience pretty clearly mirrors what you've said, and by now, I have pressed and had 3-4 psychs candidly admit most of that, especially that they do not really have any understanding of how they work if they do, and that they absolutely cherry pick the studies to use.

Anyway, I too have found natural things that help MUCH more, albeit mine or not vitamins.  Pharmas or oil companies? I'll have to give that some thought.  

No I won't ever tell someone not to do something that is helping them.  My problem with medication is it seems a lot like drugs and alcohol.  Somehow they are notorious for helping symptoms while somehow finding a way to give a lower quality of life.  We're told that all that matters is making symptoms better to make life better and that's far from the truth.  Believe me lot's of years of my life were spent managing symptoms and watching life pass me by at the same time.  I won't do it anymore.  I will always say that diet and exercise works the best.

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3 hours ago, In2deep4me said:

I would argue that not taking meds for depression is the right answer for everyone. There are a good number of people who come out ahead, all things considered, like side effects etc

Do you mean you would not argue that not taking meds is the right answer for everyone? I think, and I'm hoping, that you don't mean that not taking meds would be better for everyone with depression.

 

3 hours ago, In2deep4me said:

I'm with @JD4010 on the insurance companies. They are dictating what and how your doctor can treat you if they want to play in network with the insurance companies. So your doc will go for the cheapest and easiest way to get you out of their office if they have to deal with major insurance carriers unless they are willing to go to bat for you. Each year you get less support and at more cost per month and copay regardless of how big your employer is. They are cutting corners everywhere because medical benefits hit them hard. They tell the insurance company their rates are too high and need to lower them. So they cut back and cut corners to lower their bid. You end up getting good to mediocre depending on your company. Great coverage is pretty much a thing of the past.

I am so not a fan of private health insurance companies. If we can't have single payer healthcare in the US, there should at least be some regulation on costs and reimbursements on both sides. It's interesting because I have health insurance through a non-profit insurance company right now and it seems like I have the opposite problem that a lot of people do - they've approved anything that a doctor has recommended. For example, I was taking Strattera for awhile for ADD. If no one has taken that, it's an expensive drug because there's no generic yet, so even with insurance I was paying $45/month. According to the health insurance information, I should have had to try at least one other ADD drug first before going to that, especially since it had been about 10 years since I had taken anything for ADD, through a different doctor, and then I was on Adderall for only about 6 months. But they didn't give me any problems with approving it.

But on the other hand, a lot fewer people take my insurance, especially for mental health services, because their reimbursements are lower than other insurance companies. I know that because my former therapist told me flat out that's why she doesn't take it, when I started this job.

 

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3 hours ago, sober4life said:

No I won't ever tell someone not to do something that is helping them.  My problem with medication is it seems a lot like drugs and alcohol.  Somehow they are notorious for helping symptoms while somehow finding a way to give a lower quality of life.  We're told that all that matters is making symptoms better to make life better and that's far from the truth.  Believe me lot's of years of my life were spent managing symptoms and watching life pass me by at the same time.  I won't do it anymore.  I will always say that diet and exercise works the best.

That's a very interesting point and analogy to drugs and alcohol, and I agree with your basic point.

Not to split hairs, but I would say that there are more than a few 'enlightened' mental health professionals who know it is NOT 'all [about] making symptoms better.'  And improving symptoms--IF in fact something actually does that--is at least something positive.  Again though, I do generally think you're right. And I completely agree re: diet and exercise.

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11 hours ago, gandolfication said:

Not to split hairs, but I would say that there are more than a few 'enlightened' mental health professionals who know it is NOT 'all [about] making symptoms better.'  And improving symptoms--IF in fact something actually does that--is at least something positive.  Again though, I do generally think you're right. And I completely agree re: diet and exercise.

I agree. While I've definitely had experiences with bad and/or clueless mental health professionals, I know there are good ones out there, too. And the good ones are clear that medication is not going to cure everything, but more that improving symptoms can help give someone the capacity to do the work of processing things that might be at the root of the illness, learning new habits to help manage the illness, get control of their diet and exercise, etc.

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33 minutes ago, skblue said:

I agree. While I've definitely had experiences with bad and/or clueless mental health professionals, I know there are good ones out there, too. And the good ones are clear that medication is not going to cure everything, but more that improving symptoms can help give someone the capacity to do the work of processing things that might be at the root of the illness, learning new habits to help manage the illness, get control of their diet and exercise, etc.

Yah, it's holistic for lack of a more precise term.

Over the past 5 years at least I guess, whenever I work with a mental health professional, at some point fairly early on, I ask them straight up if they have personally ever experienced serious depression themselves.  Not a friend or family member.  Them self. I try not to be intrusive or obnoxious about this, but it matters.*  My personal belief and I think experience, is that on balance, professionals who are supposed experts about depression and mental illness from med school or masters or PhDs in psychology often do not really have a much greater understanding and ability to assist other people with this extraordinarily complex, subtle and multifaceted experience, if, to state the obvious, they have not in fact ever experienced it.  To me, it would be fairly analogs to going to someone who had never experienced the emotion of anger for one's anger management program.  All the academic platitudes and directions in the world would be utterly fruitless. 

 

*Some don't like that I ask this, but candidly, I am not there to do what they like, I am there (and usually spending the scarcest of resources) primarily to get better.  Most answer the question; or if they don't I know the answer fairly well and it may be one indication of a lack of openness and communication in the professional relationship. I mean think about it - if a professional is unwilling to just simply say, yes or no, I have/haven't personally dealt with serious clinical depression, I can't think of a lot of reasons I would have to trust them for much.  And there's been one exception to my above-generality - I think probably the best therapist I've ever worked with said that no, she really had never had any kind of serious or long term depression.  Which wasn't an issue, because she was good, and had genuine human empathy and listened anyway.

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