The Future of Private Practice Psychology

I couldn't resist writing a quick reply to my local psychologist listserver where there is worry about the future of private practice psychology given the changes in the healthcare delivery system.  I certainly could elaborate, but here's the 10-minute treatise as I await my next client:

                                 [Photo after a recent snow storm.  I can see the general outlines, but clearly enough?]


I don't think there is reason for so much pessimism about psychologist private practice.  Actually, I think psychology can shine brighter than ever in the years to come because of:  (1) The ever increasing need and psychological orientation of the population and openness to what we offer.  All living generations now are open to our services, and at least the older generations remember well, and often desire, the "psychotherapy" model as opposed to the technician/screening/checklist-writing, texting and tweeting ...  How satisfying will the 'fast food' versions of mental health care remain over time? (2)The media gives psychology widespread attention and opportunity to keep ourselves visible to the public.  So many folks have had at least an Introductory Psychology course in school, and we all see psychology and psychologists in all media outlets daily, and even more often around the big new stories. Psychology and psychologists are a much larger part of life than a line item in an insurance policy. (3) There is the ever less appealing alternative treatments, including growing legions of less trained or experienced providers, so many of whom will be entrenched in (and encumbered by) the medical system and the difficulties of access and threats to privacy involved there.  Just the threats to privacy, as we see in the news everyday, will encourage people to seek more private alternatives for the most personal issues in their lives. (4) The backlash against psychotropic medications and the data that's diminishing the appeal of these products of the pharmaceutical industry; (5) The increasing reality that people will need to be in charge of their own health care, and will research and choose how best to spend their healthcare dollars. With high deductibles and confusing health insurance policies, people will be wiser shoppers.

I remember George Albee, Ph.D., saying a few decades ago that we will rue the day that we get involved with the medical insurance industry.  Yes, before we were included in medical insurance.  So many of my colleagues seem to rue it every day, and all the while pursue it.  What a dysfunctional relationship!  I think about how so many psychologists have seemed driven to be 'real doctors' by inclusion in the medical system.  Now again there seems to be such worry that we need to change and accommodate or else be left behind, excluded.  OK, I am the person who sells my stock market investments when I see the masses rushing in.  I have the same attitude here.  I believe in Psychology, want to keep the public informed and desiring what we provide, and believe we can stand on our own.

I think there will be psychologists practicing within the medical system, and there will be a larger number of psychologists increasingly outside of the medical system.  You will get your triage and referrals to a limited menu of possibilities within the medical system ... But when you really want someone to talk with about your problems in living -- your difficulties in your family, your struggles in your marriage, the pressures in your workplace, your worries about your children, your concerns about the meaning and direction of your longer life filled with so many more concerns -- you will seek a more substantial relationship. That can be with a psychologist outside of the medical maelstrom. There will be fewer satisfying alternatives and a chance for psychologists to feel more special again about what we do.


Carl Hindy, Ph.D.
Clinical Psychologist
120 Main Street, Suite 103
Nashua, NH 03060
(603) 880-8773