May 13, 2009
To: APA Practice Summit Delegates
From: the Crisis in Psychotherapy Practice Task Force of the NYS Psychological Association
The Crisis in Psychotherapy Practice Task Force (CPP) was formed in 2007 by Dr. Dianne Polowczyk while she was NYSPA President. Members of the Task Force are: Drs. George Northrup, Beverly Lawson, Jerry Grodin, Jamie Shiffner, Sharon Brennan and Dianne Polowczyk; Drs. Frank Goldberg and Barbara Fontana are co-chairs.
Many psychologists both in New York and across the country are in independent private practice providing psychotherapy services and want to continue to do so. Yet many of our colleagues are struggling to earn enough money to support their families and early career psychologists have the additional burden of student loan debt. We are all aware of the stagnant reimbursement rates over the last twenty-plus years and the increase in master degree level practitioners who also provide psychotherapy services. We believe psychologists are the best trained mental health professionals; consumers want and need our services but it becoming increasingly difficult for them to access care by a psychologist.
We support the vision of Dr. James Bray and others to expand the practice of psychology into other areas such as integrated care and prescription privileges. But we also think APA must make a heroic effort on behalf of the vast majority of psychologists, young and old, who pay the Practice Assessment and provide psychotherapy.
We have summarized below some of our concerns and recommendations.
- We value the Practice Organization’s efforts to fight cuts in Medicare rates and have psychologists designated with equivalent status to physicians within Medicare. But, in our opinion, the compelling issues of psychologists in private psychotherapy practices are not being addressed at the level necessary to preserve our profession.
- While we know that psychotherapy often helps people live happier and more functional lives, medication rather than psychotherapy is being used more frequently to alleviate mental health problems.
- Many students enter doctoral programs in psychology because they want to provide psychotherapy. If graduates can’t earn a living in psychotherapy practice, admissions to these programs will eventually drop because of supply and demand. This will affect our academic colleagues.
- Data we have collected indicate that both NYSPA and Division 42 members overwhelmingly chose fair reimbursement as the number one priority for APAPO in health care reform. In a NYSPA survey this year, 75.9% of the 673 respondents chose “reasonable compensation for psychotherapy in private practice” as the top priority for APA to address during health care reform discussions. In a Division 42 survey 71% chose compensation as the top priority and in a Tennessee Psychological Association survey 47% of 58 respondents also chose compensation as the top priority. (NYSPA survey results are attached)
- In the same NYSPA survey psychologists were divided on the statement: “APA is making good use of the practice assessment that private practitioners pay in addition to regular dues.” Of 684 respondents, 30.2% disagreed or strongly disagree; 21.7% agreed or strongly agreed; 24.7% neutral; 23.7% no opinion.
- A number of psychologists in private psychotherapy practice resigned from APA because they felt abandoned by APA and the PO; many others withheld the practice assessment for the same reason.
- Our data indicate that psychologists resign from insurance panels primarily due to low reimbursement rates. These resignations negatively impact consumer access to treatment by psychologists (see attached Phantom Panel Survey Results).
- Our data indicate that NY psychologists received many calls from consumers who have contacted several psychologists in their plan’s network and cannot find a psychologist who is in the plan and accepting new patients. Again, consumer access to care by psychologists is negatively impacted. (see Phantom Panel Survey Results)
Recommendations to APA and/or the Practice Organization are as follows:
- Launch a historic marketing campaign with the message that psychologists are the best trained mental health doctors, we provide psychotherapy based on science and research, our treatment is highly effective and in some cases more effective than medication.
- Aggressively pursue reasonable compensation for psychologists as a top priority in health care reform discussions since it affects consumer access to treatment by the best trained mental health professionals.
- Be a major player in health care reform and form strong alliances with other professional organizations to influence health care reform and fair compensation in all plans.
- Allocate much more of the practice assessment to save psychotherapy practice from extinction.
We are most interested in the survival of psychotherapy practice and appreciate your assistance in this crisis. You can reach the co-chairs of the CPP Task Force or the President of NYSPA if you have any questions or would like to start a similar task force in your region or division.
Dr. Frank Goldberg, co-chair, firstname.lastname@example.org
Dr. Barbara Fontana, co-chair, email@example.com
Dr. George Northrup, NYSPA President, firstname.lastname@example.org
Attachments: NYSPA Survey of APA Health Care Reform Issues
CPP Phantom Panel Survey