Tuesday, January 13, 2009

Economics of Psychiatry

The other day I called a psychologist colleague, to check whether he had space in his practice for a couple I wanted to refer to him for therapy. He's excellent, highly experienced, and in the past often booked up, so I wasn't optimistic. But his response was unequivocal: "My practice is shot completely to shit. Ever since the stock market crashed. Send over anyone you can."

Another other day I was having coffee with a social worker colleague. "How's your practice going?", I asked. "Well", she replied with a sigh, "I put in an application for a part-time job at Starbucks. If that answers your question."

When you have a regular job and the economy tanks, at least you have a steady paycheck until they lay you off. And then at least you know you're unemployed and need to look for a new job. When you're self-employed in private practice, though, you start getting laid off incrementally, and immediately. No one sends you a notice, or tells you what the plan is. Right now, it's pretty uneasy and uncomfortable. I definitely picked a bad year to start my own practice.

I keep a log of weekly receipts from the practice. It's very irregular, but overall my new practice was growing until the end of the summer-- and has been going down the toilet since then. You have to think there's a direct correlation to people's savings evaporating this fall. Here's a graph of the S&P 500 for 2008 (light red line) and my weekly gross income (jagged light blue line). The heavier, smooth lines are 4th-order polynomial trendlines for each. It might just be a coincidence, or seasonal variation. But I doubt it.


Blogger KyleM said...

It's very interesting that the Psychiatrist replied that way. It sounds to me as if he is guilty of what many other American's are. Not saving money, leaving it all to chance, and not being educated about the economic ramifications of their decisions.

1/13/09, 11:23 AM  
Anonymous s said...

I should fire my shrink. God, I could be paying off student loans. If it were helpful, that would be another thing...

I always want to hear more about private practice. What kind of patients do you see? Is it therapy stuff more? Is it something that people could consider non-essential? (IE a schizophrenic can't really give up psychiatric treatment, but anxiety can. I could scale back as to quality and length of appointments to just med checks, but probably not quit altogether unless I want disaster.) Write more!

1/13/09, 11:39 AM  
Blogger pjm said...

Are you sure you're not an engineer?

1/13/09, 7:43 PM  
Blogger Turboglacier said...

"Are you sure you're not an engineer?"

Oh, I'm very sure. I'm a real psychiatrist. I only play "engineer" on the internet. This is much safer for everyone.

1/14/09, 9:23 AM  
Anonymous Ivory said...

Your trend line seems to follow the S&P so maybe things will be getting better soon.

1/18/09, 9:12 PM  

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