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.