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What Am I Really Worth?

By Joan Normandy–Dolberg, LPC
Chair, Public Awareness, Advocacy, and Marketing Committee

Every year I go through “The Great Insurance Debate,” trying to decide if I should continue to remain on managed-care panels and accept insurance. And every year for the past eight years I have played it safe, opting to remain on the panels despite the numerous negatives … but this year I finally decided to make a change.

The financial reasons to terminate insurance participation are very clear: I can continue to see 40 clients a week and be reimbursed by insurance companies at between $55 and $65 per session, or, I can see 20 clients a week and charge the going rate in my area of $125 per session and make the same amount of money. 

Instead of working harder, I can work smarter ... so why has this decision been so hard to make?

First, I don’t want the insurance companies to win. I am angry that they get away with overcharging their members and underpaying their providers. As a consumer, I pay exorbitant premiums. I always look for an in-network provider whenever a family member or I need care, so why shouldn’t I provide this in-network care that I so appreciate?

Second, I am committed to the individuals and families I already treat, most of whom found me through their insurance panels. I do not want to abandon them, or make their lives more difficult in these stressful financial times.

And finally, I like working with the working class, treating real people with real problems. Will I like working with individuals who can afford care? Will they have different kinds of problems? Will I suddenly be treating the “worried well”?

Despite these familiar arguments circling in my head, this year my response is different than in past years, thanks in part to a wonderful practice-building and business-development mutual support group that began in our area. 

This group is composed of six therapists in private practice in Northern Virginia, and, much to my surprise, none of them takes insurance! It occurred to me that they all get paid what they are worth. If I continue to accept less than others in my area, does that mean that I am a less-than-average therapist? Do I work less? Do I have less education, fewer skills, less compassion? The answer to these questions is … absolutely not! 

I know I am a highly skilled and compassionate mental health counselor who has developed valuable skills during the 10 years I have been in practice. I have the structure and discipline to market myself to my community, and I realize that I am not only a mental health counselor but also a business person. I went into this field in order to help others, but not at the expense of struggling to meet my mortgage payment every month.  

So I am now committed to a different use of my time and energy. Instead of spending hours on the phone with insurance companies arguing about payments, I will use that time to develop and implement a marketing plan. Stay tuned for updates on the results!