‘Beyond the Barricade’?

I love the music from “Les Misérables,” and when the cast gathers on stage for the finale and sings, “Will you join in our crusade? Who will be strong and stand with me?,” it is all I can do to keep from jumping to my feet and volunteering. Maybe it is time for our own crusade regarding mental health care issues—to speak out assertively and act proactively, as we’ve been preaching.

I don’t think I deserve to be treated so disrespectfully by insurance carriers. I know that since resigning all my insurance contracts and opting out of Medicare two years ago, I’ve felt like a real psychiatrist again.

My patients have been surprisingly understanding. We now contract directly regarding charges, and I am free to negotiate an appropriate fee schedule. The patients pay at time of service and receive a receipt/super bill to file for reimbursement. When their insurance companies fuss or delay, they get mad at them, not me.

It is true that my income and patient volume have dropped, but I’ve found that I at least get paid for what I do, and I had been too busy anyway. I’m now 55, and it feels good to slow down a little.

How about you psychiatrists out there—“Do you hear the people sing? . . . Is there a world you long to see?”