2 Comments

Thanks Gary, I hadn't thought of all those complications. Just reading it felt overwhelming. I'm glad you made it out. I was talking to a young doctor a couple of weeks ago. He is caring and compassionate and bright and quitting. He has had enough and will go into another line of work. Sigh

Expand full comment

Great post, Alan.

As a psychologist I was feeling the pressures of the collapse of workable healthcare for too many.

We used to have adequate social service resources to follow up on crisis prone clients and the ability for them to have extended inpatient treatment when in crisis.

With the advent of psychiatric medications for psychosis and other psychiatric meds, many state hospitals were shut down. Community mental health was supposed to meet the needs of many but has been increasingly underfunded. So the burden falls on outpatient psychotherapists to keep these folks safe.

Police are underfunded and don’t have adequate mental health crisis support teams and it’s harder to get safety checks. Insurance companies sometimes challenge long term therapy.

Clients needing medical care for more rare or complex conditions have to wait and jump between isolated doctors instead of being worked up and treated by a team. Some with severe chronic pain had to struggle to get adequate dosing under current opiate mandates. And I had to help these folks stay hopeful and keep trying.

Then clients shuttle between insurers and we need to register with those companies, some of which vastly underpay, like Medicaid.

We have to limit access to attend to all of this and turn away people seeking help.

On top of this, mandates are legislated that we must follow. Licensing boards make it harder to get credentials approved. Education is expensive for professions that are underpaid.

When I could afford to retire, I chose to do so rather than carry the stress and worries.

Expand full comment