For some people, the idea of spending their hard earned money to see a psychiatrist seems unreasonable or too expensive. There are a variety of reasons why someone may consider seeing a psychiatrist, including: feeling overwhelmed, anxious, stressed, depressed or hopeless; having difficulty functioning in life; experiencing odd thoughts or behavior; struggling with alcohol or drug use; and difficulty in relationships at home or at work, to name a few.
Some people may feel that they need help but don’t understand the difference between seeing a psychologist, social worker or psychiatrist. While all three types of providers can generally provide psychotherapy (talk therapy), there are some very important distinctions. A psychiatrist is a medical doctor who has completed 4 years of medical school and an additional 4 years of residency in psychiatry. They may have even gone on to complete additional training known as fellowships (I completed fellowships in Public Psychiatry and Emergency Psychiatry). Psychiatrists are trained to diagnose and treat all medical conditions but specialize in treating mental (psychiatric) disorders. They are able to order and interpret medical tests and prescribe medications. In addition, they are trained to provide all types of psychotherapy. Psychiatrists are different from social workers and psychologists, who usually have a bachelors, masters or doctorate degree and primarily perform psychotherapy. Social workers and psychologists are not medical doctors, do not complete medical school and usually cannot prescribe medications.
So, does it really matter who I see?
Yes, it definitely does. There are many reasons why someone may be experiencing psychiatric symptoms, and an important cause can be medical problems such as thyroid dysfunction, medication side effects, infections, electrolyte abnormalities, and brain injury or tumors. Since psychiatrists are trained medical doctors, they are able to diagnose these medical problems and provide treatment for them, or refer you to a specialist who can. Since psychologists and social workers are not medically trained, they are not able to make medical diagnoses, and hence may not appropriately provide treatment for you. Not everyone will have medical problems contributing to their psychiatric symptoms, but if there is any chance that there could be, it is helpful to at least see a psychiatrist first, who can rule out any medical conditions which may be causing or worsening your psychiatric symptoms.
But why does it cost more to see a psychiatrist?
Since psychiatrists have extensive medical training and experience, their rates are usually higher than other types of mental health providers. You are paying for the higher level of care and expertise. It’s a classic “you get what you pay for” situation.
What if I see a psychiatric nurse practitioner (PNP)? I heard their rates are lower than psychiatrists.
Yes, psychiatric nurse practitioners (PNPs), also known as Psychiatric-Mental Health Nurse Practitioners (PMHNPs) also receive some medical and psychiatric training. They can frequently prescribe medications and order some medical tests. Nurse Practitioners can be very competent clinicians and many times have excellent bedside manners. However, their training pales in comparison to the length and breadth of training, which psychiatrists possess. For this reason, psychiatrists are considered to possess a higher level of expertise, see more complex cases, and their rates are usually higher.
Okay, I think I might need to see a psychiatrist but why should I have to pay for it?
In a perfect world, you wouldn’t! It would be great if we had universal healthcare in the United States and no one had to pay for their medical care. However, that is not the case. It would also be great if no one had to pay for groceries or dog food or new shoes or anything, really! However, that is not the case. You probably don’t think about what it means to pay someone to make your food at a restaurant or groom your dog or mow your lawn. You are used to paying for these things, and it makes sense to pay someone for the service that they provide. However, due to the creation of health insurance companies in this country, many people have forgotten the basic concept of paying someone for providing a valuable service. I covered this topic in more detail in a recent blog post, “Why We Don’t Participate with Health Insurance Plans.” However, when you stop and think about it, doesn’t it make sense to spend money on your physical and mental health? After all, I would argue that your health is the most valuable thing you can have!
We certainly have no problems spending money on things that negatively impact our physical and mental health (myself included!). Have you ever thought twice about giving the McDonalds sales associate your hard earned money for a double quarter pounder with cheese? Have you ever thought twice about handing over your money for a pack of cigarettes when you were really jonesing for it? Do you blame your bartender for charging you for an all night drink fest resulting in a nasty hangover the next day? Perhaps you do, but my point is that it’s frequently easier to spend money on things which make us sick. But doesn’t it actually make more sense to spend money on things which make us healthy?
I want to be healthy and get help, but I don’t think that I can afford it.
I think it’s important to keep in mind that spending money to improve your physical and mental health is actually a MONEY SAVING INVESTMENT, and it can actually SAVE YOU MONEY in the long run. How so? Let’s use diabetes as an example. If you spend the extra money up front and invest it in a healthy lifestyle, you can actually PREVENT yourself from ever developing diabetes and/or basically cure it to the point that it’s no longer an issue. However, once you have developed diabetes, you will then need to spend money on seeing a primary care doctor, a podiatrist, an ophthalmologist, and possibly an endocrinologist. You have to spend money on oral medications, insulin, insulin needles and syringes, alcohol pads, and glucometers, etc. If you end up having complications of diabetes you may need to pay for even more medications, emergency room visits, limb amputations, dialysis and much more. The concept is very similar to that of taking care of a car. If you spend money on keeping oil in your car, you can avoid having to pay tons of money down the line when your engine seizes and needs replacement! The idea is the same for your mind and body. Spending some time, energy and possibly money on your mental and physical health can save you on time, energy and money down the line!
Even though much of this may make sense to you, we realize that making a decision to change your life is not easy and can be a challenging and scary step to take. At Free Range Psychiatry, we are here to help make it easier for you! If you’re feeling confused, please consider making an appointment for a free 15-minute phone consultation. We can help answer your questions and address any of your concerns!
In addition, always feel free to email Dr. Campbell at Doc@FreeRangePsych.com.