The biggest impact to private practice was an initiative commenced on 1 November 2006. This initiatives intention was to provide limited therapy access to all Australian's. While this might be the case, a few unintentional consequences of this initiative have occurred. Such as it helped create a divide the industry, set an expectation that clients can be "fixed" in 10 sessions, and established an expectation that psychologists should happily accept a pay rate of $80-120 (before tax and expenses).
Expect to pay a plumber $60 to $140 to fix a tap or leaking toilet, $250 to install basin taps or a new shower head, $550 to install a toilet.
As it stands, anyone can set up shop and bulk bill their clients. What we know about this is that clients will (hopefully) receive ten sessions of therapy, the practitioners providing bulk billing sessions will continue to generalise (primarily working with anxiety and depression), and will have a very difficult time getting away from the bulk billing mindset.
Here's the deal though, your biggest threat is not another psychologist - whether they bulk bill or are clinical or are a large private practice. Your biggest threats come from the following:
Beyond Blue
In June 2018 Beyond Blue's Financial Report indicates they had a $4,251,008 surplus in their account. As a tax exempt organisation with board members like Julia Gillard, Beyond Blue offers a free CBT program called NewAccess.
NewAccess is provided through PHN's (another threat) and uses Coaches to provide short term low intensity CBT for anxiety and depression. Coaches.
Medicare rebates are available for up to 10 individual allied mental health services in a calendar year. A range of acceptable strategies has been approved for use by allied mental health professionals utilising:
1. Psycho-education
2. Cognitive-behavioural therapy
3. Relaxation strategies
4. Skills training
5. Interpersonal therapy
6. Narrative therapy
PHN's (Primary Health Networks)
An aspect of these 31 PHNs "is to provide an efficient and less costly alternative to higher cost psychological services available through the Medicare-based Better Access initiative and other primary mental health care services funded from the PHN flexible pool as a form of early intervention" Source: health.gov.au . They are funded to ensure that the broader aspect of anxiety and depression is treated by (pretty much) any means necessary. Even if that means using coaches.
Your own mindset
I hear so many clinicians say that they need to be able to service anyone who walks through their doors. It's the norm to be generalised. This idea that to be generalised (either as a Clinical Psychologist or a General Psychologist) is the only way to "compete" in private practice is not true. If you don't want to be niche'd because you don't want to be stuck with a caseload full of borderline clients, well then we understand that. However, if you don't want to niche because you feel you won't have a place in private practice, we hope this series will dispel that for you.
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