Since the pandemic telehealth has mushroomed as psychotherapists have closed their offices and moved their practices to telehealth only. This move has saved them a lot of money in office rent, utilities, commute expenses, parking, etc.
The move to telehealth which makes it easy to practice across state lines as most state professional licensing regulations limit a professional practice to the state the professional is licensed in and the place the professional and client is situated when the professional provides the service.
Requests, and provision of service to clients in states other the state in which the professional is licensed and is located is out of compliance with licensing regulations. This has generated some anxiety on the part of the professionals who are faced with the possibility of providing services to clients our of their state.
Practicing across state lines seems be an anachronistic regulatory interference from days gone by. We are living in an age of telehealth and a global economy. Does anyone think that psychotherapists in New Jersey are better qualified than ones in New York or Maryland or Florida or West Virginia? Maybe state laws licensing professionals 100 years ago made some sense but I don't see how they make any sense currently.
The chance that a psychotherapist would be prosecuted for practicing across state lines seems ludicrous to me. It seems that the therapist would have a better chance of being struck by lightning or winning a multi million dollar lottery jackpot.
I appreciate that people want to practice within the regulatory guidelines within their state but when those regulatory guidelines interfere with carrying out ethical responsibilities for patient care, it seems to me that the ethical responsibilities take precedence, at least in my book. There are far greater egregious breaches in ethical conduct that could be and should be professionally addressed.
The biggest one in this day and age is allowing insurance companies to dictate the guidelines for practice. Therapists who allow this to happen are far more culpable for malpractice. It happens all the time. The first question I get asked usually in a request for service is "Do you take my insurance?" How have we allowed insurance reimbursement to be the primary consideration for access to mental health care? This barrier and obstacle is a primary violation of a community mental health model where the barriers to care should be lowered as much as possible to provide accessibility to service. The provision of mental health services is more than a mercenary activity governed by a profit motive. Professions, if they are truly professional, have an obligation to serve their communities regardless of the ability to pay. Willingness to pay is another story.
Well said, David!ReplyDelete