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Medicare intakes will all be in office going forward. Existing Medicare patients must be seen once a year for us.
Sounds like the party in power understands the strength of the senior vote which is increasingly utilizing MH services. That or you just missed the part about yearly in person visit requirements starting on Jan 1, 2026:Am I missing something?
"Medicare patients can permanently receive telehealth services for behavioral/mental health care in their home."
Telehealth policy updates
Learn about recent Federal legislation and policies related to telehealth.telehealth.hhs.gov
Eh, yes and no. I do think in person is superior, but I see patients in a rural half of the state where the nearest psych NP is 2+ hours away. Imo it's ridiculous to make someone take an entire day to drive 5 hours both ways for a refill of lamotrigine and Zoloft and I'm not even in a state that's all that large geographically.
They could easily make rules that allow people located in specific zip codes be treated via telehealth, or require less frequent in person visits. I don’t see why someone in Los Angeles should get their Adderall from an NP in Kentucky
I am so glad to see someone taking a stand.
Sure, there are plenty of possible solutions including exemptions for certain geographic areas, allowing telehealth but only if patient and psychiatrist are in the same state, requiring psychiatrists to be contracted with a local physician, etc. You know there would be plenty of discrimination lawsuits from urban centers filed following anything like that passed though.
I'll also make a modest proposal to quadruple you down:
I think this may be true if you primarily work with physically healthy adults. In my practice, I work almost exclusively with patients over 60, and those with the greatest needs often have the hardest time seeing me in person. Two patients from this past week illustrate this well. One believes she has a “sac” around her body and is unable to drive. Another is wheelchair-bound and depends on her husband, who is in his 80s, to physically lift her from the chair each time they leave the house. After watching their process, I told them that unless absolutely necessary, I didn’t want her to come in person again—it was simply too dangerous for both of them. I don’t expect upcoming regulatory changes to affect her care, as her prognosis is likely less than a year.
Yeah the whole government subsidy of medical resident training really falls apart when you recognize that academic hospitals are safety net locations taken care of uninsured or medicaid populations and collect paltry sums of money for the same work (typically more complicated patients who receive better care). Additionally the idea that residents after intern year need supervision but we allow NPs or PAs to do the same work with dramatically less training just adds to the farcical nature of those statistics.
Yes and no. It falls apart a bit but I don't think the idea of subsidized training is bad from a government standpoint for fields where trainees can reasonably start practicing independently fairly early like psychiatry. Like you say, it's heavily discounted labor for those who are uninsured or underinsured who would otherwise be financial sinks for the gov. Add in that residency years count towards PSLF and if a good number of those people continue to work for gov/underserved facilities for 6+ more years it's not a bad deal for them.
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