Thread by @kateneuropsych

@awaisaftab @viscidula @PsychTimes Elitism abounds and in US psych/Med grad/schools what's worse is that as much (frankly as little) as diversity is stressed in lipservice and in text (which means really nothing re: experience) THERES NO TALK OF INTELLECTUAL & CLASS ELITISM & that's t/1st mirror we should all
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@awaisaftab @viscidula @PsychTimes be lookin in. That's also why over 80-90% (depending on region) US Psychologists & Psychiatrists are only and all too comfortable NOT TAKING ANY INSURANCE nor do they care that that particular practice violates the ethic to maintain the same standard of care across all of
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@awaisaftab @viscidula @PsychTimes society; nor do they care that that practice actually leaves those who are the most vulnerable & in need of GOOD MH TX WITHOUT MUCH IN THE WAY OF MH CARE. Because if care had of gone into that dilemma in the first place MH profs would've advocated for insurance
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@awaisaftab @viscidula @PsychTimes coverage for all patients like their lives and liveihoods depended on it from git because when all patients are insured your income is equally assured.

But was not the case and what we have now is a bunch of heels dug in justification narratives that excuse any one of us
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@awaisaftab @viscidula @PsychTimes who ditches INS for out-of-pocket pay as you go schemes that feel more like patient blackmail than treatment.

Moreover given the large majority of MH profs have chosen the out-of-pocket pay as you go model the APA should have developed and ethical code MANDATING a
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@awaisaftab @viscidula @PsychTimes certain % of your practice be pro-bono in order to maintain the standard of TX/care for all practicioners.

But the APA didn't and MH profs routinely dismiss that concept anyway stating "I have a sliding scale" (yet another non-sequiter) WHICH IS NOT PRO-BONO.
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@awaisaftab @viscidula @PsychTimes Sliding scale is a marketing tool.

Pro-bono means FREE.

And no my grad classmates did not like my coverage of "The standard of care and the ethics of money in Psychology and Psychiatric clinical practice." Then again I come from where they dont want to practice and
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@awaisaftab @viscidula @PsychTimes that's also why I'm headed back.

Ultimately because of the way Psych profs way back when shaped today's enviorns when choosing themselves over the harder path of advocating for insurance coverage for all patients it now comes down to which comes first, your duty to
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@awaisaftab @viscidula @PsychTimes patients and taking a lesser income while fightin like hell for M4A or you and money first (which so far has been the lazy laissez-faire approach which only made things worse)?

This is the result of not only our elitist
mindset but our failure to address it in training &/or
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@awaisaftab @viscidula @PsychTimes call it out & monitor for elitist mindsets within the professional body and in ourselves in practice.

And who exactly is suffering from this failure?

NOT US BUT RATHER A LARGE SWATH OF THE POOREST OF THE POOR AND THE BLACKEST OF THE BLACK PATIENTS that do not have a stash
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@awaisaftab @viscidula @PsychTimes of out-of-pocket concierge funds to access MH treatment.

And what exactly is holding MH profs back
b/c let's face it, not one of us is gonna starve; make less money taking insurance than pay out-of-pocket, yes; starve? No.
So what's the better newer even more
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@awaisaftab @viscidula @PsychTimes heartrending excuse next year cuz I guarentee you the patients who need the care you went to school to deliver HAVE IT WAY WORSE THAN WE EVER WILL.
Can we not put patient's first via M4A and equally come out winners too?
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