Transitioning to private practice: What it has taught me about our underserved

After four years working as a child and adolescent psychiatrist in Brooklyn treating the underserved, I decided it was time to dedicate myself fully to my growing private practice.

Functioning solely as an out of network provider in private practice, as expected, my clientele grossly changed. Unlike my hospital patients, a majority of my patients are upper class to wealthy. Finances are not concerns or stressors.

Wealth does not predict a decrease in the percentage of those affected by anxiety and depression. We know this. I see just as many patients presenting with the same biological symptoms, albeit to different stressors. I spend these sessions reflecting with the plight of the artist with unrequited ambitions and dreams of fame. I find myself empathizing with the investor whose millions invested have not reaped the promised return. I counsel the recently retired football profession who up to now, has not had to deal with paying a credit card bill or launder his own clothes. These are real issues, very often demanding me to reach the entire expanse of my expertise.

However, the daily dilemmas of my Medicaid-insured hospital patients still haunt me. Whereas my current patients will maintain access to their family and seek resources among their peers, my former hospital patient cannot. Yes, America is struggling to improve its formative and vocational availability, and to augment its ability to offer aid to the impoverished. Yet, my former patients will continue to experience disparity. Their progress will continue to lag. Frustration ensues. Anger is inevitable. The unfortunate events in Baltimore recently will be the culmination.

I am not a politician. I do not have the answers. Yet I can tell you of the near impossibility of accessing programs such as big brother/big sister. These programs, though lauded as ubiquitous, are clearly not meeting the demands of the community they serve. We could say the same of programs addressing speech and language disorders, educational resources for children with learning disabilities, childcare provisions for the parent looking for employment, and so forth. Absence to these interventions will worsen social strain and lead to lack of preparation for healthy adult living. Substance abuse will continue. Young adults will continue to go to prison. Unemployment will not abate.

I truly empathize with the frustration various folks are experiencing in this country. I agree more needs to be done including advocacy and educational programs to allow the future generations of children from overworked and undereducated parents of this country to have optimism for a healthy future. If not, as I already fear, we will become a tale of two cities.

Johnny Lops is a psychiatrist and the author of Reinvent Yourself: Essential Tools From A Brooklyn Psychiatrist Who Has Seen It All. He can be reached at his self-titled site, Dr. Johnny Lops.

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