For what it’s worth I’m on the other side of this. I’ve been a licensed counselor for 13 years and working in behavioral health for 17-18 years and I’m itching to change careers. Basically the opposite of the post above.
The work can be rewarding but it can also be emotionally demanding and the pay and benefits can be quite shit, frankly. The mental health system (assuming USA) is designed to be exploitive to someone; either it’s going to exploit you, your clients, or both.
You can get an administrative job that pays a bit better and has better benefits but your work life balance will be poor and you’ll still generally struggle to make what tech workers make in equivalent roles. You can work outpatient but you’ll make less unless you charge a lot but then you’re excluding a large segment of the population who have a high need for services. Depending on where you live this may not be feasible even if you’re open to it. It’s dependent on your ability to keep a stream of somewhat affluent individuals coming in, obviously
Or you work with insurance but then you open yourself up to a great deal of red tape and financial liability that you either eat or pass on to clients, thus creating financial burden and worsening their mental health. It’s not your fault but it can feel really awkward and shitty to charge a client $800 when their insurance claws back 6 sessions worth of appointments. Alternatively you eat the loss, which can be something that inherently happens because (rarely) they’ll claw back appointments from 12+ months ago. This can also be challenging from an obtaining clients perspective. I run a private practice and contract with a group and right now I have 0 people coming in with no wait list. This isn’t common but it does happen and it means my income dries up a bit. It’s not the end of the world because the holiday season was a heavy period and it will likely pick up again soon but even people with insurance struggle to afford therapy now. More and more people have high deductible health plans with sizable deductibles so they end up paying $70-150 a visit, pretty considerable weekly/biweekly expense. Around summer I start getting a strong uptick because the high deductible people start meeting their deductibles (although young healthy ones often never do)
Sometimes it’s hard to leave work at work with this job. That’s any job of course but with this job you can hear some real heavy shit sometimes. That’s generally not the norm though; most people are just not doing so hot or having relationship troubles or whatever. But every once in a while you’ll get a person that has had some truly awful experience that sticks with you for a bit. Or a person that is manipulative, constantly tests your boundaries, and sticks with you in a bad way.
There’s a lot of positives to it too of course. I set my own hours, I don’t have dumb staff meetings, I set my boundaries with people so if a client goes too far or is outside my scope I can cut things off, etc. I earn 100% of my money minus minimal overheads (telehealth practice is really light on overheads). There are tedious clients of course but many clients are interesting and challenging in an intriguing way. But I feel like people don’t advertise the ugly side really
I always wonder who do counselors go to for counseling. And then, recursively, who do the meta counselors go to for counseling... where does it end? Or are we just adding emotional stress to an overtaxed system with no relief?
we go to other counselors, generally. although some do specifically specialize in counseling counselors, often who have quite a bit more experience and act as supervisors
supervision in counseling is odd. it's ethically obligated but not enforced. continuing education in many areas is loosely enforced too. this leads to other critiques about the field becoming, for lack of a better term, crappier. there are and (hopefully) always will be inspired, ethical, and passionate clinicians but there are also a lot of lazy ones who just burn through the checkpoints so they can bill insurance or clients $130/hr. Once they get licensed no one will check to make sure they do CEUs (depending on state), no one will check to make sure they consult with supervision for outside feedback, etc
it's one of those "we will self regulate" things but I don't know how well the field self regulates
this argument comes up every time and it always ignores a critical aspect of medicine: not all procedures can be “shopped for”.
If I have cancer and I need to start treatment as soon as possible I’m not going to waste precious time comparing rates of infusion centers, especially given that one may be able to take me in for treatments 2 weeks sooner. That two weeks could make all the difference
If I have a heart attack, stroke, car accident, etc, that incapacitates me, I am simply incapable of shopping around for the best price. I am going to be taken in for emergency care and treated to the point of stabilization (or better, depending on whether I have a guardian who can approve more. Said guardian could theoretically shop around at this point but it is difficult given the potential emotionality involved and danger in moving someone who is critically injured)
Increasing provider supply is certainly a huge part of fixing things, if it’s done correctly. If you merely lower standards you just increase supply with substandard practitioners that overall worsen outcomes
What percentage of the money spent on healthcare is the type of emergency you're talking about?
5%? 10%?
I'm not saying stuff like that doesn't happen but insurance for healthcare in this country is totally insane. If car insurance worked the same way Geico would be paying for my gas and oil changes. Heck they'd be paying to have the car cleaned once a month.
well my insurance company just doubled the rate on my 2009 clunker because i had the audacity to move to a low-income neighborhood, so i find these terms acceptable.
most people spend a lot of money on healthcare as they age. Many times this is emergency stuff that’s unplanned and not possible to shop for, or it’s just flat out expensive to care for. Stuff like falling at home and breaking a hip, cancer, heart attack, dementia care, etc. Once you’re admitted into the hospital it’s game over. You think someone is going to shop around while in a hospital bed connected to IV’s? That’s crazy talk.
A little boo boo or an urgent care visit can be shopped for, sure, but that’s all cheap stuff compared to emergency or end of life care! That’s the stuff people actually stress about in my opinion. So why not fix that?
Another example: a mother “shops around” to find a cheap place to deliver her baby. Great! But maybe she’s unlucky and needs emergency C-section or another emergency intervention. What good is shopping around if it’s not actually practical?
People expecting children are exactly the type of people who should be able to shop around. Even in the case of an emergency delivery it's an event that you have what, 6 months to plan for?
I see you conveniently ignored the fact that any emergency before age 65 is hard to shop around for. From a hospital bed and all that…
Anyway i simply think the idea of “shopping around” for medical care is barbaric. As a concept. We’re talking about peoples lives here. I think as a country we should have some actual pride and treat our citizens well. Not like an inconvenience.
just my opinion, as a lucky person with great health insurance.
As somebody having once "shopped for healthcare" in the US: It's pretty high on my list of all-time most frustrating and stressful situations, and that was for a relatively minor dental issue. I can't begin to imagine how it must be for somebody facing a major life-threatening (but not urgent in the emergency room sense) condition.
I'd gladly "overpay" a few (or even many) percent if that's what it takes to get systematic protection from being a pawn in a game of 10d chess between doctors needing to overtreat to recoup their enormous investments, insurers pushing back by possibly declining to pay for what I actually need to get done, and medical administration and billing companies, and industry for the size of which I have yet to hear a compelling economic argument.
It's actually easier to shop for medical care than dental. Health plans are now required to give members an online price comparison tool. You can just log on to your insurance company's member portal and search for the care you need to see prices for network providers in your area. Unfortunately, the same rule doesn't apply to dental insurance.
Still, a problem at least as big as finding various options and their prices seems to be finding somebody incentivized to give an honest evaluation of whether a given treatment is medically necessary at all.
Sometimes I wonder if it wouldn't make sense to have a doctor "on a retainer" that just gets a fixed yearly compensation for advising what to do, and what to better decline, but there's probably tons of ways this could go wrong in either direction (overtreatment vs. missing important issues) as well.
You are essentially describing "concierge medicine". This can be a good option for affluent patients who can afford the monthly fee but it's not a scalable solution for the systemic problems in the US healthcare system. A lot of the people who take advantage of it are what is known in the industry as the "worried well" — rich hypochondriacs willing to pay for personal reassurance whenever they have a tummy ache.
Microcenter still does but it costs 50% more for worse quality parts and the selection is still not great. Handy if you need flux or solder in a pinch though
The limit was mainly due to lack of hdmi support. There are obviously some crts with hdmi but they’re fairly uncommon as display manufacturers basically abandoned crts quickly in favor of significantly lighter yet larger display tech that was much more popular with average consumers. Obviously crts can do much higher resolution over dvi or even vga. with home av stuff they abandoned those connectors as well as component early on in favor of hdmi.
One of the other niceties associated with crts as a result. A monitor that you could just plug in to a source and it would work, from a time when manufacturers didn’t have the ability to kneecap your setup with handshake bullshit. Now hooking up stuff is just a bit more likely to be frustrating and nonstandard setups are much more likely to simply not work without pricey extra hardware. Want to split your bluray player or playstation 5 between a an oled television and a projector? It may just work with a basic hdmi splitter, or it may not. It may only work with certain hdmi splitters. It may only work if one display is on at a time. With dvi you could’ve gotten a basic splitter and it would’ve worked guaranteed regardless, but hdcp means that hdmi splitting will give you headaches because god forbid you hook up a secondary source to record a copy of content you purchased. Despite that, it’s still easily defeated with relatively cheap hardware, making it completely and utterly pointless as well
Yeah 0 chance I would drop that much cash on this from an unknown brand. Even from a reputable brand I would be wary. I still feel burned from buying a few hundred dollars of “smart” smoke detectors from firstalert, a smoke detector company that has been around for ages and is still around. They were a terrible product with terrible support and instead of just hiring better people to rewrite a decent firmware they abandoned the whole product line after a year or two offering a $40 smoke detector as a replacement for the $129 unit that was a buggy piece of shit.
firstalert acquired luma, which had acquired birdi, which was kickstarter campaign smart smoke thing, which shipped nothing to most of kickstarter backers
some m&a execs clearly did not have good vaporware detector there!!
I’d imagine it has to be a regulatory nightmare. There’s really no options on the market. First alert at this point just has the zwave one that can’t be hardwired or interconnected so it’s not to code in many locales. Nest is pretty good but it won’t work intranet only and that’s a dealbreaker for me; I do iot but it has to be gear that can cope with being on a vlan with no internet access. The only other options are sketchy brands that don’t give a fuck about us regulations. Sometimes it’s a chinese company that has some staying power like xiaomi but sometimes it’s one of those random ones that likely won’t exist in 2 years
A shame because I would really like to be notified if my house is burning down while I’m away from it. Would be pretty handy.
I can sort of understand ending life for allowing purchasing on the platform but why would you not create servers for the new consoles in a way that allows you to continue to serve downloads or at the very least whatever licensing necessary to launch the software to old hardware?
If I buy a game I should be able to launch it and redownload it. If the above is not feasible then strip the drm at the consoles end of life and allow me to download my library and launch it indefinitely until bitrot destroys it. Absurd that we have this current system of “purchase digitally and play until the servers are shut off, which is a timeframe that is unclear”
> If I buy a game I should be able to launch it and redownload it.
unfortunately, this is not the right for which you paid, despite the fact that it is what people believe when they click purchase.
That's why i condone piracy. It enables preservation, regardless of the choice of the copyright owner.
That's why i would always want to make an offline backup of whatever i buy. It's hard to do sometimes, and the onus being on me to do it is a failing of the consumer protection laws that did not evolve with digital purchases.
Agreed and why when I do purchase I only purchase physical. The digital downloads of games I have are either games that were so hilariously cheap on sale my moral compass didn’t matter (eg marked down to sub $5) or the free downloads I get from various promotions like the epic store. I don’t pirate video games but I don’t have any qualms with someone who does given the gross anti consumer practices the industry has been getting away with for ages
Unfortunately consumers don’t seem to agree and have no problem shelling out billions of dollars for these things. The current console generation is clearly pushing hard to shift things entirely to digital; it is actually becoming difficult to purchase physical copies of games. The recent yakuza game didn’t get a physical release in the USA and I had to import a copy from play-Asia. It works fine on my us ps5 but they were clear as it’s a region 3 release any future patches/dlc/psn support may not work correctly unless I create a region 3 psn account specifically for that game. Quite a headache. Although funny enough the game itself was $10 cheaper so even with tax and shipping it worked out to be the same as if I had bought it on psn.
I disagree. I’ve lost touch with numerous casual acquaintances over the years because they went to one app and I didn’t or vice versa. If there was a better effort at standardization it would have been easier to maintain these connections rather than lose touch because some people went to Facebook messenger while others went to WhatsApp, discord, snap, etc and the fragmentation made it a nightmare to keep up with everyone. SMS is the standby but a surprising amount of people hate using text messages or email despite being completely comfortable with asynchronous text communication on other platforms. It makes no sense to me because it is functionally the exact same and the people I have met who have this concern are definitely not worried about things like message encryption
Additionally nowadays it’s becoming more common to be ideologically against usage of platforms and it sucks to be locked out of communication because of that. I don’t use meta products because I think they’re a disgusting company but a lot of my older family members refuse to move from the platform. If there was an open standard that allowed for me to use a platform I was comfortable with that could interoperate with Facebook messenger I could live with that.
I'm in a similar situation.
Would you be happy interacting with Meta-product users via a non-Meta-product if it involved your data being stored (e.g. in a "shadow profile") and used to target ads against you?
I'm not sure I would, but it hasn't cropped up yet.
That actually highlights the other issue of fragmentation: sometimes I would bother to download the app and register but then we’d fall out because I wouldn’t regularly check an app for 1 or 2 people. It’s notifications get lost in the sea of notifications
If I could just have one app that allows me to cross platform communicate that would eliminate this issue. And of course let it go both ways
A core element of the problem is that Americans are vehemently opposed to involuntary long term psychiatric treatment. Long term, in this context, meaning anything longer than 72 hours or so.
So there’s a push to decriminalize because the alternative is jailing non violent drug offenders. This is counterproductive in many ways and keeps them in cycles that enable addiction like preventing gainful employment, increasing access to network of people that can provide hard drugs, increase hopelessness and worthlessness, increase likelihood of violent behavior, etc.
A better system would be to decriminalize with the alternative of connecting people with serious and persistent mental health issues to significant inpatient mental health supports. Not someone that smokes pot or drops acid every once and a while, but the people like you describe that abuse hard drugs like methamphetamine or fentanyl to the point that they become homeless and frequently experience psychosis. Programs that provide housing, counseling, rehab, etc. but again most people vehemently oppose this for various reasons. Distrust of psychiatry, refusal to fund government programs, a libertarian belief that a person should be able to let themselves self destruct even if it destroys the community around them, etc
The work can be rewarding but it can also be emotionally demanding and the pay and benefits can be quite shit, frankly. The mental health system (assuming USA) is designed to be exploitive to someone; either it’s going to exploit you, your clients, or both.
You can get an administrative job that pays a bit better and has better benefits but your work life balance will be poor and you’ll still generally struggle to make what tech workers make in equivalent roles. You can work outpatient but you’ll make less unless you charge a lot but then you’re excluding a large segment of the population who have a high need for services. Depending on where you live this may not be feasible even if you’re open to it. It’s dependent on your ability to keep a stream of somewhat affluent individuals coming in, obviously
Or you work with insurance but then you open yourself up to a great deal of red tape and financial liability that you either eat or pass on to clients, thus creating financial burden and worsening their mental health. It’s not your fault but it can feel really awkward and shitty to charge a client $800 when their insurance claws back 6 sessions worth of appointments. Alternatively you eat the loss, which can be something that inherently happens because (rarely) they’ll claw back appointments from 12+ months ago. This can also be challenging from an obtaining clients perspective. I run a private practice and contract with a group and right now I have 0 people coming in with no wait list. This isn’t common but it does happen and it means my income dries up a bit. It’s not the end of the world because the holiday season was a heavy period and it will likely pick up again soon but even people with insurance struggle to afford therapy now. More and more people have high deductible health plans with sizable deductibles so they end up paying $70-150 a visit, pretty considerable weekly/biweekly expense. Around summer I start getting a strong uptick because the high deductible people start meeting their deductibles (although young healthy ones often never do)
Sometimes it’s hard to leave work at work with this job. That’s any job of course but with this job you can hear some real heavy shit sometimes. That’s generally not the norm though; most people are just not doing so hot or having relationship troubles or whatever. But every once in a while you’ll get a person that has had some truly awful experience that sticks with you for a bit. Or a person that is manipulative, constantly tests your boundaries, and sticks with you in a bad way.
There’s a lot of positives to it too of course. I set my own hours, I don’t have dumb staff meetings, I set my boundaries with people so if a client goes too far or is outside my scope I can cut things off, etc. I earn 100% of my money minus minimal overheads (telehealth practice is really light on overheads). There are tedious clients of course but many clients are interesting and challenging in an intriguing way. But I feel like people don’t advertise the ugly side really
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