06/05/2026
Today was my first day of training in autism diagnostics and screening. One of the presenters, a psychologist, made a comment that really stuck with me.
She talked about how comprehensive autism evaluations take a significant amount of time, yet insurance companies often do not reimburse providers for the full work involved. As a result, some clinicians feel pressured to use shorter, less comprehensive tools simply because the more thorough evaluations are not financially sustainable.
It reminded me of a question I hear often: “Why don’t you take insurance for all of your services?”
The answer is more complicated than many people realize.
Ask any of my patients how long my appointments are. I intentionally schedule fewer patients because I believe people deserve time, attention, and a thorough evaluation. When I provide conventional insurance-based psychiatric care, reimbursement is often so limited that the system pushes providers toward shorter visits and higher patient volumes.
For example, if someone comes to me for ADHD treatment through insurance, I can address the ADHD diagnosis and medication management. But what if Hashimoto’s disease, hormone imbalances, nutritional deficiencies, sleep disorders, or other medical issues are contributing to those symptoms? Insurance often doesn’t support the time needed to investigate and address those root causes.
This is not a criticism of patients. It’s not even a criticism of individual providers. Many clinicians are doing the best they can within a system that rewards volume over depth.
I hope that instead of asking providers why they don’t simply “change how they do things,” we start asking why the healthcare system is structured this way in the first place.
The real issue is not the provider trying to spend more time with patients. The issue is a system that often values billing codes and productivity metrics more than comprehensive, individualized care.
Patients deserve better. Providers deserve better. And healthcare should be designed around what people need—not around what is easiest to reimburse.