Telepsychiatry in Private Practice

Telepsychiatry is being increasingly adopted in private practice and is predicted to play an important role in increasing access to care in rural communities and other underserved areas. The growing evidence base supporting the comparative validity of diagnoses and efficacy of treatment has served to increase interest in this method of care delivery. In the past, low reimbursement rates and high technology costs have confined the use of telepsychiatry to major academic institutions and hospitals. However, as more insurers pay for telepsychiatry services and connectivity costs are reduced, the landscape is changing. With the current level of need, it is unlikely that all of the required services can be fully met through existing telepsychiatry practitioners. Thus, in light of this new research and the significant needs of rural communities, this article looks at challenges that are unique to the private practice setting and proposes adaptations to increase provider comfort and the success of the endeavor in that setting. The barriers most likely to impede the implementation of private practice telepsychiatry can be broken down into 3 broad categories: (1) concerns about adequacy of support, (2) provider comfort with care delivery in this medium, and (3) concerns about financial feasibility. Some of these concerns are not unique to private practice because all providers face similar challenges in becoming comfortable with a new medium of care delivery. However, private practitioners often do not have built-in access to integrated information technology (IT) services or colleagues who are already engaged in telemedicine. In addition, many practices have limited access to institutional or grant funding that early programs used to subsidize technology costs. However, costs for technology are diminishing greatly and there are new means of getting technological support. Increased use of telemedicine across a broad array of services is contributing to a growing evidence base that allows for additional information to be brought to bear on these concerns about costs. This article examines historical barriers to adopting telepsychiatry in private practice and offers adaptations