Come Tomorrow

I'm guilty. I'm guilty of putting things off until the last minute. I've been this way my whole life. Procrastination, it feels like a weight bearing me down until I am almost crushed. But at the same time, I'm infused with a sense of responsibility and integrity. Procrastination and responsibility do not go hand in hand, in fact it's more like they are in constant conflict with one another. Why can it feel so impossible to begin, much less finish, a necessary task right now rather than tomorrow or the next day or the next until all of a sudden you're far behind and have to climb out of the hole you've dug for yourself? What would have been easy to do today becomes nigh impossible when you finally get around to it. It's not like I'm unintelligent, I'm fully aware of the argument for being timely with tasks I'm not so excited to accomplish. And yet, somehow I manage to convince myself time and time again that this time, it's not a big deal, I really can do the job tomorrow and be completely fine. I read a blog post today on Huffington Post written by Sadhguru, an Indian philosopher who founded the Isha Foundation which administers yoga centers around the world. He writes about the phenomenon of procrastination in a beautiful way that I never thought of before.

Quality vs. Quantity

The most popular article on nytimes.com right now discusses the changing face of psychiatry in the United States. A psychiatrist tells a sad story of how his practice has changed from one of care and careful attention serving individual patients with names and stories to one of cold efficiency administering medications in a veritable factory of nameless faces. Dr. Levin laments the loss of humanity in his practice due to the nature of health insurance reimbursement. In psychiatry, insurance companies will not reimburse physicians for their time spent getting to know the patient's life and narrative. They pay a set amount per quantifiable action which is often valued quite cheaply forcing physicians (and mental health clinicians) to pack as many patients into as short a time as possible in order to make a living and pay off education and training loans. This makes developing a personal relationship with patients next to impossible which in turn leads to decreased job satisfaction on the part of the healthcare provider. Perhaps this system might make some sense for conventional medical doctors, but a psychiatrist must depend in large part on the personal side of appointments to come to an accurate and appropriate diagnosis and consideration of treatment options.

Psychotherapists who do not prescribe medication, bill insurance companies for the cost of a 50-minute therapy session and often have to fight with insurances to authorize mental health treatment and obtain reimbursement in a timely fashion. The back-and-forth phone calls with insurance companies - being transferred from one operator to another, put on hold, and receiving conflicting information from different people - is arduous, time-consuming, and frustrating.