I had an HMO when HMO's were new and that makes sense for them. It's their professionals/employees and they can control the costs.

I haven't found where the therapist is a problem if the therapist and you work well together; I use to have to drive 1-1/2 to 3 hours each way to see mine once a week. I'd leave work at 1:30-2:00 and get home around 7:00.