I agree with everything you said. I know that there are pressures from insurance and managed care. That's why I feel that my situation is so different because there are many in my community who offer intensive therapy as psychiatrists and lower their fees for clients who have either no insurance or have reached the limit. So my shrink doesn't ask more than an MFT or psychologist. It is still a factor in that I can't really afford it, but it is so important to me that I figure out how. That means that I can't do full analysis which would mean at least 3 times a week. I have done that when I could, and it was amazing the amount we got done. It made a huge difference. I sorta miss it, but am happy with the work we do and am busier now so can't take on that intensity because it's not just in the session but all the stuff that comes up alongside it. It is still intensive, but with more space around it. I just don't think I would work well as you sorta say with two different people. I like that my shrink is both my MD and therapist. And I have seen 3 of his colleagues; they do the same type of thing. I don't think they are interested in their earning power, but in the challenges of treating patients. They are all in reading groups together and constantly are challenging themselves as well as having to learn about all the new psych meds so they work really hard and don't make an obscene amount. In my community the median price for a house is more than $600,000. To even make a mortgage they have to work really hard. And the cost of living is high as well. I appreciate this group and feel that they are actually noble in how they have chosen to practice. Some even take patients for free. And most don't charge for phone calls. It is a generous and dedicated group.