My pdoc charges for (and does) a therapy session. So I'm scheduled for 60 minutes but often am there 75 and have been there longer when things were extremely bad and she was trying to figure out how to help. If I had insurance covering my therapy I'd have to see them on different days but I pay for therapy out of pocket so it doesn't matter.

I know this is really rare and I do have a few things in place that make it this way. One is that I'm willing to drive 2.5 hours each way to a teaching hospital so my pdoc is being paid by the hospital, not by how many patients she can squeeze into a day. She and the hospital both believe in providing the amount of care needed over the amount earned. Another is that I've seen her for 16 years and at this point she only treats people she's seen a long time, all of us complicated. So she knows that every session is not going to be simple. She also sees me at a time that she doesn't see other patients so she just happens to have some extra time if needed.

The negatives are that I can't get in between sessions. I can email her for med adjustments and phone calls if things are absolutely desperate but she's hard to reach between sessions.

I'm sorry for those who have such bad times. I had a pdoc before this one who was spending only a few minutes with me and based everything on her belief that if I was able to work in health care that I wasn't nearly as sick as I was and she couldn't seem to hear me saying "I'm really not doing well and I need help badly".

If you can get in at a teaching hospital seeing an attending sometimes that means you get more time.