An Exchange of Views

I was speaking last night with a friend who is a clinical psychologist and who has been opposed to the two-tier system since the day it was announced.

We often meet over meals with other colleagues, most of them non-clinical and discuss our work. My friend repeated last night what she has said many times before: ‘There is obviously no difference between us. We do the same work, and we are equal in our competencies. I don’t know more than you and am not better than you as a psychologist in any way. We each use many methods; we’re not different in what we do with clients.’

But she admitted that since a higher rebate was available for her, she was gladly using it.

I asked her: “What if the government decides to introduce a one-tier system?”

She said: “On the moral and emotional levels, I would be happy because I would know it’s the right decision.”

“What about if we all got the lower rebate?”

“That would be hard,” she said. “I would be happy morally and emotionally. No doubt about that. But I am being frank with you. I am human. I would not be happy financially.”

She tried to explain that while knowing it’s unfair, over the past 10 years, she has got used to being paid more for her work.

She said she would feel better “financially”, if a singlerebate was somewhere between the two current amounts.

As it happens, research shows that although clinical psychologists are still only a minority among all psychologists, they draw more than 50% of funds allocated by Medicare to psychologists. As new students choose the clinical stream, attracted by the higher remuneration, other schools of psychology are disappearing, and Medicare’s costs in supporting psychology will continue to grow.

Research also indicates that even if my friend’s wish was realised and a new rebate in a new on- tier system was to be ‘in the middle’, say, $95 or even $100 for all, the load on the federal budget would decrease.

Next time I speak with my friend I will ask her the following: Let’s apply a standard psychological method of reframing, and let’s consider the last 10 years as an experiment or a lucky 10 years for clinical psychologists. Whatever the reason for it having occurred in the first place (e.g. belief CBT will last forever as the only method), after the 10 years that the clinicals have had to provide evidence their therapeutic results are better than their colleagues’ – which they haven’t – the time has come for a one-tier system. Instead of grieving a loss, they could rejoice that they managed to keep a higher rebate for 10 long years, which nobody will ask them to reimburse. It’s not only a question of money. We will all benefit from unity in the profession.