Focus on Clients
Australia clients are disadvantaged by the two- tier Medicare system. While, understandably, much concern has been expressed about the damage of this system to generalist psychologists and to the profession as a whole, consideration needs to be given to the destructive impact of the two-tier system on our clients.
Financial Impact on Clients
Because non-clinical psychologists receive a lower rebate, they need to charge a top-up fee to clients to maintain income. This has a direct financial effect on the client and may work as a disincentive to clients to seek psychological assistance.
There are far fewer clinical psychologists than other registered psychologists. This means that clients may be influenced to choose from a smaller pool of psychologists who, based on the evidence, are no more skilled and have no better outcomes. Clients may need to travel further or experience other organisational inconveniences in being confined to clinical psychologists.
Inevitably the two-tier system creates the erroneous impression that clinical psychologists are superior practitioners, and that, perhaps, the trusted and long-term relationship the client has with a non-clinical psychologist is somehow less than adequate. This can cause doubt and confusion.
Essential to therapeutic progress is the trust and confidence Australian clients have in the treating psychologist. Any system that tends to create doubt and confusion in the minds of our clients also undermines therapeutic progress and satisfaction with psychological services. This is completely contrary to positive psychological practices.