Psychiatry in therapy practice. The largest practices tend to be owned by psychiatrists. They then hire other mental health providers as employees in the practice. It is no secret that the mental health system is psychiatry oriented.
Psychiatry has many advantages in the marketplace over other mental health disciplines. For example, psychiatry is an essential part of treatment of the seriously mentally ill. And these clients utilize the largest part of the mental health budget. And psychiatric patients will often stay in treatment because of the pain they experience if they refuse treatment–increase symptoms and perhaps more hospitalizations.
Additionally, psychiatrists can see up to five or six patients in an hour for medication management, a large part of the typical psychiatrist’s practice. The volume of patients is therefore many times as great for a psychiatrist than for a therapist doing psychotherapy. Each of those psychiatric patients may additionally require outpatient psychotherapy. The psychiatrist then collect fees for their own work and a percentage from the clinicians working for them.
Additionally, hospitals have an interest in supporting the psychiatrists’ efforts to keep their units filled. They need to have a steady flow of patients into the hospital and psychiatrists are the gatekeeper and the managers of each unit.
There is a somewhat different path to building a successful psychiatric practice than to building a practice without these advantages. The non-psychiatrist-based therapy practice is not going to have pharmaceutical companies and hospitals helping it. Therefore these non-psychiatrist-led organizations must find other sources of referrals. (See this section on Marketing.) This requires more marketing activity in order to grow therapists’ caseloads. This probably accounts for why non-psychiatrist-based practices tend to be smaller and why non-psychiatrist-based practices are so much more marketing-oriented in their outlook.
For more on various types of practices see these posts: