F***ing Human Nature

Chuck Ross called me this morning.  Early.  Too early.  My mother had just died, I couldn't sleep, and I was distracting myself, including by writing an e-mail to Chuck and Rox to tell them that my mother's death finally, mercifully, happened.  But when Chuck called, I needed at least to pretend to try to get some more rest, because I have patients today.  So, I told him I would get back to him later.

When I called back, Chuck and Rox and I talked about a number of things related and unrelated to my mother's death, and one of them was what I was going to do with myself professionally and geographically, now that one of my employers was drastically cutting compensation, and I had no further reason to live in south Florida (my mother lived in Surfside, and it was necessary that I be available to her on a regular basis).

Chuck has a recurring piece of advice, of which Rox reminded me (as if I needed to be reminded), which was to charge higher fees.  I had resisted this for decades, in spite of Chuck's droning urging, until I was dating a psychiatrist in 2015, and she suggested something that hadn't occurred to me: that if my fee is unusually low (which it is), people might be reluctant to seek treatment from me, concluding, perhaps, that they would get what they paid for.  So I reluctantly and somewhat grudgingly agreed to raise my fee, starting in the first half of 2015.  But last year, for a number of reasons, the higher fee (still very low by general standards) was starting to bother me, even though I discount the fee to anyone who can't easily pay it, and I lowered it back to where it was.  I told that to Chuck today.

This, of course, got Chuck going again, and he urged that I re-increase my fee, and don't work for the employer that was preparing to make a drastic (40%!) cut in compensation.

Chuck is a genius, he's deeply devoted, he's generous to a fault, and he's also very highly opinionated.  He is, as I put it to him and Rox, a pain in the ass.  But I also pointed out that this combination of traits of his is why people like Rox and me and others love him.

I have a version of the same conversation with couples when I do marriage counseling, which I do a lot.  People choose each other, from among many choices, for a reason.  And that reason is in more or less 100% of the cases, neurotic.  We all have conflicts, and those conflicts play a major role in determining whom we choose as a partner.  What we love about our partner also makes us crazy about them.  What drives us nuts about them, and makes us want to scream, hit them, or get a divorce, is part of why we chose them to begin with.  It's easy, and convenient, to forget one part of the conflict, so we can focus on the other, but it's all there, all the time.

So, thanks, Chuck.  Yes, I agree that if the employer in question reduces compensation by 40%, I'm going to quit.  But no, I'm not going to re-increase my fees.  And I'm going to continue to discount them if it's not easy enough for the patient to pay my preferred fee.  Sorry.  I still love you, though.