Should you trust a healthcare trainee to save a few bucks?

NEW YORK - When she was in college, Traci Lowenthal went to her university's health service training clinic for psychological services. It saved her $3,000 and inspired her career choice.

Now a licensed clinical psychologist and owner of Creative Insights Counseling in Redlands, California, Lowenthal has supervised scores of graduate students and interns who treat patients in a supervised clinical setting for reduced fees.

As any reader of the classic children's book series featuring Ramona Quimby knows, trying to save money by seeing trainees can be a mixed bag. At the beauty school the Quimbys frequented, Ramona loved her pixie cut, but her big sister Beezus left in tears over a bouffant.

Hair is one thing, but what about your teeth, your eyes and your emotions? Call any major university and they are likely to have a training clinic for dental, ophthalmology, psychology and even veterinary services.

You can expect to save as much as 50 percent for dental care in many clinics, says Dr. Kim Ruona, an assistant professor at the University of Texas Health Science Center.

For orthodontics, discounts can run 30 percent to 40 percent, even for popular treatments like Invisalign, says Dr. Ravindra Nanda, who chairs the Division of Orthodontics at the University of Connecticut School of Dental Medicine.

Lowenthal sees it as a two-for-one: You get a well-trained and highly motivated student and an experienced supervisor. Seeing graduate students is akin to going to see any other kind of medical doctor and being primarily treated by an intern or resident, she said, except there are lower fees.

"In medical, we don't question it," Lowenthal said.

LOWER FEES

Those who take the plunge with a student practitioner are often looking to pay less, but that does not mean the clientele is indigent. Rates for private psychological services in New York City, for instance, can exceed $200 an hour, and fewer doctors are taking insurance, said Kristene Doyle, director of the Albert Ellis Institute in New York.

Yet people still balk when Lowenthal mentions turning to trainees as a way to lower their costs. She charges $150 an hour, while her post-grad interns charge $125. At a university setting a few years ago, she supervised graduate students who charged $10 or less for a session.

At Albert Ellis, which trains psychologists in cognitive behavioral therapy, the staff tries to avoid the word "intern" altogether.

"We call them pre-doc therapists or advanced pre-docs," Doyle says.

Albert Ellis charges $220 to see a staff psychologist, $120 to see a licensed practitioner who just got a Ph.D, and $95 to see a trainee.

"Some people who call say that's still a lot and they can't afford it," Doyle said. "Then they call back because they see it's more expensive elsewhere."

One way to insure that you are getting quality service along with your discount is to make sure the clinical program is accredited by the governing body of that field.

For psychology, for instance, it is the American Psychological Association. Member organizations like the Association of Psychology Training Clinics also provide resources, like a list of 180 accredited clinics on its website.

CAUTIONS

Trainees are not for everyone. Tony Cellucci, president of Association of Psychology Training Clinics, said some people with privacy concerns might not appreciate their sessions being taped and shared with not only a supervisor, but also possibly other graduate students in the practice group. All would be trained in confidentiality, though.

For those who need long-term consistent care, students might also not be best because they will move on after one or two years, Cellucci said.

Doyle said Albert Ellis retained most of its clients who started out seeing students, especially when the students became full-fledged therapists, stayed on at the institute and charged higher fees.

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