ECT $$$

There is an interesting thread on The Student Doctor Network about the profitability of electroconvulsive therapy (ECT).

One contributor to the discussion, posting in September 2019, says:

“I think ECT has the potential to be extremely lucrative, but the challenge is that it only becomes so with volume…. I say this as someone who does “interventional psychiatry” – primarily ECT – full-time. However, I’m at an academic center so I’m insulated from many of the pressures that would be present if you were trying to do things on your own. From the perspective of the medical center, these treatments are by far the most financially lucrative that we offer, thus there is no doubt that there is money available in interventional psychiatry.”

The poster describes their location as “Deep in the heart of Texas”. So, looking for “interventional psychiatry” at an academic center in Texas, I came across the electroconvulsive service at UT Southwestern Medical Center. I have no idea if it is where the poster works, but they say they treat hundreds of patients a year so they appear to have overcome the challenges of “volume”.

The UT Southwestern Medical Center describes ECT in the following terms:

“Electroconvulsive therapy (ECT) is a treatment that sends a brief electrical stimulation through the brain while the patient is under general anesthesia. ECT causes changes in brain chemistry that can substantially improve symptoms of certain mental illnesses.”

It then promises to debunk four myths about ECT.

Myth number one is – you’ve guessed it – is One Flew over the Cuckoo’s Nest.

Myth number two is a more surprising one – that ECT is a miracle cure. Depression, it warns, is a chronic condition and relapses can occur. But never mind, they have the answer to that in the form of maintenance treatments. (Well, that is one way to keep the volume up.)

Myth number three is about getting injured during the seizure – no longer a danger with muscle paralysing drugs.

Myth number four is about brain damage, but prospective patients are told not to worry: “Some patients have slight memory loss of recent events, and in most patients, this resolves within a few months after treatment ends.”

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2 Responses to ECT $$$

  1. Welton says:

    This is terrifying. But unfortunately, true. A single electroshock “treatment” today is billed at $300 to $1000 per treatment. In 1967, when I was being shocked as a teenager, my mother paid $88 per treatment. Her insurance paid 80% of the cost, so the $88 was 20% of the cost, which would thus have been billed as $440, with her paying $88 out of pocket, and the insurance paying the remaining $352. So electroshock was lucrative for the practitioner even back then.

    Given the fact that the majority of people who receive electroshock are women, and most of these women are “elderly,” — In the United States, Medicare would cover a reduced rate, say, $300 — even it the procedure were billed at, say $1000. If the patient had insurance such as a supplement plan, their supplement plan would pay the part not paid by Medicare. So yes, it looks very lucrative, indeed, for a practitioner.

    I thought Texas was one of the few states in the USA where informed consent was a strong rule and patients could refuse treatments more easily than elsewhere. A friend of mine here in Texas, who was subjected to electroshock treatments in 1994 told me that she was given a consent form to sign before every treatment and if she hadn’t signed, they could not continue the treatment. After a few treatments, she realized the treatments were not helping her. She hated and feared the treatments. She experienced troubling memory loss and the treatments were not helping her PTSD. ( She had been a victim of brutal rape.) She committed suicide, because she did not want to be subjected to any more shock treatments. Somehow her psychiatrist had coerced her into allowing the treatments, into signing the form, every time, and she didn’t see any way she could refuse to sign. This happens all too often — patients consent, but it isn’t really consent. They are told there are no alternatives and most want to “get better.”

    Electroshock should be banned and doctors who practice it should be put in prison. Instead, they are making money from the “lucrative” procedure. This procedure produces brain damage and patients usually eventually become “compliant,” not causing as much “trouble” for staff or family after or during the treatments. Maintenance electroshock, which was forced on me as a teenager for over 3 years when I had no right to refuse, can keep patients from causing trouble. I was kept in line by the threat of more treatments or extra treatments if I disobeyed or protested. Fortunately for me, Dr. Ritchey ceased the treatments when I was 21 years old (the legal age for consent to medical treatment in Alabama at the time). I have large gaps in my memory which have never filled in. Years, people, friendships, all are as if they had never happened, and I only know the gaps are there because friends remember those times and have told me what happened. If you don’t remember something at all, you don’t know you have forgotten it. My situation was very unusual, since I managed to remember how I was treated and how I was taken to the hospital. Most people do not remember thiis.

  2. Welton says:

    PS: On the website https://www.medicinenet.com/electroconvulsive_therapy/article.htm I found this summary:
    “What does ECT cost?
    The cost to the consumer for ECT varies depending on if the person has health insurance, if the insurance covers this procedure, and to what extent. The cost of each ECT session is about $2,500, for a total of $25,000 for the 10 sessions an average course of treatment entails. That does not include the cost of a hospital stay if necessary.”

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