Grodzki's theory is that anyone who has a health care private practice is either:
1) Insurance driven
2) Consumer driven
3) Belief driven
The insurance driven practitioner is guided by the imperatives of the large managed care companies.
"If this is your path, you need to position your practice for the competition. Your success is determined by the (insurance) industry's evaluation of your practice results. You need to achieve insurance-determined objectives to stay profitable and understand the recent concerns about current trend of insurance-driven therapy from efficiency to effectiveness."
The consumer-driven practitioner has adopted a consumer-friendly stance and reaches out directly to the consumer, to avoid the middle-man.
"If this is your path, success is based on how the client reviews each session and the overall treatment. To survive and thrive in practice, you need to understand the structure, measures, and marketing that help a consumer-driven practice to succeed."
The belief-driven practitioner is driven by a school of thought, using one of over a hundred therapeutic approaches, which they believe is more effective than others.
"Therapists who operate a belief-driven practice usually rely on fee-for-service payments and this will increase in the future since non-industrialized, evidence-based methods will probably be cut out of health care reform. If clients want what Greenberg calls the “essential healing relationship” they will pay for it out of pocket, similar to alternative medicine.
If this is your path, success will rely on your reputation, passion, expertise in your approach and be measured by you, the therapist."
I believe there is a fourth fork in the road. As time goes on, more and more practitioners are going to be technology driven. They will focus on the technologies that make treatment delivery increasingly possible, affordable and ubiquitous.
Therapists and other professionals will use e-mail, instant messaging, video chat, virtual worlds, and methodologies not yet invented to reach clients located in far flung regions of the earth (where professionals are scarce), who might otherwise not access help, or would not have the time to get it.
In time, technology may become the most powerful imperative of them all.