So far, I’ve decided to accept credit cards, but I’m deeply ambivalent. The arguments on the “to” side are numerous – ease, convenience, and, most of all, normalcy. I pay every provider in the world via credit card – all my healthcare providers, and so on. It feels almost like it’s an act of aggression not to accept credit cards – just as, once upon a time, it became so not to have an answering machine.
On the “not” side, there are, to my mind, two arguments, one of which doesn’t concern me so much, the other of which sort of does…. The one that doesn’t is the economic consideration. I don’t mind, either financially or conceptually, paying a card processor 3% for the added convenience they provide me. That feels reasonable, and I can part with the money. And in any event, it’s relatively simple: it doesn’t (to me) have a lot of clinical implications. (I suppose there’s another set of questions about whether or not to pass on transaction fees to patients/clients. I haven’t thought a lot about that.)
The thing I struggle with is the following:
A patient/client using a credit card to pay me is, actually, not paying me. S/he is instructing someone else to pay me, and promising that third party that s/he will pay them. In other words, paying me by credit card introduces two additional factors into the interaction – time (s/he pays her credit card company at some time(s) other than the time at which I’m paid) and a third party. I’m getting paid today, but my patient may not pay for weeks, or months, or ever. And/or, s/he may pay precisely what I’m receiving (minus a transaction fee) if s/he pays within the grace period. Or, s/he may multiply that with ongoing finance fees. And, s/he may have all sorts of feelings about paying me when she actually pays her credit card bills, at times substantially removed from when I got paid.
I generally (try to) give my patients their monthly statements at the beginning of our sessions, so we have the chance to confront whatever feelings the fact of their paying me might bring up. If I give a patient a statement, and s/he pays me with a credit card at home, via some electronic system, and s/he pays her credit card bill a month, or six months, later, then all sorts of stuff is happening between us, away from our sessions.
All this seems very… complicated. Transference leaking out, toward the credit card company; meaning oozing all around with credit card balances, time-shifting, and the like. For all these reasons, I feel a bit unresolved about my decision to accept credit cards.
And yet, for the time being at least, I do.
