In the 90s part of the promise of the web was that it would disintermediate service provision, these economics would seem to act against that possibility. With large aggregator middle men best positioned to profit with large scale small margin offerings.
One possibility I see is for many shrinks to come together form a co-operative and compete with vc backed alternatives.
This isn’t clear to me at all. I actually associate low-margin business with worse outcomes for traditionally high-touch services.
I suspect that this would be at least somewhat balanced by therapists who work for said online therapy providers suddenly needing to work directly with clients again... but I could see that leading to less therapists per capita in areas of high cost of living, like major cities.
But I hadn't really thought about the potential human harm that could be caused by their failure, which is scary to think about.
Kind of like non-profits in 3rd world countries who warp the local economy by providing some things for free, destroying the market for those, and then pulling out of the country after businesses previously filling that role have closed.
It's like any random problem around Google and Facebook can be chalked up to a monopoly claim.
It's unclear that this is ACTUALLY competition for the service or just competition for the ads. I personally would not do therapy remote unless I had to so any therapist I would be looking for would be local even if I have to do therapy remote in the short term.
So this comes down to therapists living in expensive areas complaining about competition from therapists from cheaper areas. Given there are still people who need/want local therapy, there will be a new price equilibrium but most likely it will be lower than before. No amount of complaining about Google or ads or arbitrage like BetterHelp will make the price stay as before. Nothing much to see here - this looks mostly like a market adapting to a new changed market condition.