The Coverage Gap No One Talks About: Fixing Private Practice's Biggest Flaw

Ana Zedginidze remembers the moment clearly. As a therapist specializing in urgent and crisis cases, she understood the weight of being someone's lifeline. But she also understood something else: the impossible calculus that private practice therapists face when they need to step away. No paid leave. No coverage system. No clear path to taking time off without abandoning clients or jeopardizing a carefully built practice. It was a gap that felt particularly acute for women therapists who were often juggling caregiving responsibilities alongside their clinical work. That realization became the seed for Therapy Coverage, a platform designed to solve a problem that has long been treated as unsolvable.

The Data We're Missing

When asked where she would start if she could redesign one part of the health system from scratch, Zedginidze doesn't hesitate. Her answer reveals both her background in psychology and business analytics, and her deep understanding of how systemic change happens.

"I know how foundational good data is to every decision that follows," she explains. "Yet across healthcare, from medical research to workforce design, women are still underrepresented in the data itself. The lack of gender-inclusive data shapes everything: How conditions are diagnosed, how treatments are tested, and even how our workplaces are structured."

It's a perspective that goes beyond the typical calls for better representation. Zedginidze is pointing to something more fundamental: the way invisible assumptions about "standard" workers and patients create systems that fail women by design. She questions who decides what those standards look like and what happens when they unintentionally exclude half the population.

Her vision is radical in its practicality. She imagines healthcare systems built on flexibility, where taking time off isn't a career risk but an integrated feature of sustainable practice. Where data doesn't just describe what is, but helps design what could be.

The Gap Between Intention and Infrastructure

The maternal mental health field presents a particularly stark example of this systemic failure. Many providers in this space are women of childbearing age themselves, supporting new mothers through some of their most vulnerable moments while navigating their own pregnancies, postpartum recovery, or caregiving responsibilities.

"Most private practice therapists don't receive paid leave, coverage systems, or even clear guidance on how to navigate the challenge of running a mental health practice when they take time off," Zedginidze notes. It's a reality that sits uncomfortably alongside the field's stated commitment to wellbeing and mental health.

When she describes what true maternal mental health support would look like, she's clear that we're still far from the ideal. "I believe that true maternal mental health support must be holistic. It's not about fixing one isolated piece, it's about creating a wraparound system that supports women at every level."

The distinction she draws between good intentions and actual infrastructure is crucial. "True support requires infrastructure, not just good intentions," she emphasizes. "It means built-in systems for coverage, flexible scheduling, and financial models that make taking leave sustainable. It means licensing boards, insurers, and professional associations recognizing that rest and recovery are not luxuries, they're essential to ethical, effective care."

Redefining Sustainability

Therapy Coverage emerged from Zedginidze's recognition that sustainability in mental health has been defined too narrowly. The field has focused on funding models, productivity metrics, and client outcomes while overlooking a fundamental question: What sustains the therapists themselves?

"For too long, 'sustainability' in this field has been defined in terms of funding, productivity, or client outcomes," she says. "But a truly sustainable mental health system must also sustain the therapists themselves, their wellbeing, their capacity to rest, and their ability to step away without guilt or disruption."

The platform she built is elegantly simple in concept: it connects mental health therapists in private practice who need coverage with licensed peers who can provide it. But the impact is profound. It allows therapists to take leave without worrying about continuity of care for their clients or losing their carefully built caseload. It creates what Zedginidze calls "infrastructure for balance."

For women therapists especially, this matters deeply. "Many of us are caregivers both inside and outside the therapy room," Zedginidze explains. "Sustainability means building a system that honors that dual role, one that supports both our humanity and our professional roles."

Building Systems That See the Whole Person

What sets Zedginidze's approach apart is her refusal to accept that therapist wellbeing and client care must exist in tension. Her background in crisis work taught her the importance of reliable support systems. Now she's applying that same principle to the therapists who provide that support.

She's also challenging the notion that the ability to rest and recharge represents some kind of professional weakness. "It's about creating infrastructure for balance, where the ability to rest, recharge, and have a life outside of work isn't seen as a weakness, but as part of what makes us better clinicians," she argues.

It's a reframing that recognizes what many in healthcare have been reluctant to acknowledge: that the systems we've built often assume workers without bodies that need rest, without caregiving responsibilities, without lives that require tending outside of work. These assumptions don't just make life harder for individual practitioners. They shape who can build and sustain careers in the field, and ultimately, they shape the care that patients receive.

A Vision Grounded in Reality

Zedginidze's vision for healthcare isn't utopian, it's pragmatic. She's not calling for a complete overhaul of how medicine works. Instead, she's building specific solutions to specific problems, creating the infrastructure that would allow more people, particularly women, to build sustainable careers in mental health.

"At its core, Therapy Coverage helps therapists rest, recharge, and return, without compromising their clients' care or their business," she explains. It's a simple promise that addresses a complex web of challenges: the isolation of private practice, the financial precarity of self-employment, the ethical responsibility to clients, and the human need for rest.

By creating a marketplace for coverage, Zedginidze has done something rare: she's built a business model that aligns financial sustainability with practitioner wellbeing and client care. It's proof that the tension between these goals isn't inevitable, it's a design flaw.

As healthcare continues to grapple with burnout, workforce shortages, and questions about sustainability, Zedginidze's work offers a different starting point. Not asking practitioners to sacrifice more, but building systems that actually support them. Not treating rest as a luxury to be earned, but as a necessity to be integrated. And not accepting that the way things have always been done is the way they must continue.

For therapists who have long felt they had to choose between their practice and their own wellbeing, Therapy Coverage represents something profound: permission to be human, backed by the infrastructure to make it possible.

Follow Zedginidze's journey: Website | Instagram

About Women at the Helm

Women at the Helm is an interview series celebrating the founders and leaders redefining what’s possible in women’s health. We spotlight the bold voices driving innovation in femtech—women who are building with purpose, leading with vision, and reshaping care for the better.