Abundant Practice Podcast – Episode #624: Good Enough Systems

Release Date: February 26, 2025

Host: Allison Puryear
Guest: Mary

Overview

In Episode #624 of the Abundant Practice Podcast, host Allison Puryear engages in a candid and insightful conversation with Mary, a therapist who recently transitioned from a group practice to establishing her own solo private practice. Titled "Good Enough Systems," the episode delves into the challenges Mary faces as a new solo practitioner, particularly around credentialing, billing, documentation, and managing the emotional toll of starting a private practice.

Transitioning to Solo Practice

Mary shares her journey of leaving a group practice in June and launching her solo practice in August. Despite beginning to feel more comfortable in her new role, she encounters significant hurdles:

• Outsourcing Challenges: Mary initially decided to outsource credentialing and billing, believing it would allow her to focus solely on clinical work. However, her experience was less than ideal. “[05:00] Mary: 'The folks I hired to help me with the credentialing… it was just kind of a mess. I just came into this feeling frustrated…'”

• Ineffective Relationships: The outsourced team left her feeling unsupported and unclear about her practice’s status, leading to frustration and financial strain. “[05:26] Mary: 'It was really stressful and not very productive… I just feel like I'm bleeding money.'”

Allison advises Mary to reconsider the necessity of outsourcing certain tasks, especially those that can be managed efficiently with existing Electronic Health Record (EHR) systems like Simple Practice. “[08:19] Alison: 'It's so easy. Like, when you start doing the billing, you'll be like, oh, why was I paying for this?'”

Embracing DIY Credentialing and Billing

Encouraging self-reliance, Allison emphasizes that many credentialing and billing tasks can be handled personally with minimal time investment:

• Efficiency of EHR Systems: “[08:50] Alison: 'It literally takes you seconds to build seconds… if she is doing a lot of the call and verifying benefits, it depends on the insurance company.'”

• Cost-Effectiveness: By taking over these tasks, Mary can reduce expenses significantly. “[09:20] Alison: 'She should be super cheap, and you shouldn't be talking to me about this.'”

Mary decides to take back control over credentialing, reflecting on Allison's podcast insights: “[05:55] Mary: 'I think I should have listened to Allison's podcast and just… set aside time to do it.'”

Overcoming Perfectionism in Documentation

A significant portion of the episode focuses on Mary's struggle with perfectionism in her clinical documentation:

• Delayed Documentation: Mary admits to procrastinating transferring her handwritten notes into the system until she achieves the "perfect" template. “[07:42] Mary: 'I'm a little bit of a perfectionist, and I delayed actually transferring my handwritten notes to the system until I had the perfect template.'”

• Allison’s Reassurance: Allison reassures Mary that documentation does not need to be flawless to be compliant. “[12:01] Alison: 'Just like, here you go. Like, it's been behind two locks… so you're still abiding by HIPAA.'”

• Practical Solutions: Allison suggests practical strategies, such as scanning existing notes or hiring assistance for non-critical tasks. “[12:17] Alison: 'You could hire a college kid… just pay them an hourly rate… or you could do that while watching TV.'”

Mary grapples with letting go of perfectionism, recognizing it as a barrier to her practice’s sustainability. “[13:38] Mary: 'The perfectionism is going to slow you down and make your life a lot harder.'”

Managing Loneliness and Building Community

Transitioning to solo practice often leads to feelings of isolation. Mary expresses concerns about the lack of regular interaction with colleagues:

• Decreased Social Interaction: “[18:02] Mary: 'I've moved from having 20 co-workers to zero over the last five years.'”

• Allison’s Advice: She recommends reaching out to local therapists to form support networks or virtual consultation groups. “[18:45] Alison: 'Consider reaching out to therapists that you respect in town and just saying… a Zoom clinical consultation meeting once a month.'”

• Focusing on Real-Life Relationships: Allison emphasizes the importance of enriching non-work relationships to combat loneliness. “[19:43] Alison: 'I would rather you make your real life, your non-work life, so rich with exactly the people you want instead of trying to fit some therapists that may be a great into like a round peg in a square hole.'”

Addressing Stress and Resource Management

The episode also explores the psychological aspects of starting and maintaining a private practice:

• Redefining Stress: Allison introduces a nuanced understanding of stress, suggesting that sometimes what is perceived as stress may stem from a dislike of certain tasks. “[20:11] Alison: 'The demand is not exceeding your resources. You have so many resources… somebody's got your answers.'”

• Utilizing Available Resources: Mary is encouraged to leverage the podcast’s community and other available resources to alleviate feelings of being overwhelmed. “[20:34] Alison: 'You've got access to every support and answer that I actually need.'”

• Mindset Shifts: Shifting from viewing tasks as stressful obligations to seeing them as manageable responsibilities can significantly reduce anxiety. “[21:25] Alison: 'Instead of labeling it stress… maybe I just simply don't like some of the things I feel responsible for right now.'”

Recommended Resources

Allison mentions a book that could help Mary and other therapists dealing with similar documentation challenges:

• "Stress-Free Documentation for Mental Health Therapists" by Melissa McAffrey: This book offers templates and practical advice to streamline documentation processes. “[14:13] Alison: 'Melissa McCaffrey runs QA Prep… this might calm your perfectionist…'”

Key Takeaways

1. Evaluate Outsourcing Needs: Only outsource tasks that are not easily manageable with available EHR systems to save costs and reduce dependency.

2. Combat Perfectionism: Aim for “good enough” in documentation to prevent delays and ensure compliance without unnecessary stress.

3. Build a Support Network: Establish connections with other therapists locally or virtually to mitigate feelings of isolation.

4. Reframe Stress: Identify whether challenges are genuinely stressful or simply tasks you dislike, and approach them accordingly.

5. Leverage Resources: Utilize community support, educational materials, and practical tools to build a sustainable and fulfilling private practice.

Notable Quotes

• Mary on Outsourcing Challenges:
  "It was really stressful and not very productive… I just feel like I'm bleeding money." ([05:26])

• Allison on Billing Efficiency:
  "It's so easy. Like, when you start doing the billing, you'll be like, oh, why was I paying for this?" ([08:19])

• Mary on Perfectionism:
  "I'm a little bit of a perfectionist, and I delayed actually transferring my handwritten notes to the system until I had the perfect template." ([07:42])

• Allison on Redefining Stress:
  "Maybe I'm not stressed. Maybe I just simply don't like some of the things I feel responsible for right now." ([20:37])

Conclusion

Episode #624 offers a compassionate exploration of the hurdles faced by new solo practitioners. Through Mary’s experiences and Allison’s expert guidance, listeners gain valuable insights into managing the business aspects of a private practice while maintaining clinical excellence. The emphasis on realistic systems, community building, and mindset shifts provides a roadmap for therapists seeking to create sustainable and joy-filled practices.

For more resources and support, visit Abundance Practice Building or Abundance Party.