Scaling Behavioral Health While Preserving Clinical Autonomy with Ben Johnson

Summary

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Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode: Scaling Behavioral Health While Preserving Clinical Autonomy with Ben Johnson
Date: May 3, 2026
Host: Ella Reuter
Guest: Ben Johnson, Director of Behavioral Health Provider Practices and Operations, Lakeland Regional Health

This episode explores how Lakeland Regional Health is successfully scaling its behavioral health services while preserving the autonomy of its clinical providers. Ben Johnson shares operational insights, the role of technology (including AI), the challenges around standardization versus clinician flexibility, and his vision for national improvements in behavioral health information exchange.

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Key Discussion Points & Insights

1. Introduction to Lakeland Regional Health & Behavioral Health Services

• Lakeland Regional Health’s Growth: Began as Morrell Hospital in 1916; now one of Florida’s largest hospitals.
• Behavioral Health Expansion:
  • 96-bed inpatient unit
  • Multiple outpatient sites

  • 50 clinicians spanning psychiatry, psychology, social work, addiction medicine

  • Services include IOP, interventional psychiatry (ECT, TMS, ketamine), and integrated primary care behavioral health.
  • Newly added walk-in psychiatric med management clinic
• Ben Johnson’s Background: Clinical therapist by training; now leading administrative and operational efforts (00:25–02:31).

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2. Operational Variation & Standardization

• Where Variation Occurs:
  • "The most significant variation in behavioral health is usually not the therapeutic work itself. It’s in the operational infrastructure... access, intake pathways, referral management, handoffs, documentation, expectations, and scheduling workflows." — Ben Johnson (02:50)
• Approach to Standardization:
  • Focus on standardizing infrastructure, not clinical encounters.
  • Use guiding principles over excessive rules to ensure access, safety, coordination, and team function.
  • Avoid over-policy making which restricts clinical flexibility:
    • "Behavioral health is difficult to fully manualize... It doesn't respond well to rigid one size fits all operational models." (03:55)
  • Support a quasi-private practice environment within the system.

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3. Role of Technology in Behavioral Health Operations

• Strengths of Technology:
  • Helps with referral pathways, documentation, communication workflows, performance tracking.
  • Reduces reliance on fragmented “tribal knowledge” and ad hoc workarounds.
• Limits and Pitfalls:
  • Technology should not define the care model or overburden clinicians.
  • "An EHR can standardize the fields and the steps, but it really can't replace the clinical judgment, the therapeutic alliance, or the reality that behavioral health is often nonlinear." (06:31)
  • Poorly designed tech = more clicks, duplicative work, operational policing (06:50).
  • Technology should enable, not become a mechanism for administrative intrusion.
• AI in Documentation:
  • Recent implementation of AI listening tools for session documentation led to substantial provider satisfaction.
  • "It also helps our providers get home quicker to their families and move on so they're not having all of that extra documentation at the end of the day." (08:23)

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4. Balancing Standardization and Clinical Autonomy

• Ben’s Philosophy:
  • Standardization ≠ automatic improvement. Must not sacrifice patient/clinician experience for operational throughput.
  • "Providers should be doing the provider work and not spending their day fighting avoidable operational barriers." (09:57)
  • Emphasis on true access: Not just quick appointments, but meaningful, appropriate connections with long-term providers (10:48).
  • Process improvements must be evaluated both operationally and from a care experience lens:
    • "If it improves throughput but weakens trust, continuity, or the provider sustainability, then it’s truly not optimized." (11:49)

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5. Provider Feedback and Continuous Improvement

• Communication Structure:
  • Open door policy, frequent department and sub-team meetings.
  • Providers encouraged to bring up friction points and participate in problem-solving.
  • "If they've identified a friction point, that they're also, you know, helping us try to find solutions as well. Because we're, we're a team here." (12:32)
  • Willingness to pilot new ideas, monitor and adjust rather than sticking with the status quo.

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6. If One Thing Could Be Standardized Nationwide...

• Ben’s Choice:
  • "If we could standardize one thing nationally, it would be a true health information exchange across community agencies, behavioral health providers, addiction treatment centers, hospitals, other care settings." (14:01)
• Reasoning:
  • Current fragmentation = incomplete records, poor treatment continuity, inefficiencies, and patient safety issues, especially for transient populations.
• Anticipated Impact:
  • "It would be enormously valuable if our providers could see the full picture and pick up where the last provider left off rather than having to start over from scratch..."
  • Improved safety, better treatment planning, more efficient transitions, less fragmented care, and more intelligent system use (15:41).
  • "If behavioral health is ever going to function… like a truly integrated continuum, then the information has to move with the patient." (16:41)

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Notable Quotes & Memorable Moments

• On the art of behavioral health leadership:
  • "We’re here to solve the operational headaches, not to micromanage the art of the medicine or the psychotherapy itself." — Ben Johnson (04:21)
• On technology’s dual edge:
  • "When technology is well designed, it creates clarity, it reduces friction. But then on the opposite side, when it’s poorly designed, it amplifies both frustration and fragmentation in the system." (07:12)
• On actionable provider feedback:
  • "On my team, they know that I like to volunteer us for lots of different pilot opportunities... willing to trial things to make it better." (12:40)
• On the need for data transparency and exchange:
  • "The impact would be improved safety, better treatment planning, more efficient care transitions, less fragmented care..." (15:17)

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Important Timestamps

• 00:25: Ben Johnson introduces Lakeland Regional Health’s behavioral health footprint
• 02:50: Operational variation and philosophy on standardization
• 05:46: The role, utility, and limitations of technology and AI in workflow consistency
• 09:22: Navigating the tensions between standardization and clinician autonomy
• 12:10: Approaches to collecting and responding to provider feedback
• 13:54: What Ben would standardize across the U.S.—health information exchange

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Conclusion

This episode offers a nuanced exploration of how a large health system can grow behavioral health services, maintain operational rigor, and still protect the clinical judgment and satisfaction necessary for effective mental health care. Ben Johnson emphasizes guided standardization, technology as an enabler—not a burden—and the centrality of open feedback and care continuity. His wish for a universal health information exchange sums up the urgent need for better-connected, less fragmented behavioral healthcare in the U.S.

Transcript

[A]

Welcome to Becker's Behavioral Health Podcast. I'm Ella Reuter, your host and I'm thrilled to be introducing our guest today, Ben Johnson, Director of behavioral health provider practices and operations at Lakeland Regional Health in Florida. Ben, thank you for joining us today. For those in our audience who may not be familiar with you and the work that you do, could you please introduce yourself and tell us a little bit more about Lakeland Regional Health?

[B]

Sure. Thanks Ella. Thanks for having me on today. I'm glad to be here to talk a little bit more about what we do at Lakeland Regional. My name is Ben Johnson. I have the privilege to serve as the director of behavioral health providers and practice operations at Lakeland Regional Health. Lakeland Regional Health is based here in Lakeland, Florida. We have the privilege to serve the central Florida community over the last 110 years. We started out as a small community hospital called Morrell Hospital in 1916 and now we're one of the largest hospitals in Florida with a physician group of over 400 providers, 40 specialties in 35 locations. Over the last five to six years, the footprint of behavioral health at Lakeland Regional has grown significantly. We have a state of the art facility of a 96 bed inpatient behavioral health unit. We have a thriving outpatient practice with multiple locations. Our behavioral health provider group is now over 50amazing clinicians from psychiatrists, child adolescent psychiatrist, psychiatric nurse practitioners, addiction medicine physicians, psychologists, therapists, clinical social workers, and now psychiatry physician residents. Besides inpatient outpatient behavioral health, we offer IOP interventional psychiatry services like ect, tms, ketamine. We also have a robust consult liaison psychiatry service at our 910 bed hospital. We have psychiatrists embedded right within our emergency department and integrated behavioral health in our primary care practices. This year we've also added a walk in clinic for psychiatric med management. Just a little bit about myself. I've been in behavioral health leadership for over a decade and between behavioral health and consulting practices across multiple states, I started out as a therapist. Marriage and family therapy is my background. But I quickly wanted to move into administrative administration, which has led me here today.

[A]

Well, wonderful. Thank you so much for that brief overview and introduction. I'd love to kick us off with our first question. As Lakeland Regional scales its behavioral health services. Where have you seen the most operational variation and how are you standardizing workflows without losing clinical flexibility?

[B]

Great question. The most significant variation in behavioral health is usually not the therapeutic work itself. It's in the operational infrastructure. Infrastructure surrounding care including access, intake pathways, referral Management handoffs, documentation, expectations, and scheduling workflows. My philosophy is really that behavioral health leaders need to be very careful not to over insert themselves into the clinical encounters. I've seen way too many organizations policy, policy themselves into a corner and create operational rules that unintentionally compromise patient care. Behavioral health is difficult to fully manualize. It's not a commodity service line, and it doesn't respond well to rigid one size fits all operational models. Because of that, I do not believe the goal is to standardize the clinical encounter. The goal is actually to standardize the infrastructure around the encounter. At Lakeland Regional, we try to create an environment where providers can operate as closely to a private practice model as possible while still benefiting from the strength of an integrated health system. That means myself, my leadership team, and our support departments at Lakeland Regional Health are really here to absorb as much of the administrative burden as possible so that providers can stay focused on patient care. We're here to solve the operational headaches, not to micromanage the art of the medicine or the psychotherapy itself. The way I think about standardizing is through guiding principles, not excessive rules. You know, we defined the minimum standards necessary for access, for safety, coordination and team function. But we leave the room for the provider judgment and the patient specific nuance. That is especially important in behavioral health, where trust, the therapeutic alliance with the patient, and the individualized care planning are central to outcomes. So the balance is really this, the standardize what protects the patient and supports the team, but do not over standardize in ways that intrude on clinical judgment.

[A]

Yeah, that's really incredible. Thank you so much for giving that overview there. And I'm really curious about how technology is playing a role in this. If you could kind of dive into where it's driven consistency versus where it's kind of fallen short.

[B]

Great question. Technology has played an important role in helping us create consistency in the administrative and operational aspects of care. It can support the standard referral pathways, documentation templates, the order sets, the communication workflows, the tracking tools, and performance visibility across our practices. It's especially helpful in creating a shared infrastructure so that teams are not solely relying on their memory, their tribal knowledge, or even like the local workarounds. That said, technology has its clear limits in behavioral health. It can support a workflow, but it really shouldn't define the entirety of the care model. Where technology really falls short is when organizations try to force behavioral health into a rigid system that doesn't always reflect the nuance of the work. An EHR can standardize the fields and the steps, but it really can't replace the clinical judgment, the therapeutic alliance, or the reality that behavioral health is often nonlinear technology. It can fall short when it becomes another layer of administrative burden, rather than a tool that actually removes the burden. In behavioral health, that is a real risk. If the system creates more clicks, more duplicative documentation, or more operational policing than of the actual clinical encounter, clinicians will feel it immediately. So I view technology as more of an enabler, not the solution itself. It should support consistency in the administrative scaffolding around care, but it should never become a mechanism through which administration overreaches into the clinical encounter. When technology is is well designed, it creates clarity, it reduces friction. But then on the opposite side, when it's poorly designed, it amplifies both frustration and fragmentation in the system. One of our big wins for our team this past year has been adding AI to help our providers document their sessions. It's been a huge patient satisfier or a huge provider satisfier, rather that they can spend more patient facing time and not have to worry about getting to the next session. It also helps our providers get home quicker to their families and move on so they're not having all of that extra documentation at the end of the day.

[A]

Yeah, that's really incredible. I know. I've talked to a lot of leaders about kind of that workforce strategy there with the AI listening tools and documentation tools. So thank you so much for talking more about how AI is affecting Lakeland Regional Health. I'd also love to dive more into. I know you mentioned standardizing versus clinician autonomy, and I was kind of wondering if you could dive more into the challenges there and kind of how you're navigating that so that you are balancing the two in your system.

[B]

First, I do not assume that a more standardized process is automatically a better one. In behavioral health, a process can look more efficient on paper and still create friction that damages patient care or clinician engagement. I look at whether the process is actually helping patients enter care more smoothly or move through the continuum more effectively and connect with the right provider with less confusion and less duplication. I also look at whether it is protecting clinicians from unnecessary administrative burden. One of my core leadership principles is that providers should be doing the provider work and not spending their day fighting avoidable operational barriers. If a process improve improves throughput by pushing work back onto clinicians or by creating an impersonal patient experience, I really don't consider those to be a successful design. We try to Build systems that reduce administrative drag and create role clarity for the entire support around the provider. That means having schedulers, mas operational leaders and support teams really carry that administrative load that they're meant to carry so the provider can remain focused on care delivery. You may hear me say that multiple times because it's really important to me. It also means being honest that not every access metric tells the full story. I'm very cautious about those workflows that technically satisfy payer timeline standards. So that in a way, it fragments the patient experience for me. True access is not just about getting a patient seen quickly. It's about getting them meaningfully connected to the right level of care, ideally with the right long term provider relationship too. So we evaluate the process design through both an operational lens and a care experience lens. If it improves throughput but weakens trust, continuity, or the provider sustainability, then it's truly not optimized.

[A]

Yes, and I'm really curious too about how you're connecting with providers to make sure there isn't an added friction. I was kind of curious about how you're receiving that feedback and maybe closing those loops.

[B]

So I really think it's important that you have an open line of communication between your provider group, your support teams and your leaders. And that really does require open door policies and frequent meetings, particularly within, within our department, we have one large department meeting and then we have smaller meetings. Within behavioral health, like our outpatient team, we meet once a month where we discuss those friction points. And what I ask of my team is that if they've identified a friction point, that they're also, you know, helping us try to find solutions as well. Because we're, we're a team here. And on my team, they know that I like to volunteer us for lots of different pilot opportunities. So it's not turning away, turning down an idea just because we want to continue. Well, this is, this is the way we've always done it. You know, if there's some, if there's a different way for us to find a, find a solution for a problem, then let's try it and then monitor and adjust from there. So it's having those open discussions about those friction points and being willing to trial things to, to make it better.

[A]

Yeah, that's great to have that feedback from your team and really be in, in close communication there. And for our last question, I'm really curious if you could standardize one thing across behavioral health programs in the country, what would it be, if any, and what kind of impact would it have?

[B]

That's another great question. You know, I've thought about this a lot and just, it's just what kind of one of those things that I think we as behavioral health operators, we would love to have across the nation. And that is one thing that if we could standardize one thing nationally, it would be a true health information exchange across community agencies, behavioral health providers, addiction treatment centers, hospitals, other care settings. One of the biggest barriers in behavioral health today is fragmentation. Many of the patients that we serve have interacted with multiple systems over time across different organizations, different levels of care, and sometimes different states. Particularly, you know, in our location in Florida, we hit quite transient. We have people that, you know, snowbirds that'll come down. But yet providers are still often forced to piece together the story from incomplete records and patient recollection. This is a major problem, especially in behavioral health, where patients may have, you know, complex treatment histories, multiple diagnoses, prior medication trials, prior hospitalization, substance use treatment episodes, and, you know, and trauma histories that are highly relevant to the current care. It would be enormously valuable if our providers could see the full picture and pick up where the last provider left off rather than having to start over from scratch. That would really improve continuity, reduce duplication, reduce reliance on patients, perfect, you know, being perfect historians and help clinicians avoid repeating interventions that have already failed. For a large hospital system like ours, that would. That would be particularly important because we serve patients from across the state. We also care for seasonal residents that may only be here for part of the year. A robust information exchange would create a better coordination across a full continuum and across geographies. The impact would be improved safety, better treatment planning, more efficient care transitions, less fragmented care, and much more intelligent use of the system as a whole. If behavioral health is ever going to function truly like a truly integrated continuum, then the information has to move with the patient.

[A]

Well, wonderful. Thank you so much, Ben, for sharing more about Lakeland Regional Health and your perspective as director of Behavioral Health Provider Practices and operations. Thanks to our listeners for tuning into Becker's Behavioral Health podcast and we'll see you next time.

[B]

Thank you. Thank you very much.