Podcast Episode 15: Questions From Our Audience

Enlightened Practice Podcast

In this new episode, our hosts Dr. Ken Braslow and Dr. Kari Kagan read some questions from our listeners and give their thoughts.

If you want your question featured and discussed on the show, simply send it to [email protected]. We’d love to hear from you.

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Transcript of the podcast

Ken: Hi Kari. Welcome back.

Kari: Hi Ken. Thanks for having me.

Ken: Sure. Today, we’re going to take a different approach instead of us asking each other questions we’re going to read some questions from our listeners and give our thoughts. 

Kari: All right. 

Ken: So, let’s dive right in. First question is, how did you name your practice? Why don’t you go first and then I’ll tell you how I named my practice.

Kari: Okay. Yeah, I named my practice, some factors that I thought about in the process were, what kind of practice do I have? So, I wanted it to represent in general, for example, my theoretical orientation, or I wanted something in the name that represented the kind of population I work with or how I approach therapy or something like that. So, that was a factor I took into consideration. And then, some other things I thought about were just from a marketing perspective, what would help my website pop up if someone Googled something looking for a therapist in the area. 

Ken: Hmm.

Kari: So, I took that into consideration and eventually got it. And what was already out there, so I started to do some Googling of similar practices to mine to get a sense of what’s out there, didn’t want to copy what had already been done and wanted to make sure that the web address was available. With all that process I eventually got to what my practice is called, which is SS Base CBT. So, that was a representation of the location that I was in and CBT which is the kind of practice, the kind of treatment that I use primarily. So, I felt like that was a good representation of my practice and also would help people to find me online. What about you? What did you take into consideration?

Ken: That’s great. Wow, I should have been doing this with you a long time ago. None of that occurred to me. I just named it after myself. I actually think I remember filling out a business license application and it was like, what’s your name? What’s the name of your business? And I probably came up with something else and immediately below it said, have you filed for a fictitious business name permit? And, have you posted this in a local newspaper? I feel like in San Francisco that was a requirement when I was setting up my practice. And you had to run for four weeks and you couldn’t place the ad online, you had to go into the office to do it. I was like, I think my name will have to work. 

Kari: Yeah. 

Ken: I can’t possibly be bothered to go through all that and that’s what I’ve used ever since. 

Kari: Yeah.

Ken: What do you think, should your business have its own name now, like think about now how far you’ve come. I don’t know how many people now are finding you on Google. Do you think it’s fine that it’s not named after yourself now, no big deal or do you wish that it was named after yourself? 

Kari: Yeah. I think it’s fine. I think that there’s so many approaches to naming your practice and there really is no right or wrong way. And I’ve seen everything from really lovely names like Healing Hands or whatever it may be, to something more like middle of the road like mine that’s kind of practical like the kind of therapy and location, to just names. So, I just really think it’s a combination of what suits your personality. What really represents you as a person and your practice, but also like what’s practical from a marketing perspective and just from a business perspective because it is a process to name your practice. So, I don’t think there’s a right approach to it. 

Ken: I agree. This is great advice. I should have listened to you a long time ago. Okay. Why don’t we move on to our next question, which is, how do you handle communication outside of session in your practice?

Kari: That’s a good one. I’m curious what do you do?

Ken: Well, I tend to push people toward communication within the portal. I tell people, you’re welcome to call me, and if I get an email notification that you’ve left over voicemail, but I typically don’t answer the phone because I’m either in session or I’m busy. Rarely do I answer the phone and it’s something I want to engage in a long conversation about. So, I typically tell people, you’ll get my voicemail, but I’m much more likely to respond in the portal even though you called me because I can sneak in a message during the day in between other patients or at the end of the day. Whereas a phone call, I never know how long a phone call is going to last and I don’t have time budgeted for that. And then if it’s really complicated and you think that the portal is going to take too long, go ahead and book an appointment online first and then let’s see how far out that appointment is because I agree that email is not optimal for complex or multiple subjects. For example, I’m on 5mg and I’ve been fine on this for a week, can I go to 7 and a half mg? Okay, that’s much easier for me to handle in the portal.

Kari: Right.

Ken: I don’t want people to have to make an appointment just to ask me a tiny dosing tweak question. But in general, either send me a message on the portal or leave me a voicemail but I’ll get back to you in the portal. That’s how I handle it during a business day. So, why don’t we start with that? How do you handle it during the business day? 

Kari: During the business day, just when I get started with a client in the informed consent period, I let them know to give just in general, give at least 24 hours before I can get back to them. Whichever way they reach out, whether it’s email, portal, phone, just that I’m not an on-call therapist. It’s hard to be that when you’re in private practice. And since I don’t do prescriptions, that kind of issue would not be discussed at all in my practice. So, usually it’s either a scheduling thing or a clinical thing like there’s something that’s really stressing them out between sessions. In which case, I tell clients, do not email about that, it’s actually not appropriate informed to talk about that. To email about scheduling an appointment or to message through the portal, but I won’t do any clinical work over email. 

In terms of phone calls, I would potentially set up phone calls with clients during business hours if I can get to it, if a client is really struggling with a clinical issue. But again, I do give myself space in an informed consent to let the client know that if there is a clinical emergency or something that’s really urgent that actually leaving a message, or a text, or an email doesn’t guarantee that I’ll see it. And it’s actually probably better to go to the hospital if it’s that kind of situation. But usually, I’m open to however a client wants to reach out to me. I actually don’t have a preference. I just want to make sure that the more important thing is that they know that I won’t be able to respond right away. And scheduling an appointment would be the best way forward if it’s a clinical thing.  

Ken: And do you get any push-back from clients when you talk with them about that?

Kari: No. No, I think they understand that it’s like a one-man show in private practice. If I’m with another client I can’t be checking emails, or listening to voicemails or something like that. But if a client emails me and says, I really would love to be able to talk today. I would encourage a client to either send an email that’s similar to that or through the portal, that’s more secure messaging platform. And then I will try to make time to schedule a call. But usually, still that call will be brief and it will ideally be under 15 minutes and then we would schedule a time to have a full session in person or on video.

Ken: Got it. That makes sense. 

Kari: Yeah. 

Ken: Do you give out your cellphone number? 

Kari: I have a work cell and yes, my clients have that and they can text to that number, but I don’t do texting for clinical issues or chatting, and no, I’ve not had any experience where a client used text in that way. Usually, it would be for the appropriate use of text in my practice is if a client is running late and they send me a quick text saying, I’m running late or I can’t show for some reason. So, that would be an appropriate use of the “work cell” but not for chatting or anything like that, or an emergency. 

Ken: Got it. 

Kari: Do you have a cellphone clients can contact?

Ken: I do have a virtual work cellphone. Texting, I try to avoid that at all costs. For one, it’s just not easy to get that into the chart. Also, I don’t get notifications of it like I would with regular texting. So, sadly a text could just sit and you would think oh, it’s a text, they must be getting it right away, but actually, I don’t even know it’s there. So, the only times that I’ve appreciated a text is like if I needed to cancel an appointment, really late notice, of course I would message and call, but texting for some people is the only way to get through to them. And then also, occasionally scheduling changes that are really painful to pull off for some reason, even in spite of online booking, and then to message, sometimes that’s fine. It’s easier to text that way. But that’s it. 

Kari: Yeah. 

Ken: I used to when I first started in practice, I actually had an answering service and that was not inexpensive, and it was hardly ever used and I had to give them a fact essentially. If anybody calls, here’s what they might ask and here’s how I’d like you to respond. So, I had to envision all these different scenarios, which is what they’ve requested because they said, how do we know what to say? And at the end of the day, it was almost always that they would page me, which was not so useful. 

Kari: Not so helpful. 

Ken: Yeah. It kind of led in a circle. So, yes, it was a bit of a buffer between me and that patient directly. Working with med-management is potentially meaningful, especially if you have a really high volume of patients. But it just seemed more work than it was worth. So, I agree with you, I just tell people now, just message me or leave me a voicemail and I’ll try to get back to you as fast as I can. But it’s within business hours and if it’s truly a crisis I will call you back right away, but I don’t always get notified right away, or I’m in session, or busy and I say, if you can’t wait for a response then you have to go to the emergency room. So, that’s how I try and frame it, but I’ll do my best as soon as I can. 

Kari: Yeah, exactly. And I will just say one note, on after hours and weekends you know how to handle that. I was given advice early on and I’ve taken it and I think it also depends on the population you’re working with so that’s worth considering when you make your policies around after hours, but before I worked with just the adult population, it’s not a high risk population per se. So, I’m pretty strict on, don’t expect to hear from me after hours or on weekends and in fact, I try my best to not even respond to emails after hours because I don’t even want a client to see it like that at 9 p.m. I answered an email, which might start to set the president that maybe I’m reachable then, even if I do happen to read it, I’ll still wait till business hours the next day. So, I tend to err on the side of just being a little bit more protective of my time, that I really am a business hours only therapist. And as long as I inform a client of that, if they want more of an on-call therapist they can make that decision for themselves. Plenty of therapists have more of an on-call model for various reasons because of the population and it’s because it’s what they want to do. For me, that doesn’t work. So I hold that boundary, on the weekends and evenings, and if that doesn’t work for a client then they can definitely find a better fit when it comes to schedule and on-call availability. So it’s something to think about. 

Ken: I think that’s a really nice way that you put it. And being able to say to a perspective patient or client, you know, I might not be the right fit for you, is a really smooth way of conveying your own boundaries, but also helping them feel empowered. 

Kari: Yeah.

Ken: As in many types of relationships in life, it’s the fit that matters and it’s not always meant to be. And I think it’s good that they get that you can be assertive too, and that’s probably what we model for our patients because that’s often clinically a challenge for them in their own relationships. 

Kari: Yeah.

Ken: Okay. Well, I think that covers the questions today and I look forward to reviewing more listener questions with you soon. And a reminder to our listeners, that you’re welcome to send us a question and you click the link right below this podcast and send it to us or send us an email and we’ll be happy to think out loud about your questions that you send us.

Kari: Yeah, that’s fun. 

Ken: All right Kari, it was great learning from you today.

Kari: Yeah, you too. 

Ken: I’m going to go think about renaming my practice now. You take care. 

Kari: You too. Bye. 

Ken: bye.

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