Experience with ZocDoc

[Dr. Pookie]

Hello all. I wanted to get a feel for others' experience using ZocDoc to get referrals for their outpatient practice. I listed my practice about a month ago and so far have had three referrals. Unfortunately, they all ended up being drug-seekers (red flag PDMPs, fake names, scheduling intake right before the holidays asking for controlled substances originally prescribed out of state, etc.). I wasn't sure if I'm just very unlucky to have attracted this type of patient on ZocDoc, or if they have a reputation for this type of thing. Any input would be greatly appreciated. At this rate, though, I'm probably going to deactivate my profile because they charge per booking.

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[nexus73]

never used them, but have heard similar to what you've described

seems like it would be better financially to find a local primary care clinic with 4+ docs/midlevels and cater lunch there to meet people.

 

[WisNeuro]

If you take insurance, you could also cater lunch to large therapy practices who don't have in house psychotropics management. They're always looking to get their patients in somewhere that doesn't have a huge waitlist for initial intakes. With that option, you'd also theoretically have a pretty good diagnostic assessment already done, if it's a psychologist clinic, anyway.

 

[Ironspy]

I’ve heard that zocdoc is awful for psych from multiple sources in person and in forums

 

[allantois]

This has been the largest referral source; they are psych patients, however, most do seek controlled substances especially stimulants. You can put a disclaimer that you do not prescribe those (even if you do) or screen the patients out. Once you get reviews, you will be getting a lot of requests.. After you deny some drug seekers they will write you some negative reviews stating such and deter other drug seekers from your practice..

 

[allantois]

never used them, but have heard similar to what you've described

seems like it would be better financially to find a local primary care clinic with 4+ docs/midlevels and cater lunch there to meet people.

PCPs are just as bad if not worse at dumping a mess onto psych

 

[allantois]

If you take insurance, you could also cater lunch to large therapy practices who don't have in house psychotropics management. They're always looking to get their patients in somewhere that doesn't have a huge waitlist for initial intakes. With that option, you'd also theoretically have a pretty good diagnostic assessment already done, if it's a psychologist clinic, anyway.

I find that therapists rarely if ever refer patients to psych.. some actively discourage it or even sabotage medication treatment. May be different with psychology practices idk

 

[WisNeuro]

I find that therapists rarely if ever refer patients to psych.. some actively discourage it or even sabotage medication treatment. May be different with psychology practices idk

Going to vary depending on the degree type, most likely. Midlevels like to "cure" everything with whatever flavor of the week pseudoscience is in vogue.

 

[allantois]

Going to vary depending on the degree type, most likely. Midlevels like to "cure" everything with whatever flavor of the week pseudoscience is in vogue.

EMDR is the flavor

 

[WisNeuro]

EMDR is the flavor

EMDR is so yesterday, now they like EMDR on steroids, Brainspotting.

 

[Ironspy]

I find that therapists rarely if ever refer patients to psych.. some actively discourage it or even sabotage medication treatment. May be different with psychology practices idk

Consider setting up a call with individuals or offer to buy them coffee if local. I’ve set up calls with a few therapists who had websites that targeted a similar niche and they have referred multiple appropriate patients since they “know” me now. 1:1 calls/zoom are more time consuming than a presentation to a group but higher yield overall imo. They have my cell and can reach me easily to collaborate (hasn’t happened) which helps with trust. I told them I don’t give my cell to patients, don’t do controlled substances and have gotten zero inappropriate referrals. These have mostly been LCSW but a few psychologists also

 

[PikminOC]

EMDR is the flavor

Or marijuana or CBD. I see that as a rec from midlevels

 

[PikminOC]

Consider setting up a call with individuals or offer to buy them coffee if local. I’ve set up calls with a few therapists who had websites that targeted a similar niche and they have referred multiple appropriate patients since they “know” me now. 1:1 calls/zoom are more time consuming than a presentation to a group but higher yield overall imo. They have my cell and can reach me easily to collaborate (hasn’t happened) which helps with trust. I told them I don’t give my cell to patients, don’t do controlled substances and have gotten zero inappropriate referrals. These have mostly been LCSW but a few psychologists also

I've found those to be low yield. Mainly them selling their services since they are so many of them competing with each other.

 

[PikminOC]

If you take insurance, you could also cater lunch to large therapy practices who don't have in house psychotropics management. They're always looking to get their patients in somewhere that doesn't have a huge waitlist for initial intakes. With that option, you'd also theoretically have a pretty good diagnostic assessment already done, if it's a psychologist clinic, anyway.

I've only found a small percentage of psychologists do good testing. The rest won't share their notes or impressions or just give people ADHD diagnoses even when their data doesn't support it

 

[WisNeuro]

I've only found a small percentage of psychologists do good testing. The rest won't share their notes or impressions or just give people ADHD diagnoses even when their data doesn't support it

Well, when it comes to basic notes and DA's, they have to, if you have a release. I don't know what it is about your situation, as you've mentioned problems before, but I have never run into those problems, or heard about them happening 99% of the time.

 

[PikminOC]

Well, when it comes to basic notes and DA's, they have to, if you have a release. I don't know what it is about your situation, as you've mentioned problems before, but I have never run into those problems, or heard about them happening 99% of the time.

I have reported them to their respective board which don't care either. So they are empowered to be difficult

 

[WisNeuro]

I have reported them to their respective board which don't care either. So they are empowered to be difficult

Again, I'm not sure what is going on in your situation, as it is exceedingly rare. Also, you likely have statutes you can fall back on and go right to the state health department at that point if you have a legitimate case.

 

[forchinet121]

I have reported them to their respective board which don't care either. So they are empowered to be difficult

You reported them for what? I wouldn’t report someone unless it was something egregious, not giving documentation could simply be a clerical miscommunication…

 

[WisNeuro]

You reported them for what? I wouldn’t report someone unless it was something egregious, not giving documentation could simply be a clerical miscommunication…

Depends on the steps taken. If you've sent a reasonable ROI request, with documentation, not heard back, and then called back about the medical records. You may have a case, granted you've documented things. I've honestly only ever had one instance where it was difficult to get records from a MH provider. And, that issue resolved very quickly when I informed them that my next step was a board complaint given the steps I had already taken. So yeah, one instance in over a decade of practice, that was still resolved without needing to file a report.

 

[PikminOC]

Depends on the steps taken. If you've sent a reasonable ROI request, with documentation, not heard back, and then called back about the medical records. You may have a case, granted you've documented things. I've honestly only ever had one instance where it was difficult to get records from a MH provider. And, that issue resolved very quickly when I informed them that my next step was a board complaint given the steps I had already taken. So yeah, one instance in over a decade of practice, that was still resolved without needing to file a report.

The last one I had they said the patient needed to sign their consent. Fine no problem. After we got that, they then said they had to talk to the patient. The patient didn't want to talk to that therapist. So in that case they threw up tons of roadblocks. And we all know my roi was adequate and he also signed theirs so it's total nonsense.

This isn't clerical. This is purposeful. And maybe your state will actually adhere to the law and force the notes. The last time I reported this, the board said the patient had to make the complaint.

 

[WisNeuro]

The last one I had they said the patient needed to sign their consent. Fine no problem. After we got that, they then said they had to talk to the patient. The patient didn't want to talk to that therapist. So in that case they threw up tons of roadblocks. And we all know my roi was adequate and he also signed theirs so it's total nonsense.

This isn't clerical. This is purposeful. And maybe your state will actually adhere to the law and force the notes. The last time I reported this, the board said the patient had to make the complaint.

That would be a weird precedent from a state board, as I am not aware of that rule in any state that I am familiar with. This is something I have never encountered or even heard about in my experience. Again, if you wanted to, you could push to the state agency level as there are likely statutes that deal with these rules. Up to you. Or move out of whatever anomaly area you reside in.

 

[PikminOC]

That would be a weird precedent from a state board, as I am not aware of that rule in any state that I am familiar with. This is something I have never encountered or even heard about in my experience. Again, if you wanted to, you could push to the state agency level as there are likely statutes that deal with these rules. Up to you. Or move out of whatever anomaly area you reside in.

I work in two states and have the same issue in both states

 

[WisNeuro]

I work in two states and have the same issue in both states

I am honestly not sure what to tell you, as this is an exceedingly rare issue in the five states that I have practiced. And one that I have never not had resolved without board/legal action.

 

[PikminOC]

I am honestly not sure what to tell you, as this is an exceedingly rare issue in the five states that I have practiced. And one that I have never not had resolved without board/legal action.

You've practiced in the five where they help with this. I'm in two where the board doesn't enforce so the therapists don't care. Lots of states out there.

 

[WisNeuro]

You've practiced in the five where they help with this. I'm in two where the board doesn't enforce so the therapists don't care. Lots of states out there.

I've been part of national psych associations and am familiar with many Board rules and Regs, this would be the first instance of such behavior that I have heard from a board, if true. I am not aware of states that do not have records laws on the state books, and you also have federal statutes at play. I would urge you to look at your process for requesting records, as this seems to be the one constant here. And, if all else fails, you have legal remedies at the state agency level, considering that laws are likely being broken if someone is not sharing records from an appropriate ROI request.

 

[PikminOC]

I've been part of national psych associations and am familiar with many Board rules and Regs, this would be the first instance of such behavior that I have heard from a board, if true. I am not aware of states that do not have records laws on the state books, and you also have federal statutes at play. I would urge you to look at your process for requesting records, as this seems to be the one constant here. And, if all else fails, you have legal remedies at the state agency level, considering that laws are likely being broken if someone is not sharing records from an appropriate ROI request.

I'm not paying a lawyer. The states I'm in are hands off. My roi is not the issue. And I'm not lying. There are laws but they aren't enforced by the board

 

[WisNeuro]

I'm not paying a lawyer. The states I'm in are hands off. My roi is not the issue. And I'm not lying. There are laws but they aren't enforced by the board

You don't need a lawyer, you can simply report it to the department of health, or if the board will not enforce clear statutes, the attorney general, along with any documentation of the issue that you have. There are many ways to resolve such issues that do not require you to get a lawyer.

 

[PikminOC]

You don't need a lawyer, you can simply report it to the department of health, or if the board will not enforce clear statutes, the attorney general, along with any documentation of the issue that you have. There are many ways to resolve such issues that do not require you to get a lawyer.

I'd hate to give patient names to more people like that

 

[WisNeuro]

I'd hate to give patient names to more people like that

Up to you and whether or not you want the issue resolved. You can do this without patient info up front.

 

[sighchiatry]

Hello all. I wanted to get a feel for others' experience using ZocDoc to get referrals for their outpatient practice. I listed my practice about a month ago and so far have had three referrals. Unfortunately, they all ended up being drug-seekers (red flag PDMPs, fake names, scheduling intake right before the holidays asking for controlled substances originally prescribed out of state, etc.). I wasn't sure if I'm just very unlucky to have attracted this type of patient on ZocDoc, or if they have a reputation for this type of thing. Any input would be greatly appreciated. At this rate, though, I'm probably going to deactivate my profile because they charge per booking.

Zocdoc is a waste of time and money.

 

[SmallBird]

I've only found a small percentage of psychologists do good testing. The rest won't share their notes or impressions or just give people ADHD diagnoses even when their data doesn't support it

That is very surprising, I have almost only worked with excellent psychologists, I wish they were a more prominent part of the clinical workforce, particularly in hospitals.

 

[WisNeuro]

That is very surprising, I have almost only worked with excellent psychologists, I wish they were a more prominent part of the clinical workforce, particularly in hospitals.

Yeah, I suspect that there may be more going on there. As far as the ADHD stuff, may be something to that, though I suspect that it's due to some bad actors who account for the lion's share of diagnoses. For example, I know one of the two places in my metro that I could send someone to and get a nearly guaranteed diagnosis of ADHD. To no one's surprise, these places are almost exclusively staffed by diploma millers. But, they churn out a ton of these evals.

 

[forchinet121]

Yeah, I suspect that there may be more going on there. As far as the ADHD stuff, may be something to that, though I suspect that it's due to some bad actors who account for the lion's share of diagnoses. For example, I know one of the two places in my metro that I could send someone to and get a nearly guaranteed diagnosis of ADHD. To no one's surprise, these places are almost exclusively staffed by diploma millers. But, they churn out a ton of these evals.

How profitable is that? The neuropsych near me have a one year waiting list..are they making a killing?

 

[WisNeuro]

How profitable is that? The neuropsych near me have a one year waiting list..are they making a killing?

The ADHD clinics? Can be very profitable as many take insurance for a portion and then do additional testing for cash pay.

 

[forchinet121]

The ADHD clinics? Can be very profitable as many take insurance for a portion and then do additional testing for cash pay.

How profitable is very profitable in terms of average numbers compared to a general psychiatry/therapy clinic?

 

[erg923]

I've only found a small percentage of psychologists do good testing. The rest won't share their notes or impressions or just give people ADHD diagnoses even when their data doesn't support it

This is your very limited personal experience, not an empirical study on the matter.

That said, I can agree in part, in that integrating everything and make optimal use and insights from various Psychological Testing/Tests is difficult and requires great attention to detail, psychometric knowledge/competence, history, psychosocial environment, and knowledge of psychopathology. Thus, not surprisingly, it is very easy to not be great at it in terms of it being super helpful or additive.

I don't really know what all this secretiveness from psychologists is about? I mean, there are certainly some limits about sharing raw test data with non-psychologists or psychotherapy session notes if the patient has not signed a release....but alot of what you seem to be speaking about doesn't seem kosher. So, again, not sure what is happening there?

 

[WisNeuro]

How profitable is very profitable in terms of average numbers compared to a general psychiatry/therapy clinic?

Depends on the area, how many employees, and whatnot. I haven't seen the accounting books of these places, but knowing what they are charging for assessments, they're doing fairly well, comparatively, probably a little better than a therapy practice of the same size.

 

[forchinet121]

Depends on the area, how many employees, and whatnot. I haven't seen the accounting books of these places, but knowing what they are charging for assessments, they're doing fairly well, comparatively, probably a little better than a therapy practice of the same size.

A little better than therapy? That doesn’t sound very profitable therapy practices make like no money is my understanding..I thought neuropsych is making bank considering they charge like 2k an assesment

 

[WisNeuro]

A little better than therapy? That doesn’t sound very profitable therapy practices make like no money is my understanding..I thought neuropsych is making bank considering they charge like 2k an assesment

Most people doing ADHD assessments are not neuropsychologists, doesn't make much money if you do it the right way. Those of making bank are doing legal work, at a good bit more than that for an assessment.

 

[forchinet121]

Most people doing ADHD assessments are not neuropsychologists, doesn't make much money if you do it the right way. Those of making bank are doing legal work, at a good bit more than that for an assessment.

They’re charging 2k an assessment and are booked a year out, I would think with that data they should be making a killing, should raise fees or something and decrease wait times

 

[WisNeuro]

They’re charging 2k an assessment and are booked a year out, I would think with that data they should be making a killing, should raise fees or something and decrease wait times

I'm sure the owners are making a killing.

 

[forchinet121]

I'm sure the owners are making a killing.

Yeah that’s exactly what I’m talking about not the employees lol

 

[WisNeuro]

Yeah that’s exactly what I’m talking about not the employees lol

Works better in some areas. Here you can hire some of the diploma millers from the shutdown school who are having trouble finding employment elsewhere at a 50/50% split pretty easily.

 

[allantois]

Who’s waiting a year out to get their Adderall? Lol

 

[erg923]

They’re charging 2k an assessment and are booked a year out, I would think with that data they should be making a killing, should raise fees or something and decrease wait times

This is not ****ing complicated, lol. This is bread and butter differential diagnostic stuff. Sometimes complicated, but not usually not. If this really all about "protection" from control substances prescriptions...it's waaaay over done.

 

[forchinet121]

This is not ****ing complicated, lol. This is bread and butter stuff.

I don’t know what you mean

 

[erg923]

I don’t know what you mean

2k for diagnostic evaluation for possible ADHD is ridiculous.

 

[forchinet121]

2k for diagnostic evaluation evaluation for ADHD is ridiculous.

Oh..well that’s what they’re charging in my area in the Midwest and as I said they’re booked a year out, some have altogether stopped taking any referrals because they’re so busy

 

[erg923]

Oh..well that’s what they’re charging in my area in the Midwest and as I said they’re booked a year out, some have altogether stopped taking any referrals because they’re so busy

Yes, often I hear: "Psychiatrist wants testing before prescribing for this (possible) diagnosis." Is this a motivational barrier to weed out drug seekers? Or do you want to see deficits on laboratory controlled cognitive tests first? Cause...I don't think that how this diagnosis works, per the DSM?

 

[forchinet121]

Yes, often I hear: "Psychiatrist wants testing before prescribing" for this (possible) diagnosis." Is this a motivational barrier to weed out drug seekers? Or do you want to see deficits on laboratory controlled cognitive tests first? Cause...I don't think that how this diagnosis works per the DSM?

It’s a mixture between weeding out drug seekers and reducing liability of prescribing controlled substances..this is not my personal policy but the rationale I’ve heard colleagues use