Work Life Balancers and Slackers of SDN, teach me your ways.

[PsyDr]

1) How many patients are you seeing a day?
2) For assessment practices, you're seeing how many a week?
3) What are you doing in the office in your down time?
4) How often are you taking a personal day?
5) What happens to your caseload when you take a personal day? Sick day?
6) How do you handle phone calls while you're gone? Emails?
7) How many conferences are you going to a year?
8) Books read a year?

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[Ollie123]

1) How many patients are you seeing a day?
2) For assessment practices, you're seeing how many a week?
3) What are you doing in the office in your down time?
4) How often are you taking a personal day?
5) What happens to your caseload when you take a personal day? Sick day?
6) How do you handle phone calls while you're gone? Emails?
7) How many conferences are you going to a year?
8) Books read a year?

1. Projected caseload to full-time (I'm mostly research) would be 6-7/day therapy. I'd need to schedule ~9 consistently to get that. This is one of the reasons I keep my research effort higher.
2. N/A
3. SDN, other forums (primarily financial) occasionally. Mostly do research work. Its usually a good window for me to crank through a manuscript review or do some other mundane task. Today I spent it iterating through a bunch of manual MRI processing scripts I have been too lazy to write a bash script to automate.
4. 2-3 vacations a year. In between I almost never take days off unless I'm severely ill, which fortunately happens quite rarely. I do work from home sometimes.
5. So far - I just don't see folks that day. Sometimes I'll shuffle things around if I have folks that are higher-risk. In general, we just bump them to the following week and move on with life.
6. Depends on your definition of "gone." I'm on email constantly, though try to unplug on true vacations - at least during the day. When we go to Europe, I deliberately do NOT arrange for cell service. I occasionally get lost without access to google maps. I have always made my way back. I have not regretted this for a second. I arrange coverage and make sure folks have a way to contact me in emergencies. Fortunately, these are extremely rare.
7. Usually 2-3. At least one of those we try and extend into a vacation, but obviously this depends on the awesomeness of the conference location. Florence definitely became a vacation. Baltimore did not. Some additional travel in between for trainings. Go to California 2x this year to do grant reviews.
8. Work-related or pleasure? I think I typically knock out at least 6-8 "fun books" per year, though its usually more. Work it varies enormously from year to year.

I work a ton and stress about work entirely too much and should probably not have replied to this thread.

 

[Pragma]

1) How many patients are you seeing a day?
2) For assessment practices, you're seeing how many a week?
3) What are you doing in the office in your down time?
4) How often are you taking a personal day?
5) What happens to your caseload when you take a personal day? Sick day?
6) How do you handle phone calls while you're gone? Emails?
7) How many conferences are you going to a year?
8) Books read a year?

1) How many patients are you seeing a day?
N/A

2) For assessment practices, you're seeing how many a week?
N/A for me since I do mostly research. Would probably schedule 4-6 evals per week if I was not.

3) What are you doing in the office in your down time?
I avoid down time mostly because I try not to bring work home with me if I can avoid it. But otherwise, reading the news and SDN.

4) How often are you taking a personal day?
I try to do that 2-3 times per year when it makes sense to do it. Harder to do with children because if they are sick you have to stay home too.

5) What happens to your caseload when you take a personal day? Sick day?
Typically not an issue. Worst case would be having someone rescheduled or seen by another provider. Unless I have something contagious, I would usually still come in if there is anything particularly important happening or if there is patient care to deal with.

6) How do you handle phone calls while you're gone? Emails?
I check emails a lot but I set mine up so that I log in and check them. Otherwise the alerts would be incessant. I take phone calls when I need to but otherwise just call back when I am in office.

7) How many conferences are you going to a year?
2-3 on average. Usually travel to 2 and then local ones when they are around.

8) Books read a year?
Only 1-2. I read so much at work that I do a lot of non-reading recreation at home. Plus, kids...

Notice how it is the research people that answered you first?

 

[AcronymAllergy]

1) How many patients are you seeing a day?
Typically 1 assessment and/or 1-3 feedbacks. I'm also supposed to have 10 hours/week reserved for training-related duties. That hasn't happened yet.

2) For assessment practices, you're seeing how many a week?
Theoretically 4 full outpt evals. Been more like 5 recently while I've agreed to work in extra folks and reschedules. This will likely change as I work in triage appointments.

3) What are you doing in the office in your down time?
When it's there, typically skim the news, morningstar, or SDN.

4) How often are you taking a personal day?
I rarely take any sick time (see why below); maybe a couple hours here or there. I try to schedule a random day off here and there at the beginning of each year (works out to maybe 3-4/year). I take usually 1 big-ish trip/year for which I'll actually request a few days off, and then a few smaller trips to visit nearby family for holidays (typically over long weekends).

5) What happens to your caseload when you take a personal day? Sick day?
I have to schedule leave 45+ days in advance. I try to do this far enough out that folks aren't yet scheduled. Theoretically, if someone is canceled, we're supposed to get them back in within 2 weeks. Same goes for sick days. Which is rough, when you're booked out for months.

6) How do you handle phone calls while you're gone? Emails?
Leave away messages with a designated contact person. For training, assign supervision coverage and provide cell phone if needed.

7) How many conferences are you going to a year?
Usually 1.

8) Books read a year?
For leisure, not many (sadly). Maybe 1-2/year. Last was Moby Dick I think, been stalled on the Brothers Karamazov for months now.

 

[erg923]

1) How many patients are you seeing a day?
2) For assessment practices, you're seeing how many a week?
3) What are you doing in the office in your down time?
4) How often are you taking a personal day?
5) What happens to your caseload when you take a personal day? Sick day?
6) How do you handle phone calls while you're gone? Emails?
7) How many conferences are you going to a year?
8) Books read a year?

1. Average for a week: 1-2? Depends on what you count as clinical work, I suppose?
-I now have a side gig with the State U Athletic department: case/athlete/coaches consultation and some intervention work as needed. I have taught a class twice at a local R3 college and used to do clinical faculty (i.e., adjunct clinical supervision) work with a local graduate program, but haven't done that this past year.

2. I always do something more than just a clinical interview, but I don't do much that would be considered formal psychological testing/test batteries.

3. Home office, so Netlflix. Oh, and 902101 reruns on POP channel.

4. Flexible schedule but I still max this out for the most part: 3-4 days in the fall (usually just around the house for cleanings and projects), a week in the Spring (my Dad and I go the Masters every year), a couple days around Christmas time and/or Thanksgiving, and a week or 2 in the Summer to take the fam somewhere.

5. Coverage for my most of my duties can be done by multiple others within my role or similar roles.

6. I don't.

7. One academic (usually the state Psychological Association, but sometimes a national thing) and 1 corporate thing.

8. Varies: 1-3? I have kids and volunteer at our Parish and assist with school sports almost year round.

 

[ClinicalABA]

1) How many patients are you seeing a day?
- see #2 for most of what I do. I do 1-2 home based ABA sessions per month.

2) For assessment practices, you're seeing how many a week?
- I average 3.5 assessments, feedback sessions, and intakes per week, with a max of 4 assesments per week.

3) What are you doing in the office in your down time?
- writing reports; admin stuff; general clinical consultation (mainly ABA stuff, with formal and informal meetings with staff); peer consultation; correcting assignments; I aim to do a lit search once per week and read 5 articles; eating and goofing off (e.g. SDN). On days when I have clients, I spend ~30-60 minutes cleaning up the office and sanitizing toys and testing materials. I inventory/order protocols about every other week.

4) How often are you taking a personal day?

At least once a month, and I try to make it a long weekend.

5) What happens to your caseload when you take a personal day? Sick day?

I schedule around my time off, and will reschedule if I need to. I’m currently booking fully out to June, so I plan ahead and put in some “do not schedule days” in the calendar. I schedule out at ~150% minimum billable requirement per week, so every few months I out in a whole week of nothing scheduled so that I can catch up on writing if needed, as well as have slot for an “emergency” assessment.

6) How do you handle phone calls while you're gone? Emails?
I answer them or reply if I can. Scheduling calls go to office anyway. If I’m out for 3+ days in a row, I’ll auto reply to contact somebody else, but that never happens as things tend not to be too “emergency” in my practice

7) How many conferences are you going to a year?
3-4 regional, 1 national (though I’m really hoping to skip the national one this year)

8) how many books per year?
15-20, but mainly when I’m on vacation. I’m not good about reading fiction at home, for some reason.

 

[deleted343839]

1) How many patients are you seeing a day?
6 maybe 7 scheduled, though not uncommon for 1 or 2 to cancel/reschedule. I work with a medically complex population in an integrated setting so more than that would be untenable for me. I have one admin/teaching/research/everything else day per week.

2) For assessment practices, you're seeing how many a week?
Varies, but I try to keep assessment work to a minimum.

3) What are you doing in the office in your down time?
Catch up on notes, research work, associate editor work (chasing down reviewers, reading manuscripts, rendering decisions), preparing talks, fielding requests to teach/attend meetings/etc., listservs, checking news, squeezing in emails and phone calls mostly about stuff for my kids

4) How often are you taking a personal day?
I take planned vacations, which are usually scheduled months in advance. These usually track with my children's schedule (spring break, a week or so in summer, a week around Christmas).

5) What happens to your caseload when you take a personal day? Sick day?
I had to take a few sick days earlier this year and I moved all of the patients to other days, mostly by overbooking.

6) How do you handle phone calls while you're gone? Emails?
I check emails when I'm away from the office, but not religiously. People know how to reach me if it's truly urgent. Phone calls get an "I'm out of the office until..." voice mail and a number to call for the admin who can reach me in a true emergency.

7) How many conferences are you going to a year?
One or two at most. Used to be more.

8) Books read a year?
A few. I used to dislike audio books but I'm coming around.

 

[temppsych123]

1. Projected caseload to full-time (I'm mostly research) would be 6-7/day therapy. I'd need to schedule ~9 consistently to get that. This is one of the reasons I keep my research effort higher.

I am really curious about this. Let's say you want to do full-time clinical work (I don't, but I'm curious). If you need to get 6-7/day to make your salary, pay rent, etc. you have to schedule ~9 to get to that, given cancellations, no-shows, etc. But how does that actually work? Are clinicians booking themselves from 9AM to 6PM solid with no lunch, and just assuming that cancellations will allow you time to write notes, return phone calls, and eat? It doesn't seem feasible or ethical to double-book clients for the same time in case one no-shows, given that you can't see both of them if they both show up...

I am also curious as to how this works in primarily assessment-based settings, where you might have fewer separate clients per day, but each one lasts longer, so the consequences of a no-show might be greater.

 

[ClinicalABA]

I am also curious as to how this works in primarily assessment-based settings, where you might have fewer separate clients per day, but each one lasts longer, so the consequences of a no-show might be greater.

Short response so you can ignore most of what’s below: In my assessment only practice, I consistently schedule and bill more than my minimum requirement so cancellations (which aren’t really that common) don’t have much, if any, negative impact.

Longer response: I’m in basically an assesssment only practice. You are correct- a no show can mean 6-12 hours lost. If someone doesn’t show for an assessment, I could get another one in within a week or two. Our productivity is measured quarterly (and I’m salaried) so it wouldn’t impact meeting my hours or my take home pay. No shows and “day of” cancellations are rare for me (I assess toddlers), but if they happen I catch up on stuff or even call it an early day. If it’s an illness or transportation issue, I can typically find a slot in a week or two to see them (I only have the office schedule me with clients 3 days per week so there’s some flexibility to reschedule). I’ll work less one week and more the next. We’re also super busy (anybody want a new job) so I could bump a kiddo up if I needed to.

I also prepare for such things by consistently averaging 130% of my mininmum billable hours per month, so the impact of cancellations is minimal. We also have a minimum annual revenue projection, which I’ll typically hit by September/October. I find that working at 130% is comfortable for me. I actually have to keep check on not overscheduling, As I try to find quick “off schedule”slots for kiddos under 2 or just about to turn 3 (the age at which Early Intervention services end and they’ll need a dx to continue with insurance services if indicated).

On the topic of the original post, I think the hardest thing can be maintaining a reasonable schedule. We have ~1.75 FTEs of psychologists now (I’m full time, and two others come in a few days per week/month from our clinics in other areas of the state), but it’ll mainly be just me after the new year. This had led to me scheduling out 8 months. I could drop that by a month or two by scheduling more, but I enjoy my schedule of work and free time. I like my company, and am eager to help where I can. However, adding more clients would basically be volunteering. My salary wouldn’t increase and I currently max out on productivity based bonuses. I frequently have to remind myself that big system level problems (e.g, limited acces to providers; difficulties with professional recruitment) are not solved by me working more without additional pay. Consistently working at +30% gives me a pretty good argument against doing more. I think I’m a good team player, but I don’t work for free.

 

[awishingstar]

1) I'm in private practice. I book 6-7 clients a day and see 5-6 on average after cancellations and no-shows. This feels a little high for me personally but I work at a group practice that takes a percentage, so it's a manageable balance between workload and finances.
2) I do an assessment about once a month for fun, but it's not a huge chunk of my income.
3) I try really hard not to have down time at the office - that's a big piece of my work/life balance. Being bored at work is bad for my well-being. If I have cancellations or no-shows I catch up on report writing, paperwork, session prep. If I have a gap with nothing to do (rare), I leave and get a coffee.
4) At least once a month I have a long weekend, either because of a stat holiday or personal/vacation time.
5) They get rescheduled. I don't really take on people with major suicidal tendencies/crises, so it's usually no big. If someone is in a rough spot, I offer to call them as soon as I'm back in the office.
6) I don't check voicemail while out of the office and clients don't have my email address. Clients know they can contact the office admin who can get in touch with me if there's an issue.
7) One-ish.
8) Not as much as I'd like but I blame that on Netflix. Probably 10-15.

 

[Ollie123]

I am really curious about this. Let's say you want to do full-time clinical work (I don't, but I'm curious). If you need to get 6-7/day to make your salary, pay rent, etc. you have to schedule ~9 to get to that, given cancellations, no-shows, etc. But how does that actually work? Are clinicians booking themselves from 9AM to 6PM solid with no lunch, and just assuming that cancellations will allow you time to write notes, return phone calls, and eat? It doesn't seem feasible or ethical to double-book clients for the same time in case one no-shows, given that you can't see both of them if they both show up...

I think the reality is that a lot of this will depend heavily on the nature of the setting. My projection was based on a straight, simple multiplication of the number of clients I would have to seek based on my percent clinical effort. Reality is that it would not work like that. First off, VERY VERY few people are truly 100% clinical. Most have some combination of research, admin or educational effort coverage. It may be 95% clinical, but even that extra 5% buys you some wiggle room. I book 8-6 with a lunch on my clinic days, but am rarely full. Even when I am, notes really aren't a big deal. I'm pretty good at hammering these out in 5-10 minutes. Intake reports take me 30-40 minutes and I'll stay late to hammer them out if need be. My reports aren't the best, but I also have never had anyone express concern about it. I'll spend a little longer if I'm not planning to take the patient myself, but otherwise I think we pretend documentation is more important than it actually is in reality. Vague description of session content, any updates on symptoms, homework and time to follow-up. Done. If it takes more than 5 minutes (barring exceptional circumstances like active suicidality), you are doing something wrong.

I do think this would be very unrealistic for me long-term. If I went primarily clinical, I would likely take interns and practicum students. This completely changes the scenario since I can bill their work in certain circumstances. They earn less (intern) or nothing (practicum student) and I am essentially taking a percentage (though this is all managed through the institution so its not something I directly see). Most heavily clinical people are doing this. Throw in a couple groups, educational seminars and you are hitting your numbers without having to work completely crazy hours. I just don't bother right now because I have such low clinical effort. This may change as I am looking towards launching my own clinic/service down the road. For now, the extra time that would go into managing practicum students, seminars, etc. would be a distraction from my primary activities so I find it easier to just have longer clinic days.

I don't know anyone actually booking 8-6 M-F, let alone filling. I'm still baffled how full-time therapists actually manage to maintain near-full schedules doing outpatient therapy. Someone is inevitably on vacation, cancels because their kid got sick, can only come in biweekly, etc. Unless I'm juggling 16 patients for 8 slots (in which case I would feel like I wasn't able to provide appropriate care for anyone who needed weekly treatment) I find it pretty impossible to see more than 5-6/day for any reasonable stretch of time. Not that its stressful on me - I don't find it particularly draining relative to my research days and am happy when they all show up. Patient flow just never works that day - dips in my caseload always happen when folks are transitioning out, and I can't get someone in off the waitlist right away, etc.

 

[WisNeuro]

2) For assessment practices, you're seeing how many a week? 3-4, and some inpatients, though they are highly variable, some weeks 2-3, some weeks 0
3) What are you doing in the office in your down time? Side research projects for fun, re-learning R, setting up contacts and infrastructure in case I want to go PP
4) How often are you taking a personal day? Maybe once every couple weeks, my schedule is super flexible, so I often just work a little extra on Monday/Tuesday and just don't come in Friday
5) What happens to your caseload when you take a personal day? Sick day? I usually take personal days on open schedule days, but if I am sick when a patient is scheduled, they just get rescheduled as I am the only one of me in the hospital. I'll usually slot them in pretty quick during some open report writing time.
6) How do you handle phone calls while you're gone? Emails? Assistant takes the phone calls, e-mails wait until I get back, I refuse to check work e-mails at home.
7) How many conferences are you going to a year? Usually one, INS is my mainstay, but AACN here and there.
8) Books read a year? Hard to say, I read a lot. Here and there throughout the day, at the gym if I'm doing some biking, and usually an hour before bed.