Occam’s Oyster

The oyster has an amazing evolutionary trick.  When a microscopic particle of something or other gets into its soft tissue, it creates over time layer upon layer of nacre, a substance which creates a pearl.  What began as an irritant can go on to become a very valuable object.

You are not an oyster.

If something irritates you, you don’t always need to be stuck with it.  And although I am a big fan of the cognitive reframe, to use it all the time overlooks that you can often resolve whatever is irritating you by removing it.

Case in point, for the past several years I have used a billing service.  They’re great, but there has been something about the process of my patient intakes that irritates me.  I have patients fill out an intake form, which they bring in to me.  At the same time the billing office has a face sheet they use as well, but they need some information that is not on the face sheet but is on my intake form.

So for the past several years the patient will download my form off the site, fill it out and bring it in to me.  I then have to scan the form and fax it to my billing office.  To make things more complicated I have several computers and a scanner at home as well as an iPad.  You’d think this would make things easy, but I can not seem to get them all to talk to each other the right way to scan something and email it in under 30 minutes.  One laptop doesn’t get recognized by the wireless network.  The iPad can scan the form but not email it.  This has been going on for years, and I had grown accustomed  to the irritation as I tried putting on layer after layer of “solutions.”  I’d put off scanning the forms until my office asked me for them, which made their work harder, and payments from insurance choppy.

Then it hit me that I am not an oyster.  Whenever this irritation came up I had been so focused on trying to make things go more easily, that I had never really taken a few minutes to think about how to make this problem go away.  The answer in this case was simple.  Instead of having my patients email the form to me, my introductory email to them can instruct them to email or fax it to the office directly.  They need regular access to it, and I don’t.  They have all of my other administrative paperwork which they keep all safe and secure, so it is actually far easier to have them keep it since they are doing all the billing.  I rarely use that initial paperwork, and I’ll always know where it is.

I offer this as a nuts and bolts example of how your therapy practice needs to be evaluated periodically.  The whole craziness above is a vestige of when I was doing all of my billing, and something I now realize I was not ready to let go of.  And so I just got used to the irritant, ignored it, and hoped it would go away or become less irritating.

We therapists take more irritation for granted than is necessary in our business.  We each have a different version of layering on the nacre.  One of mine is constantly adding new gadgets and trying to find ways to make work easier, rather than making it go away entirely.  I used to spend hours learning the intricacies of a billing software and calling insurance companies, and then I realized I wanted to get rid of the irritation.  I researched different services, and finally decided on one which cost a little more, but did a lot more for me.  Now I give them 9% of my fee, and in return they keep me credentialed with the insurances I take, send out statements, answer questions from patients and submit all my claims electronically to insurances.  Not only do they trap more of my revenue because they can focus on it with more expertise than I, they save me valuable time.

I didn’t value my time as much when I started out, and I am glad I changed that, because I know I wouldn’t have had the time or energy to write a regular blog, do speaking engagements, or write my book this year if I had been chewing on all that paperwork.

So why does it often take us so long to fix systemic problems like this in our practices, or our lives for that matter?  I would suggest that the answer is that we don’t value thinking.

I know, sounds crazy on the surface, therapists don’t value thinking?  Thinking and thinking about thinking is a big part of our profession.  But when was the last time you allotted yourself time specifically to think on something.  By that I mean dedicated time where you think through something single-mindedly, not answering emails, talking on the phone, watching television, etc.  Most people I coach can’t remember the last time they did that, in fact our coaching appointments are often the closest they come to it.

You don’t have to schedule a specific “thinking time” in your day, although you can certainly do that if it works for you.  But in the case above I didn’t do that.  Instead I noticed I was getting irritated for the umpteenth time and said to myself, “Ok, stop EVERYTHING, how can I make this irritation go away?”  Within a relatively short time of dedicated thinking I identified what the system was, what the problem was, and what the new system would need to be to make the form nightmare go away.  Not get less irritating, not more tolerable, but gone.

Look, I’m not saying that everything in life that irritates you can be removed, or even that that would be a good thing.  I’m just saying don’t settle for mitigating damage before you’ve tried making the problem disappear.  Ask yourself, “am I layering nacre over and over?  Is that the best I can strive for?”

Then ask yourself, “am I making time to think, and am I thinking about the things I want to think about when I do?”  Sure there are lots of times when you run a business that you’ll need to think about stuff you’d rather not think about; but if that’s how you’re spending the majority of your time then maybe you’re running the wrong business.

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