Pros
- Amazing pay for contract work if you can get past having to pay for your own bennies and taxes.
- The clients i have encountered are great.
Cons
Like many behavioral health companies, the organization has shifted toward metrics-driven performance. Measuring performance is not inherently a problem. My concern is that the metrics have become increasingly disconnected from the quality of clinical care clinicians actually provide.
Previously, clinicians received monthly reports that included both performance data and real-time client feedback. Those reports were valuable because they provided context and actionable information. They helped me identify what was working, make adjustments where needed, and continually improve. Those reports were discontinued under the explanation that the “majority” of clinicians no longer wanted them. In my year with the company, I was never surveyed, and I considered those reports one of the most useful forms of professional feedback.
Recently, I received feedback regarding my session sign-in times and late cancellation percentage. One issue involved signing into sessions after members arrived because I had not been informed that the expectation was to enter the virtual room before the scheduled start time. That is an easy adjustment now that the expectation has been communicated.
My greater concern is how cancellation metrics are calculated and interpreted. During a legitimate medical emergency, I was required to cancel and attempt to reschedule multiple appointments. My reported late cancellation rate reached 33% at its highest across more than 76 scheduled sessions that month. When I reviewed the numbers, I counted 17 appointments that could not be rescheduled within the same week, which appeared to calculate closer to 22%. Regardless of the exact calculation, the numbers seemed unusually high, prompting me to ask whether my emergency room documentation had been shared with Human Resources or whether I should send it myself. I was told the documentation had already been forwarded to the appropriate department. Later, during a discussion about my performance metrics, I reminded them about my emergency and was told it would be documented with HR so leadership would know why my numbers were high this month. That response was confusing because I had previously been assured it had already been submitted. While I understand administrative oversights happen, the experience reinforced my concern that important context may not always be reflected in the metrics being used to evaluate clinician performance.
The reporting system also lacks meaningful context. It does not distinguish between clinician emergencies, client emergencies, technical issues, or other unavoidable circumstances. Everything is grouped together, creating data that may not accurately reflect clinician performance. This is particularly concerning because clients experience legitimate emergencies as well, yet those situations appear to affect clinician metrics in the same way as preventable cancellations.
I was also told that the average clinician’s late cancellation rate is approximately 6%. However, that comparison overlooks an important difference within the workforce. Many clinicians work part time or maintain significantly smaller caseloads. I work full time, maintain a caseload of more than 47 active clients, schedule sessions back to back, and generally take very little time off. Applying identical percentage expectations across fundamentally different workloads creates an uneven standard. The larger the caseload, the more opportunities there are for unavoidable scheduling disruptions, client emergencies, or legitimate clinician emergencies to affect the numbers.
Metrics are only useful when interpreted within the appropriate context. Without accounting for workload, employment status, documented emergencies, or the reasons behind cancellations, the numbers risk becoming misleading rather than informative.
My concern is not accountability. I fully support reasonable performance standards and continuous improvement. My concern is that an overreliance on administrative metrics, without meaningful qualitative feedback, shifts the focus away from clinical excellence and toward chasing numbers. Ironically, the removal of client feedback reports means clinicians now receive less information about the quality of the care they provide while receiving more scrutiny over administrative statistics.
Behavioral health organizations risk losing experienced, dedicated clinicians when they prioritize easily measured metrics over meaningful indicators of patient care. Good clinicians want constructive feedback that helps them become better therapists. Numbers alone cannot accomplish that.
Perhaps most concerning, this experience has left me feeling less comfortable raising legitimate concerns or asking questions. That is unfortunate, because organizations improve when clinicians feel safe to speak openly about processes that could better support both providers and the clients they serve.
