How opening your schedule can firm up your boundaries

There are many benefits to using an EHR, such as Sessions Health, which offers a robust patient portal. But if you are like I was, you may be hesitant to use the self-scheduling feature in your practice. In this article, I’ll share how I overcame my reluctance and the resulting impact of allowing self-scheduling on my work. Spoiler alert: I’ve created increased ease and tighter boundaries by loosening control over my schedule in a few specific ways, which I’ll share with you.

Self-scheduling can help with boundaries

How a client portal helps

As a practice owner and clinician, I absolutely love using an EHR platform that includes a patient portal. For many years, I’ve used the patient portal to streamline form completion and client setup. Allowing clients to e-sign their initial forms and fill out their own demographic information saves me time and has made my office completely paperless. Patient portal messaging provides a secure and HIPAA compliant means of communicating with clients, and avoids the need for additional layers of secured email. But, one patient portal feature I ignored or actively disdained was the option to allow patient self-scheduling.

What, you may wonder, created such a strong reaction from me? One of the benefits of being in private practice, in my opinion, is complete control of my schedule. I was hesitant to open up my schedule and allow clients to schedule at will, as I feared this would leave me with unpredictable hours, holes in the middle of my day, or clients scheduling willy-nilly into time I had blocked off for my own activities.

I probably would have continued on without self scheduling, fielding phone calls and responding to messages back and forth when clients needed to reschedule. The downside to rescheduling via messages is that I might offer client A a handful of options, and then before I hear back from client A, client B contacts me to schedule. This opens the door to a waiting game of how long to hold appointments until client A responds, or potentially creating a free-for-all that could leave client A frustrated when their chosen time is already taken after they respond. These sorts of situations create frustration for clients and clinicians alike, and can make an already emotionally-fraught situation of seeking out counseling during a time of distress even more burdensome.

The limits of not using self-scheduling

However, I was fumbling along scheduling all my own appointments until one of my referral sources moved to client self-scheduling through their platform, integrated with clinician calendars. By not integrating my calendar and allowing for self-scheduling, I was losing out on clients. Seeing a dip in my new referrals and moving into 2023, I knew it was time to move out of the twenty-teens and into the twenty-twenties, give up a little control, and allow for self-scheduling. Fortunately, my EHR, Sessions Health, has had that feature available and I only had to activate it.

Integrating your calendar with other platforms is not as difficult as it may seem. Essentially, the platform to which you are integrating will provide you with instructions and then you will share a specific-to-you code or link that allows cross-platform sharing. I had already shared my Sessions Health calendar with my Google Calendar (blocking client names for security purposes), so it was not that difficult for me to follow the instructions and share my calendar with my referral partner’s software.

In order to share my calendar and open up scheduling in a way that served my clients and my principal clinician and owner (in other words, me), I had to get really clear about my work boundaries. I determined my work days and my start and end time. That wasn’t too difficult to do, but it did allow me to firm up my boundaries and communicate clearly to my clients my availability. Clients appreciate this, as in my initial communications I now clarify my availability and if it is not a good fit for them, then we do not proceed to work together.

The benefits of using self-scheduling for setting better boundaries

Setting hard boundaries around my work day also caused me to focus on how I schedule clients and my ideal work day. When I am handling the scheduling, I can easily look at how many back to back appointments I have and decide where to schedule in an off hour or a lunch break. With self-scheduling, I had to decide what my ideal schedule would be rather than leave it to chance. I decided my preference would be no more than 3 appointments back to back, and that I wanted a lunch break at a specific time each day. I was easily able to set my availability around this, for a maximum number of appointments each day with a break in the middle. The reality is, when I was handling my scheduling, I did not always take a break, leaving me tired and perhaps not as sharp during my end of day appointments. Now I move into my afternoon appointments refreshed from a break, feeling cared for from taking the time to prepare and eat a meal, and eager to meet with my clients as opposed to tired and watching the clock.

Sure enough, when I integrated my calendar and allowed my referral partner to self-schedule, my caseload quickly recovered. I also found that my pre-existing clients would make use of the self scheduling feature if they needed to cancel and/or reschedule appointments, saving me the time and back and forth. I am always asked by the software to confirm my availability for an appointment, so if I was in fact not available at the requested time, I could let my client know this and offer other options. By taking the bulk of the control away from me as “the gatekeeper,” I give clients agency to manage their appointment requests. As a result, I have supported growth of a positive therapeutic relationship.

By only allowing appointment scheduling during the hours I want to work and in a manner that fits my needs as a provider, I have been happy with how my schedule works out. However, I’ve learned a few work arounds to continue to have more control over my time. On a week where one or two work days are stacking up as busy but other days are light, I will do one of two things. I may decide I’d rather have one light day and other busy days, in which case I’ll block off time on the light day as unavailable, just scheduling a “non client” appointment (I call it “block” and designate a color for it so I can see it easily on my calendar). Or, I may wish to block any remaining open times on my busy days in the same manner, essentially forcing any yet-to-schedule clients to pick from openings on my light day.

While I was reluctant to integrate my calendar and allow self-scheduling, I’ve found this to be a boon to my business and an easy way to maintain boundaries, practice self-care, and eliminate some tedious administrative scheduling tasks. From the client standpoint, I’ve provided them with more agency and autonomy, supporting our therapeutic relationship. I’m curious… Do you allow self scheduling? Why or why not? What questions do you have? We’ve been chatting about this in my facebook group, Intentional Private Practice–Community, and I’d love for you to join the conversation!

About the author: Dr. Kimberly Dwyer is a licensed psychologist, private practice business coach and consultant, and author. She practices in Denver, Colorado, and via telehealth in all PsyPact states. Learn more and access free practice building materials at www.drkimdwyer.com.