A few years back, when I first started in the eating disorder field, I was copied on an email regarding the financial discharge of a highly acute adolescent patient. I asked what “financial discharge” meant because I wanted to have an open discussion with the employees. It seems the young girl was very sick but was denied extended inpatient care by the insurance company. I asked what the doctor thought she needed. The doctor said she would probably die without at least 90 days of inpatient treatment. The insurance company denied care after 30 days.

This situation highlighted a troubling myth in healthcare: that doctors can treat in-network patients as they see fit and get paid for it. At Mindful Health Solutions, we often deal with major depressive disorder, a serious condition that can lead to tragic consequences without proper intervention.

So, what’s the solution when a critically ill patient is denied the care they not only need but deserve? At Mindful Health Solutions, we let doctors do what they’re trained to do. We don’t believe the limits of care should be defined by insurance companies.

Our VIP Program

Within our insurance billing framework, there’s a unique category named “VIP.” This comes into play when, say, a patient’s condition hasn’t improved with medication, and our provider believes Transcranial Magnetic Stimulation (TMS) is the answer, but their insurance won’t cover it. TMS, which involves 36 treatments, is then provided at no cost under VIP status.

But why call it VIP? Because at Mindful Health Solutions, every patient is invaluable. By designating them as VIPs, we not only provide them with the care they need but also affirm their importance and dignity. They can walk through our doors, proudly say, “I am a VIP,” and know they will receive the best possible treatment. It’s a testament to our philosophy that every patient deserves to feel valued and significant.

The nomination process to the VIP program is simple. The provider reaches out with the patient’s story, firmly believing that TMS is the right call. Even when insurance says no, our commitment to patient care says yes. And we’ve never turned down such a request. We just can’t.

VIP status is more than a label; it’s a lifeline. It’s granted based on the provider’s conviction that TMS will significantly benefit the patient. Despite insurance denials, our commitment to our patients’ well-being means we never refuse such treatment. We simply don’t know how to say no when it comes to saving lives.

The Impact of Our VIP Program

The impact of this approach is not just anecdotal; it’s measurable. Our VIP patients have shown an average decrease of 5.13 on the PHQ-9 scale, a significant shift from severe to moderate depression.

In the past year alone, we’ve seen remarkable outcomes in 43 patients under this initiative. While 43 may seem a small number, it represents 43 lives profoundly changed lives that would have suffered without our intervention. Among these, 31 patients improved by more than 50%, and 8 achieved total remission.

Patients Come First

At Mindful Health Solutions, our value is clear: patient needs come first. Our story isn’t just about healthcare. It’s about hope, healing, and the relentless pursuit of giving patients the care they deserve, regardless of insurance coverage. As we reflect on this during the holiday season, it’s a reminder of the profound impact compassionate, patient-centered care can have.

And the young girl from the beginning? She became the first VIP patient. She received the comprehensive care she needed, defying the odds and beginning her journey to recovery. Her story is a testament to what can be achieved when care is driven by compassion and conviction, rather than financial considerations. It’s a powerful reminder of why we do what we do in healthcare.

As a psychiatrist, you have the power to not only help your patients feel better today, but to shape the behavioral health care field of tomorrow. The next decade promises a revolution in how we approach mental health from a fragmented to an integrated care model. Mindful Health Solutions is leading the charge, offering cohesive care coordination, comprehensive services, patient-centered care, and preventative measures for improved long-term outcomes. Read on to discover how you can drive the mental health field forward at Mindful Health Solutions while being empowered as a psychiatrist.

Leading the Way in Integrated Behavioral Health Care

At Mindful Health Solutions, we take pride in being leaders in integrated behavioral health care. Our comprehensive treatment model solves the most pressing challenges faced by physicians who treat patients with major depressive disorder. Medication management is often the starting point, but not always the solution. We specialize in providing integrated care through cutting-edge interventional treatment protocols such as TMS, Esketamine, and IV Ketamine, effectively addressing major depressive disorder and other psychiatric illnesses. Join us at the forefront of mental health advancement and provide your patients with treatments that truly work.

Combining Experience with Innovation

We provide the resources and support to propel your career forward and make a lasting impact on the well-being of your patients. Our rich history of pioneering interventional psychiatry, including founding one of the first TMS-focused clinics in the United States and establishing clinics for Esketamine and IV Ketamine therapies, positions you at the forefront of mental health care innovation.

Drawing from our extensive experience and analysis, we have gained valuable insights into what works, what doesn’t, and what’s missing to provide personalized and evidence-based mental health care. With one of the largest E&M, TMS, and Esketamine clinical outcome data repositories in the world, we continually customize and expand our services to better meet the needs of our patients. As you explore the potential of psychedelic therapies, you can leverage our clinical outcomes repository to develop predictive algorithms that advise on the best possible treatment modalities.

Access to Thought Leaders and Academic Rigor

You’ll learn from and become one of the true thought leaders in the field. Our experts bring academic rigor and years of experience with novel therapeutics to an integrated treatment strategy. Enjoy the company of talented, motivated, and highly experienced colleagues with a passion for lifelong learning. Together, we cultivate a culture of creativity and collaboration that encourages thinking outside the box. You will work with other clinicians to actively research new therapies, new paths for patient education, and new ways to make our practice and services more effective.

Collaboration and Learning Opportunities

When you begin your journey at Mindful Health Solutions, you will undergo a month-long training program at our comprehensive onsite training facility in Mission Viejo, California. This program is led by leading experts in interventional psychiatry, and upon completion of the training, you will be certified to deliver TMS treatment.

Additionally, you will have the opportunity to participate in our advanced clinical trial program, collaborating with influential research institutions to validate the effectiveness of emerging psychedelic treatments. Clinical trials are a crucial step in bringing new treatment options to people worldwide, and you can actively contribute to this important work.

We understand that administrative responsibilities can be burdensome for physicians. We have built an operational infrastructure that relieves you from administrative tasks related to insurance, scheduling, billing, and more. Our fully integrated platform is designed with physicians in mind, providing a patient-centric experience while delivering evidence-based outcomes. By joining our team, you can focus on what matters most: providing exceptional care for your patients.

Purpose, Culture, and Growth

Our purpose is to transform suffering so that every person can live a joyful life. You will thrive in a culture of growth, respect, and passion. We value your expertise and dedication to helping us remain at the leading edge of behavioral health. Become part of one of the most professional, diverse, and reputable teams in the field, with unlimited opportunities for personal and professional development.

With 27 outpatient clinics across California, Georgia, Texas, and Washington, we are rapidly expanding our precision medicine platform into new markets. You will be part of a vibrant growth story, working closely with an experienced clinical leadership team that has a proven track record of implementing innovative treatment protocols supported by positive outcome data.

Join Our Team and Shape the Future

On behalf of Mindful Health Solutions, I invite you to join our team and contribute to the future of behavioral health care. Bring your ideas, ingenuity, and determination to make a significant difference in the lives of countless individuals struggling with mental health conditions. Together, we can transform the field of psychiatry and help people achieve lasting well-being.

To explore career opportunities and learn more about Mindful Health Solutions, visit our Careers site or contact us at careers@mindfulhealthsolutions.com. We look forward to welcoming you to our team and embarking on this transformative journey together.

In the service business, our assets are our people. At the end of every day, our people leave the building or log off and return to their lives. After they leave, they make a conscious effort to return to work every single day. We, as a company, must ensure our employees choose Mindful Health Solutions every single day. And as CEO, it is my responsibility to prioritize the employee experience within the company. 

The Common Employee Experience Problem  

The first step in most hiring processes is to hire employees who fit the company culture. However, for an employee to succeed, they need to be trained. Unfortunately, newly hired employees are often thrown into a job with little to no training for the duties they are expected to perform. They are told to read up on the SOPs on the shared drive when they have a question. What does that even mean? SOPs and shared drives. That is not training. Soon, the company and the employee become frustrated. People leave, new people are hired, and the cycle continues.   

As basic as it sounds, in large or growing service companies, this hiring cycle is what happens. While the CEO is focused on strategy, growth, and market position, he is not focused on the employee experience. And if he is not focused on employee experience, the rest of the company won’t be either. Sure, human resources will be, but both training and managing expectations daily require hard work and won’t happen by accident.   

The Mindful Health Solutions Employee Experience  

While understanding this common employee experience problem that other companies face, our goal is to train all our employees through a formal onboarding and training program. This program gives all our new employees the knowledge and tools to succeed. Also, we hold our managers accountable for constant and appropriate training at every level.   

I don’t believe a company can grow without a strong focus on training. Luckily, we have the best HR executive in the industry, Debbi Miranda, MSOD, SPHR, so we can focus on training and improving our operational experience. We still have a few more initiatives to roll out, but over the next few months, we will have a very robust and well-defined training program for all our employees.  

Fostering Motivation to Maintain Momentum  

Every company needs momentum to grow. However, momentum, by its very definition, dies unless you continue to exert force. The force required for a company to maintain momentum is employee motivation. It is important that all employees must experience this motivation, not just some.  

On my first day as CEO, I assembled a group of employees whose sole focus is to help improve the employee experience, enhance communication (both ways), and ensure we are fostering the motivation (and thus the momentum) needed for growth. We still meet every two weeks, and they teach me how to be a better CEO by understanding the employee perspective. I look forward to these meetings because we are all working to improve the company in fun and innovative ways. Through various initiatives and events, we work to foster connections among all employees.  

Employees understand that these initiatives are coming straight from the CEO. My expectation is for employees to participate and have fun. Leading initiatives and events such as these show employees that I prioritize their experience. And when employees feel that they are being prioritized, they maintain motivation.   

Keeping an Open Door  

Finally, I feel it’s important that everyone in the company understands our plans and has a voice. To create this transparency and allow employees a chance to speak their minds, I hold “open Zoom” meetings where everyone has an opportunity to talk with me directly. In these meetings, anyone can join and speak with me about concerns or issues they might have. To be honest, I really enjoy my time at these meetings. It’s great to see how engaged people are, how concerned they are about patients, how they think about problems, and how they want to improve.   

Learn how we foster a “Patients First” mentality at Mindful Health Solutions.

Overall, for our employees to have a great experience and want to continue working at Mindful Health Solutions, we must work hard to ensure we have an environment for success. However, a simple solution does not exist. As CEO, I must work to always listen and invest in our employees, and our executives, supervisors, and managers are all encouraged to do the same. For without our employees, our assets, we will never be able to achieve our mission of transforming suffering so every person can live a joyful life.   

Growing a healthcare business, or any business for that matter, requires processes that can scale. As you grow your business, the need for accurate, timely, and actionable data is the main ingredient for success. On the flip side is the lack of accurate and timely data, which becomes the main ingredient of failure.   

What slows down company scaling and growth?  

There are many software solutions available on the market for almost every problem or process. Some companies take the path of building their own solution. However, the implementation of either an out-of-the-box or internal solution takes time. A lot of time. It involves committees, selection, training, and implementation. As people are always trying to solve too many problems at once, scope creep becomes a major concern. Meanwhile, in the absence of a solution, spreadsheets proliferate.   

The use of spreadsheets is not a process, or at least it’s not a real process. Huge spreadsheets with dozens of tabs are not manageable. Trying to control spreadsheets through emails or shared drives allows for errors and there is no data integrity. Between emailing different versions and people not updating the data, they create an extremely limited value. From a compliance perspective, there is no ability to audit or track changes. (The most impactful change that came out of SOX, in my opinion, was the push away from spreadsheets due to the lack of controls.) Ultimately, spreadsheets do not allow for organizational scale. 

How can you still grow your business while scaling at the same time?  

For companies to scale while still growing fast, it is best to use a phased software development approach, which allows for gradual rollout without disrupting operations. With this phased approach, you work backward from the concept of what a total solution would look like and build the most important and/or simplest functions first. Most importantly, you can adjust almost anything along the way. By doing so, you can build basic functionality while solving major constraints.  

It is important to note that working backward helps create highly focused solutions that solve one problem at a time. Additionally, it is important to have very few stakeholders while working with this approach. Both working backward and having few stakeholders help to prevent scope creep as you work toward a solution, allowing your business to grow and scale continually.  

How does Mindful Health Solutions use this phased approach?  

At Mindful Health Solutions, we have several solutions that have been extremely impactful to the business. All of them replaced spreadsheets and allow for limitless scale. Each also solved a single problem and was designed and implemented within weeks.   

Learn about how we track patient outcome data to improve the patient experience.

Clickcredential.com   

In healthcare, credentialing is a constraint to revenue growth and profit. If a company does not credential correctly, so many other things go wrong downstream. We built a solution in phases.   

The goal of Phase I was to allow providers to create an account and upload all the information needed to start the credentialing process. That is all it did; gather all the information in one location. It let us know what percentage of information each provider had uploaded. If we needed to, we would move the start date based on how responsive the providers were. Everyone involved could see it: the provider, HR manager, recruiter, and credentialing department. No spreadsheets needed.   

We cut the time to credential in half with this simple first phase. A year later, we now have a fully functional credentialing solution that we built out with following phases. During this process, we did not have to sacrifice speed, and there was little to no transition time.   

Clicklocate.com  

Another spreadsheet process for most healthcare companies is one used by the intake or call center to know what providers are credentialed with what insurance at what location. Our old process was to spend half a day on Mondays updating a spreadsheet on the shared drive. Then, all intake personnel would search through this spreadsheet while on the phone with a patient. This process might work with 10 providers, but definitely not 100, or 1000.   

We built a solution for this in a matter of weeks. Since all the information resides in the credentialing software, we just created a simple search page that the whole of the intake team could access. What used to take two minutes (give or take) per call now takes seconds. When your company handles thousands of calls a week, a simple solution like this is invaluable. After creating the search page in Phase I, we added other functions like open panels and specialties.   

Clickprepare.com  

Another issue facing fast-growing healthcare companies is onboarding providers. When we onboard a provider, there are over 80 tasks involving 11 different departments. How was this handled? With spreadsheets on the shared drive.    

We were able to produce a Phase I solution in less than two weeks. We simply enter a start date, and each task is then automatically given a countdown due date. We meet weekly for 10 minutes to review. The result of this solution is that we can now onboard 15 new providers a month with no issues and no spreadsheets needed. We now do the same when hiring new therapists and opening new clinic locations. Everything scales and no spreadsheets are ever used.   

For us to help as many patients as possible, we must scale, and we must grow. Creating highly focused solutions while working backward through a phased approach has proven successful for us. We are continually admitting new patients, hiring new providers, and opening new clinic locations, all thanks to this effective process and, best of all, zero spreadsheets. I hope these insights help you to quickly yet efficiently scale and grow your business.

Mindful Health Solutions is an evidence-based practice. Clinically, offering evidence-based care differentiates us from many of the other larger practices in the United States. There are many factors that go into being an evidence-based clinical practice, but today we are going to discuss only one aspect: tracking patients’ outcome data with their depression and anxiety scores.

How we collect patient outcome data

Over the years, Mindful Health Solutions has had tens of thousands of patient visits. Almost every time a patient visit occurs, they complete a PHQ-9 and a GAD-7. The PHQ-9 is a depression score. The GAD-7 tracks general anxiety. Because of this structure, we have tens of thousands of clinical outcome data spanning years of treatment. The data is anonymized but still tied to a medical record number so we can track how well a patient is improving over time with various courses of treatment.   

Capturing this data is extremely powerful for our psychiatrists and their patients. Individually, that data is important to help each provider track the outcome of their patients. But we have gone a step further. Over the past year, we integrated business intelligence tools and now have the ability to see the outcomes of the total patient population. As a result, we can see what is and is not working when fighting depression and anxiety.

Understanding patient outcomes is especially important for interventional psychiatry as we can track a cohort of patients who have been diagnosed with treatment-resistant depression (TRD) and how they respond to medications, transcranial magnetic stimulation (TMS), and esketamine. We can also look at the data by insurance payor, treatment code, age, gender, and several other factors.

What the data tells us

First, it is amazing and heartwarming to see our improved patient outcomes. We have had patients that have gone through many types of medication over a long time and are still very depressed. Then, when TMS was prescribed to those patients, a majority of them not only responded, but responded well. For those patients who did not respond well, we prescribed esketamine. After being prescribed esketamine, most of those patients responded well.   

All this information is great to see, and we can see it all directly in the data. We have changed thousands of lives, and we have the evidence to prove it. Internally, the data is a great reminder of our mission. We are here to help people, and it is powerful to see how we are doing that.   

Let us look at an example of this data. In the example below, this patient came to us with a high depression score of 24. After a course of TMS, the patient has a score of 3. These results are life-changing! Now, add a few thousand more patients like this, and you will understand how excited we are to continue to grow and expand our access to care.  

We have the most comprehensive collection of depression and anxiety data in the world. And now, we have the tools to empower our psychiatrists to review, research, and publish so we can help other doctors improve the lives of their own patients. We look forward to sharing what we know about interventional psychiatry with others in the field to make as positive an impact on mental health care as we can. 

Mindful Health Solutions has been establishing clinics and care throughout California since 2007. Now, we are growing. However, balancing growth while not only maintaining the same level of care but improving it, is a delicate task. So, as we look to expand our mental health care to other states, it’s helpful to understand my view of opening clinics outside of California. 

My experience with expansion

During my first five years as a public accountant, more than 80% of our clients were based in Europe. While traveling back and forth between European countries, a lot of my time was spent on international tax, audit, and currency issues. For the next five years, I worked for a public company and spent most of my time in Southeast Asia and Europe.  

Because of this international experience, operating in a different state within the same country does not have the same meaning to me as it might to other executives. When first discussing moving into Texas, I considered that the language and currency are the same. Also, the time difference is not 6 to 12 hours, and, most importantly, the food is the same. Some might consider that there are cultural differences, but they are not nearly as significant as those between different countries. From a business and operational perspective, state lines are just not material. Therefore, when we started discussing moving outside of California, I did not shy away from the idea of expansion.  

Why are we expanding into new states? 

Ultimately, we are expanding into new states because there is an enormous need for mental health care in the United States. The need far outpaces the availability for patients to receive great in-network care. And unlike many other practices, we offer psychiatric services, psycotherapy , and interventional psychiatry all under one roof. In contrast, some practices are 100% virtual, don’t accept insurance, and they sure don’t have physical locations where patients can meet with their providers.

As we grow and create more access to care, we want to make investments in the community and build clinics. By doing so, our patients have the opportunity to meet with their providers. We could be more like some of those other practices. We could just hire part-time providers, license them in various states, and market to the world that we are a national healthcare company. However, we don’t think that is a long-term viable solution to the mental health issues facing our country. Instead, we are focused on the patient experience. And the patient experience is improved when given patients are given a local, physical clinic where they can be seen, helped, and treated in person.

How are we growing sustainably?

When expanding into new states, we first want to gain “regional density.” This simply means that rather than opening locations that are spread out around the US, we want to expand near or close to our existing operations. Washington state and Texas are both on the west coast and close enough to California to be considered regional.  

Georgia is nowhere near California, so why Georgia? We happen to have a few people on the operational team who live in Georgia, including me. We thought this would be a great chance to grow the business in such a way that our own community would benefit. So, we are now open in Houston, Texas, Seattle, and Washington, and we have three more locations opening in Washington, Texas, and Georgia in Q1 of 2023.

Are we going to continue to add new states? 

Right now, it is not in our growth plans to continue to enter more states. The Southern California, Texas, Georgia, and Washington markets are large enough to keep us busy for a few years. Just because we can enter other markets does not mean we should do it as fast as we did in 2022. We feel remaining focused on growth within our current states and building regional density is in line with our mission of offering excellent care while increasing access.  

What is the impact on the patient experience and quality of care? 

Both patient experience and quality of care are our highest priorities. After every visit, our patients receive a survey so they can tell us how we are doing. The surveys have 20 questions and provide us with a Net Promoter Score (NPS). We monitor this score and listen to what our patients are telling us. We have a department whose only function is to review all surveys. They read all comments and work with operations to improve the patient experience and the company. If a patient has a negative experience, they are immediately called, and we work to improve and correct any issues.  

Our requirement as we grow as a company, no matter the geographic location, is that our NPS must always be improving, and it is. We refuse to grow the company if we cannot, at the same time, improve the patient experience for everyone. Our plan is to be the best innovative behavioral health services company in the country. While I think we already are, I hope to make others think the same as we continue to sustainably grow our care and provide our expert mental health services throughout the United States.