What University Didn't Teach You: Real-World Skills Clinicians Need To Succeed

DAMIEN:

Hello everyone, and welcome to our new format of what used to be Zanda Talks and is now Health Practice Buzz. Today's topic is one I'm very excited to bring you: what university didn't teach you, or if you happen to be in the States, what college perhaps didn't teach you. Real-world skills that clinicians need to succeed. And I'm very pleased to have special guest Amanda with us today.

If you're not familiar with me, my name is Damien Adler. I'm one of the co-founders here at Zanda and a registered psychologist. Zanda began with that very traditional story: my wife is also a psychologist, we had a private practice, we wanted to grow it, and of course there wasn't any practice management software that really did the trick. So, very long story short, we co-founded Zanda with my brother Paul, and that was 14 or 15 years ago. That's how it all began. Amanda, I might throw to you to introduce yourself and explain why this topic is important to you.

AMANDA:

Thanks so much for having me. I'm Amanda Moses, also a psychologist. I run Amanda Moses Psychology, a business focused on training, historically supervision, and clinical resources and tools for psychologists and allied health professionals.

This topic is one I'm quite passionate about. A lot of my work started with predominantly early-career psychologists. Now I work with psychologists across every career stage, but to start with I was working mostly with early-career and provisional psychologists, and it was so obvious through the supervision and training I was doing that there was a real gap between what we tend to learn at university, the theory and textbook material, and the skills we actually need in the real world to practise as clinicians day to day. There's that gap between theory and practice.

DAMIEN:

Absolutely, and we're totally aligned on this topic. It leads to a whole lot of other problems, which we'll talk about as we go through.

I wanted to say to our non-psychologists: today we have two psychologists talking to each other, but the lessons we're covering are applicable well beyond psychology. We've observed the same pattern across health around the world. Zanda operates globally, and it doesn't matter who I'm talking to, anywhere in the world, in any profession, it really is the same experience. So even though some of our examples will be about psychology, they're examples you can think about in terms of your own career, because this really does cover everything.

Let's have a quick look at what we'll be covering today. We're looking at the gap between training and the real world. The hidden admin load in assessments and the significant impact that can have. The difference between system problems and clinician problems, which I know you're really strong on as well, and which is actually one of the founding beliefs behind Zanda: trying to deal with system issues. What a better structure looks like, what works, some practical tips, and we'll finish with resources if you'd like more information, including on the wonderful work Amanda does.

So let's dive in. When we talk about this gap, nobody warns you about it when you graduate. Amanda, before you graduated, what came as a surprise to you? We'll compare notes.

AMANDA:

Honestly, just how tedious the admin work can feel. That's one thing I think everyone is shocked by when they first start practising. And that's on top of the heavy load of the work itself. We do quite complex work, it can be emotionally taxing and emotionally heavy, so there's that element as well.

I remember some really brief talks about self-care and self-management at university, but I don't think it was ever a big focus. I don't think it was talked about often enough: how do we manage ourselves as psychologists, not just from an admin perspective but psychologically, in our own wellbeing. That's definitely something that gets glazed over in training.

DAMIEN:

I'd agree. I also think universities tend to prepare people for the next step, which makes sense. They're preparing you for a junior or early-career role. But as someone gains more clinical experience and naturally evolves into a private practice context, there's no trigger that says, hang on, we've never actually trained people for this. As a profession, I think we expect people to pick up those skills along the way, and that leads to people saying things like "I'm not a business person."

Sometimes there's almost an inverse relationship. Not always, there are people who have both skill sets, but sometimes some of the most amazing psychologists are the ones who struggle most with the administrative load. So you get this real contrast, and I don't think there's enough warning about it.

I used to do some guest lecturing at universities, and it was interesting that the students, normally towards the end of their training, were really interested in private practice experiences. I realised it just wasn't being covered. The reality of the day-to-day isn't there. So there's a gap.

I think the way we'd frame this is that it's a structural problem, not a personal failing. That distinction really matters. Training to be a competent therapist is what universities are set up for, and I understand that from their point of view, because they have requirements to make sure graduates have certain clinical skills. But underneath that waterline there's how to actually operate a practice, and it's important people understand that a lot of this simply is not taught. If you were to list your top few things that aren't taught and come back to bite people, what would they be?

AMANDA:

It's hard, because a lot of us end up in quite different work. Psychology is so broad, and that's one of the things I love about it. Some people go into private practice, some go into public health roles, others use their skills in different ways.

But where we're talking about operating a business, if you're someone who wants to run a private practice as a psychologist, it really does feel like a separate skill set. Understandably it's not something we're taught within a psychology degree, because it's not a business degree. That's what can make it hard. It's not that we're not competent in the job we're doing, it's that the systems around it, the admin around it, the realities of running a business, aren't our natural skill set and we're having to adapt and learn as we go.

I have colleagues and friends who own big private practices and group practices, and many of them complain about the same kinds of things. They love the work, but a lot of it feels like not quite the work of a psychologist. It's business work they were never taught, so they're having to learn a whole new skill set in order to run a business as a psychologist.

DAMIEN:

I'd agree, and it's interesting when you have these conversations. I'm saying psychologists as an example, but we have these conversations across all allied health.

Some people assume the hardest part is the interpersonal element, the therapy, how heavily you carry things, hearing about people's health problems. As we said at the start, those are legitimate things that weigh on people. But I often find when talking to allied health practitioners that it's not actually what's making them most stressed. It's the notes they haven't done. It's the reports that are overdue. If they own a practice, it's the mechanics of organising payroll, or a change to a law or an ethics guideline that now has implications. It's all the things occurring around the therapy or the intervention.

If you took a snapshot in a moment in time and asked what someone is very stressed about right now, it's often not the client who's having a really difficult time and is living in your head a little. It's "I've got to deal with this," or "I've got a team member I need to talk to about something sensitive." It's those structural things. It is universal.

Let's look at an example around assessments, and we'll use autism and ADHD assessments. I'll throw to you, because it's a good example of where perceptions and estimations versus reality come apart a little. Do you want to walk us through this hidden admin load and what it looks like?

AMANDA:

Anyone who does diagnostic assessments will probably have very similar feelings. Apart from Amanda Moses Psychology, I also have a clinical practice where I offer diagnostic assessments of autism and ADHD, and I've been doing diagnostic assessments for pretty much all of my career, so the last 12 to 14 years.

I can say fairly confidently that most people I speak to, including myself, will say the assessment work is actually great. It can even be fun. It's interesting, it's good work, it's stimulating. The assessment itself is great. It's the report writing we all hate, because it takes so long.

For me, I'm very much a person who needs a system. I need a procedure, I need things set up, or my brain just can't function. So when I started doing this more independently I created my own systems: intakes, intake questionnaires, report templates. Everything took me a lot of time to put together, but once it was done I had this nicely scaffolded template I could come back to and customise for the individual client. It gave me so much time back.

When I'm training clinicians in diagnostic assessments, part of what I try to do is fill that gap we've spoken about. I include a small component on the business and admin side: let's talk about the assessment process from start to finish, how you should organise and structure it to reduce and manage that overwhelm, what your intake process should look like, what screeners or tools to use, how you're going to set up your report.

It was interesting to me that a lot of psychologists coming into this and wanting to build assessment skills say, I know how to write a report because we get taught it very briefly at uni, but I don't know how to write a report of this depth. What's the structure meant to be? How much, or how little?

DAMIEN:

And for a lot of people the report ends up being what, 75 to 80 per cent of the work?

AMANDA:

The assessment might take between three and five hours, and then the report and the admin around it can be anywhere up to 15 hours.

Because I'd created my own, I had a lot of clinicians I was supervising and training saying, could you please create something we could use, I would happily pay for it because I don't want to do this. So it came really from demand. I ended up creating diagnostic report templates and structured intake questionnaires to help guide the diagnostic process, and people have responded so well, purely because it's evidence-based and it saves them a heck of a lot of time and energy.

When you're doing complex work like assessments, or even therapy, having those procedures and systems in place, where your template is sorted or you have a certain structure to how you approach something, ultimately removes that burden from you and alleviates some of that stress.

DAMIEN:

Absolutely. We sometimes talk about it as "once-a-fy" things. If you have to write a report and you think you'll ever need to write a similar report again, turn that report into a template so you can modify and reuse it over and over. Then once-a-fy everything else you possibly can, whether it's letters or employment correspondence. If you're recruiting, that's the correspondence for new applicants, acceptance letters, rejection letters, everything.

Do that rather than spend the brainpower reinventing the wheel, having to think or go back and find what you said last time when you had to reject 50 or 100 applicants for an admin job. By templating and once-a-fying, you remove a lot of that extra work.

AMANDA:

I'd say the same even for your basic day-to-day therapy notes, particularly now with our code of conduct for psychologists. We had that big overhaul in December, and a lot of psychologists I'm speaking to are saying, I don't know what this means for my record keeping.

Even if you could create something structured for yourself that you know is compliant by the standards, and the same goes for any allied health professional because we all have a code we need to abide by in how we keep records, having that and making sure it's AHPRA compliant and covering all the key points ultimately saves you time and energy. That's something you could do on a smaller scale, just for your day-to-day work.

DAMIEN:

Absolutely, and that ties nicely into creating good workflows. A point I make on this one is about using templates in a team that has a mix of people, from early-career professionals through to quite experienced ones.

One reaction when we start to introduce templates, if it isn't handled well, is the perception that we're going to turn this into a McDonald's practice, where everything is done exactly the same way and it takes away the individuality of the practitioner. It's important to make the distinction that having consistency in approach, and having standards that by default mean compliance with regulations or report requirements, doesn't take the individuality out of it and doesn't mean there's no room for flexibility where that's indicated or desired.

It's usually practitioners with a lot of experience under their belt who feel like they don't need any of that, without necessarily recognising the amount of inefficiency built into what they're actually doing. So if you're introducing this to a team, having the team involved in developing the templates matters, and so does the way it's framed.

Each clinician has what we informally call their superpower. There are things about them they just do really well, that are unique and not replaceable, even hard to replicate. This isn't about taking away their superpowers or making things cookie cutter. It's about having that structure without forcing it in a way that feels unnatural.

When we think about inefficient workflows, these are design problems. Without templates, clinicians are making way too many decisions from scratch every time. The cost, whether that's admin or clinical time being used, is huge and often isn't surfaced. It stays under the radar, or it pops up in other ways we'll talk about in a second.

A good system doesn't constrain, it frees clinicians up to spend more time in the moment with the client, with freed-up headspace to be present, rather than being distracted by the work they know they're behind on or the things yet to come. Like you say, the assessment work itself can be quite enjoyable. It's the write-up that's hard.

AMANDA:

I just think of it as the scaffolding. It's not trying to create a one-size-fits-all approach. We're creating a scaffolding that gives the clinician the bounds of what actually needs to be documented. As health professionals, we know we should never copy and paste the same content for every single client into a report. We all know that.

Templates and streamlining your process aren't about that. They're about making it more efficient, giving you scaffolding and structure around what can feel like a very overwhelming process.

DAMIEN:

Absolutely. The other thing we found when we were running our private practice was that where we were interacting with referral sources or people receiving the reports, because we had consistent structures for everything, whether letters or reports, they almost developed muscle memory. They knew a report from us would be structured a certain way, and if they needed to find something quickly they wouldn't have to wade through lots of text. There's always a heading called that, which has this: the recommendations, the functional impairment, whatever it might be.

Sometimes I'd be talking to referrers informally at an event and they'd make comments along those lines, that they just found it easier dealing with us. It took me a little while to understand what they really meant.

One brief point that just popped into my head, going back a slide: this also has an implication for pricing. Pricing is an area practitioners are often uncomfortable with, because of the visible time to the client versus the actual time. They think, well, the client is only going to see this amount of time, which is the assessment itself.

Having the confidence to recognise that even in efficient systems there's a lot of behind-the-scenes work matters. Being confident that this is normal, that it's not just you, and that it's okay. Not just okay: you should be factoring that into your pricing structure.

I used to do this when preparing presentations for workplaces. We'd do training for larger companies and corporates, and it might be an hour-long presentation with 20 hours of work behind it. There's a temptation to think they'll only see the hour, they'd understand an hour and some travel time, versus all the hidden things. But as a profession we should stand proud, not shy away and not personalise it and think, that's just me, I'm inefficient at writing reports. It is normal, and we should be pricing it in and feeling confident about that pricing if people push back.

So let's talk about this confidence gap and the impact on clinicians. What are your views, because I know you work with the full variety, you said in your intro you started with early career but it's grown over time. What happens here with people and their confidence?

AMANDA:

Particularly for early-career clinicians, there's often that imposter syndrome: I really don't know if I'm doing this well enough. Understandably, because you're still learning a new skill, and everyone's going to have a little self-doubt or a sense of, I'm not sure if I'm doing this right. Whether that's the clinical work itself or the admin and report writing around it.

This can be true of mid-to-later-career clinicians as well. A lot of us will retrain throughout our careers and move into different areas of practice, and whenever we're taking on something new it can feel uncertain: am I practising as I'm meant to, am I practising to that standard? As psychologists and allied health professionals we have a lot of responsibility and we're held to a high standard by AHPRA and by the community, and most of us take that really seriously. Understandably that leaves us wondering whether what we're doing is really enough.

I often say to clinicians that the feeling is normal, and it's important to reflect on how much of it is a genuine skills gap I need to address and how much is me being a little more anxious. Where it's a skills gap, we have a responsibility to address it: we upskill, we keep training, we get more supervision. If it's more purely anxiety, that's a different story and maybe a different pathway.

I don't think it's inherently a bad thing to question ourselves. It's part of good reflective practice and part of doing our due diligence as health practitioners. But there is a lot of pressure. We all have our own styles, and even when we're training, every supervisor may have a different style or approach. That can make things feel inconsistent, because for a lot of things there may not seem to be one universal approach, and it can leave early-career clinicians feeling like they don't really know what's right or wrong or how to move forward.

DAMIEN:

I think good practices set up the scaffolding, to use your analogy, which makes it harder for a mistake to be made, because the system will catch it. The template will catch it, or the way the workflow is set up will catch it. Another analogy is a safety net: even the most experienced acrobat, who's been doing it a long time, still feels better knowing the safety net is there. A good system and good scaffolding provides that.

Because it's the box or the section that isn't completed, or the question we forgot to ask because we were distracted, we had a child home sick, we were running late. All those normal human things that affect what we might do on a given day.

That ties very nicely into the retention problem hiding in plain sight. We can think about this in the practice my wife and I had. We had a wonderful team of practitioners and a very long retention period. A lot of private practices, and this is across all industries, experience problems with turnover and churn. We were always very lucky, but we were also quite intentional about it.

The retention problem can be misattributed to burnout, when the burnout itself has been caused by structural problems in the way the practice is set up. They don't have the scaffolding in place, don't have the support mechanisms, and they're not reducing the administrative burden on their practitioners by having the right processes.

One of the informal ways we used to think about setting up our practice was to go back to that new graduate who's just getting into the profession. They're full of excitement, they have a picture in their mind of what private practice is, a dream of what it looks like. And very few, I'm going to say none, are thinking about doing paperwork and writing reports. The vast majority think about helping clients and patients, helping people get better, having that one-on-one time. They're not dreaming about the admin, the paperwork, the debt collection.

So in our group practice, as we grew it over time, we asked: how do we set our administrative processes, our templates, our workflows, so that as much as possible we can match that dream for people? If they came and worked with us, it would align as much as possible with the dream. That's what I wish someone had said to us.

A lot of Zanda is built with that philosophy, and not just the practice management software, but the way you operate. By reducing that admin friction and the noise around practitioners, the retention issue can often solve itself, because you don't get the same level of burnout and you're setting clinicians up the way they dreamed it and the way it should be for them. They're often people who care a great deal about their patients and about the outcomes they get.

AMANDA:

It's a good point, because when you have that infrastructure and scaffolding in place, when you've got everything set up for them, they're allowed to just do their job as a health professional. Once you take ownership of that as a business owner or practice owner and implement some good systems, it frees up your clinicians to do the work they actually want to be doing.

DAMIEN:

And that's energising for them. If you think about what has you walking away feeling energised and excited, it isn't the paperwork. It might sometimes be the impact a report can have, knowing that's going to help unlock something for someone, give them clarity, or help them get the right services. But the actual sitting down and writing it, not so much.

The point here is the difference between capability and capacity. It's really sad to see the number of excellent clinicians who, if they're in a poor operational environment, have that capacity squandered. Worse still, it can be damaging for them personally and professionally, because they lose confidence in themselves.

I remember a very early-career experience. I'd started at an organisation, and I won't name it because they were actually very good and had been on a journey, and they were very good to me. But someone who had recently left the organisation and was fairly negative said to me, "Oh, you're starting in psychology? So you'll be our town's next real estate agent." I said, what do you mean? It was so out of the blue. And they explained that so many people, after their first year or two, end up going into another career entirely. It struck me even then, so early on, that there was something wrong.

In fact that organisation directly addressed it and became leaders in the reverse of that. But it was interesting to think that in the wrong scenarios people felt, especially early-career new grads, like they were being thrown to the wall, not given the support, without the systems and structures around them.

It's important to make that distinction. If you're supervising or you run a practice and you've got someone who seems to be struggling, before you think about their clinical capability, look at whether there's a capacity issue to do with their workload, their organisational skills, or the systems you've set up. It may be manifesting as difficulty with engagement or retention or achieving certain outcomes, but have a look at the broader picture, because often you solve those other things, provide different support, and you get a very different outcome that's beneficial to everyone.

So let's jump into what a system looks like, and how expectations can look very different in practice. What does that show up like in your experience?

AMANDA:

It depends on the workload. For clinicians working in private practice there tends to be a lot of documentation required, whether that's general note taking or the work around the client that goes unseen: case formulations, treatment planning, doing that deep clinical thinking about the client to plan how we're going to manage, help and support them. The same goes with assessments, there's a whole lot of admin load around that too.

So there's a lot of multitasking, and I find a lot of clinicians, particularly early on, feel really overwhelmed. They feel like they don't have the time they actually need to be doing their case formulations and treatment planning. By the time you get through every session and write a few quick notes, it feels like there isn't enough time left for the outside work of being a psychologist.

Coming back to building efficient systems, through my work supervising and training clinicians I've found that having systems in place has helped them so much. It removes the sense of overwhelm of where do I start, and how do I document this. Whether the practice sets it up for them, or they're doing it themselves in their own independent business, having a structure for how they do treatment plans, case formulations, therapy notes or reports takes out a lot of the work.

You mentioned muscle memory earlier, and it does become that. Think of a diagnostic report, which can sometimes span 30 pages. There are sections, and everything keeps to those sections. It's not that every section looks the same, but once you've scaffolded what's meant to be within it, the rest feels quite intuitive. My observation from training is that once I provide that scaffolding, once I say here are the elements of the report, here's what it should cover, I'll write the subheadings for you and give you the prompts, it feels so much more intuitive for them.

So creating that hopefully saves time and also allows you to build your skills as a clinician without the overwhelm of the extra work we're expected to do.

DAMIEN:

We do our best work as clinicians when we have that extra headspace. And that's not even limited to clinical work, is it? We're a better partner, a better parent, better at everything when we're able to be present. Without going too far into the weeds on mindfulness, when we're able to be still in the moment, when we know what's coming next and what the expectations are, when we know what questions we're going to ask next, that creates a rhythm and we're able to think and respond better in real time.

AMANDA:

What's interesting for me is that I offer a range of different products and trainings, but the most popular products on my website are what you'd think are the simplest things. I have templates for note taking, risk assessments, case formulations, treatment planning, mental status examinations. The basic skills we learn as psychologists.

And these aren't just early-career people purchasing them, it's clinicians all throughout their careers. These are the templates I never expected would have demand, but they're the most popular products, because they're the things people do every day and they just want a system for them.

I think it speaks to the fact that clinicians are chronically overwhelmed with this stuff and are looking for something to alleviate it. I've been blown away by how many people have taken to these products. In my mind they're just the simple basics, but they're what people want. They want systems, they want something done for them that's easy, so they can return to the work they love doing.

DAMIEN:

Absolutely, and it's probably a confidence element too. Because it's something we'd consider a basic core skill, they want to know they're doing it in a way that meets the standard of a reasonable practitioner.

When I think about the things we get requests for through Zanda, the experience is similar to what you're describing. Sometimes what's requested is the basic foundations, and we might not have included them initially when launching something new, because I thought people would have that down pat. We've learned over time that those foundations really resonate. It gives people support and confidence, and they're not caught up doing busy work replicating something they could just get.

Let's look at building a connected practice. From a Zanda point of view, this is what we spend so much of our time on and it's a core part of our motivation. If you've got separate systems for notes, billing, scheduling and documentation, and that's actually how our practice originally started, we had all these different things, and when they don't interconnect and aren't automated it's very inefficient. Things fall through the gaps, you're replicating work, and that overhead really adds up.

We had the goal from the start of building a group practice, so it needed to be scalable, and we couldn't scale that. We'd end up in trouble because things would fall through the gaps. So we started looking for software, couldn't find anything, and that's how we came to build it.

I think Zanda's the best, and you could argue I'm biased, fair enough. But I want to make the point that even if you're using a different practice management system, utilise the features available to you. Very often we see, in Zanda but also with people using other products, that there are features people could use and aren't, because they either didn't know they existed or never got around to setting them up. Integrating the workflows in your practice management system to make things as smooth as possible allows you to keep the focus on the client and remove that administrative burden.

Everyone's using practice management software of some type now. The best thing you can do, of course, is move to Zanda. But if you're not doing that, maximise what your system does so you're getting the best out of it.

The other side is having digital resources that live in your practice management system. In the Zanda example, we have a practice manual, which lets people record and build out the system of how the business operates. Right down to what the dress code expectations are for practitioners, which we learned the hard way at our practice. We thought surely we don't need a policy on that, we're hiring professionals. Until one day someone walked in wearing something, and no, we needed a policy. We'd been operating for years and it happened.

By systematising and capturing all the key things about how your practice works, putting that into a practice operations manual and ideally storing it in your practice management system, all your practitioners and team members have access to it. Then even the little things that go wrong are covered. If something goes wrong with the plumbing and the toilet isn't working, that's going to disrupt the practice. If there's a system for managing it, a directory of all the services your business uses, then instead of hunting for a plumber, with the admin person not knowing whether they can use that plumber, you have a list of plumbers, electricians, cleaners, graffiti removers, all those things in a central spot.

Including dress codes, debt collection, no-shows, attendance policies. It takes the decision making out of it and takes a lot of the overhead out of it. It means your practice can be automated at both the clinical and the administrative level, and all of that creates space and opportunity for people to be the best version of themselves. Anything else you want to add before I jump ahead?

AMANDA:

I don't think so, I think you've covered it pretty well there.

DAMIEN:

Very good. So here are some practical tips, things you can take away, and feel free to add others.

First, systematise your intake process. That's low-hanging fruit. Second, audit where your clinicians are spending time outside of session, so you really understand the admin burden, and have good conversations about it, because that helps you identify where the opportunities are to help them and help your practice. It also helps practitioners feel heard, which I think is super important.

Third, identify your top three manual handoffs: things you're doing manually that you could hand off and automate. You can literally say, when this happens, send this, automate the invoicing and the whole lot. Just pick the top three things you can hand off, whether that's to an automation in your practice management software or to an admin person, so it frees up your clinicians.

Fourth, review your clinical note templates. Look at the client journey through your practice, then look at what note templates support that journey and whether they match, and are efficient, consistent and meeting the need. Anything you'd add?

AMANDA:

They're really good points. For me the key ones are automating whatever I can, as long as it doesn't lose clinical integrity, and delegating whatever I can, whether that's to admin staff. Wherever we can save time to focus on our job, the better we're going to be as practitioners. So I delegate anything that's not clinical, anything that doesn't require my skills as a psychologist, to automations or add-ins.

DAMIEN:

That's exactly the right philosophy. In another presentation we did a while ago we talked about having the right people doing the right jobs, because they'll do it better too. Every admin person I've ever worked with would be at least 10 times better at their admin job than I would be. Get the right person who is just amazing at admin.

AMANDA:

Exactly, that's their superpower.

DAMIEN:

I'd rather have someone who's good at that do that. And everyone wins. Everyone gets a better experience, you enjoy your job more, clients get a better experience, because things are more organised and it's the right person doing it, and they do it better and faster. So, tools you can adopt immediately. What do you think?

AMANDA:

Some of these we've gone over already, but wherever I can, I'd create systems for yourself. Whether that's creating templates, or looking at purchasing ones that are done for you, or building them yourself. Things that cover your day-to-day as a practitioner, whether that's note taking, risk assessments or report writing. We should have something standardised in place that's compliant and meets the expectations of what that service is and what you need to be producing.

But it's also going to save you time. If you do it yourself, yes, it may be a lot of time up front, or you may want to invest and buy it, but once it's done it's done and it carries you through. So it's a worthwhile money or time investment as a business owner. And even if you're not running your own business, if those supports aren't there for practitioners within a business, you can still build them for yourself to save time.

For me, wherever I can add structure to the work I do, it alleviates so much burden. Many of us aren't just psychologists, we have lives outside of this. We may have families, other responsibilities, hobbies or interests. You want to enjoy the work you do, but I also want to think about my life outside work. When I have those systems in place and I can do my work efficiently, it allows me to manage my other responsibilities too, because our lives aren't just the work we do. So wherever you can, create those structures and workflows for yourself, and build them yourself where the place you're working doesn't have them.

DAMIEN:

I agree with that. And when you're assessing whether to build it yourself or buy it, it's important to look at it from the point of view of your billable hours, how much you charge. When you're evaluating the cost of something, if it would take three hours of your time to make that one thing, that's three hours times your clinical rate just to break even. And that's not even counting the effort and everything else that goes into it.

So if you buy something off the shelf from someone who has spent years thinking, breathing and living this, tapping into that is often super economical, because it saves you effort and it's something someone has thought a lot about. Our time isn't free. Even if it weren't billable, would we rather be hanging out with our kids or doing another project we're interested in? It gives you a better life.

AMANDA:

I do think of that for my own work, but even in terms of purchasing things, it's such a smart way to think about it. What will that save me in terms of my billable hour? I could get that back by working those hours instead of trying to manage it myself. That's a really good point.

DAMIEN:

It's often how we think about it with Zanda as well. If we can save people time, what's the actual financial value of that? If we can save a person an hour with a new feature, that adds value. And I can see exactly the same thing with what you're doing. It represents much better value when people view it through that frame.

All right, we've got some key takeaways. There's a gap between training and real-world practice, and that's normal and widespread. It's around the world and across different industries. What we'd want you to take home is that it's not you. If you're feeling that imposter syndrome, if you're feeling like you don't have the right organisational or business skills, that's not you. It's widespread, but fixable.

Second, admin overload is a system design problem. Structures and templates are the solution, and you've obviously identified that some time ago and spent a lot of time thinking about it. I couldn't agree more. It's shortcuts, it means you once-a-fy what you need to do, and that's better. Don't use your brain to solve the same problem over and over again, do more creative and interesting things with it.

Finally, small structural changes compound quickly and have more influence than you'd think. I like to finish with this concept, because sometimes people feel overwhelmed. We might have covered a lot today and you're thinking, that's relevant to me, and that, and that. It can be a little overwhelming. But most changes are made small, incrementally and consistently. That's the best way to do it. Pick off a couple of practical things you can do. Do part of one, or write it out as a plan of the different areas of your business where you might automate or make things more efficient, and it will build up over time.

Now, if people want to get in touch with you, Amanda, and think you might be someone who can help them with some of these templates, what should they do and how can they learn more about you?

AMANDA:

You can go and view my website, and you're very welcome to reach out to me by email. I'm active on platforms like LinkedIn, so if you want to search me up by name, Amanda Moses, or on Instagram or Facebook, you're very welcome to reach out and connect there, or contact me through my website. I'm always happy to have a chat or assist with anything you may need around the management of day-to-day practice life, or if you're looking to ask questions about any of the resources or trainings I offer.

DAMIEN:

Lovely. And I like how sometimes you share things along the lines of "you might need to hear this." For those who need to hear this, you'll share a tip or a way of thinking about something and you're like, yeah, that's spot on.

As practitioners, and it doesn't matter that we talk a lot about psychology, the things you share are equally applicable to most professions. No amount of self-care is going to fix a terrible system. I remember reading something you'd written along those lines and thinking, that's spot on. If the foundations aren't there, then doing something superficially isn't going to be the answer.

A few Zanda announcements. We've got the ideas board. People have such wonderful ideas, and Zanda's been built on getting feedback, so if you go to the help menu you'll see "submit idea." You can also see all the other ideas people have submitted and vote on them. We review this frequently, and once a week there are meetings where we talk about what's surfacing and watch for trends. A lot of how Zanda has been built is really this direct feedback and understanding of what people want.

The book we released last year: thank you to everyone who has picked it up and made it a bestseller on Amazon, I really appreciate that. That's available at the address there, forward slash secrets.

Also check out the Zanda Academy, at academy.zandahealth.com, where you can do some courses on Zanda. We're going to be adding some other things that are more broad as well, so keep an eye on that.

If you want to get in contact with us you can do that through all the usual ways, and you can also book one-on-one demos with our customer success team. They're free, and it doesn't matter whether you're a new customer or an existing one. You might want to say, I'd like some of the stuff about automations, or how do I set up templates? You can just book that in with our team. They speak in a way that's non-tech speak, so they'll explain it and show you how to do things. They are lovely people.

You can also check out the Practice Hive, the little hive symbol in your account, where you can get the latest information and communicate internally and securely with your team.

Check all those things out. Finally, we'll see you next time. Amanda, it's been an absolute pleasure having you as a special guest today and sharing your wisdom and insights, so thank you very much for joining us.

AMANDA:

Likewise. Thanks so much for having me.