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Welcome to The Health & Wellness Practitioners Podcast! Dr. Danielle and other guest experts talk about everything from getting your practice started, developing your clinical skills, growing your practice YOUR way, and dealing with the real stuff life burnout and work/life balance. Whether you’ve been practicing for decades or just started your journey, you’ll find something here for you!
DR. DANIELLE: I hope that you're all doing wonderfully well. I am here today with Amber Holly, Amber, and I have loosely known of each other for a few years now, but haven't really connected this way. I'm excited to have this conversation with her because Amber helps entrepreneurs who struggle with distraction. I mean, isn't that all of us?
AMBER: Actually now, yes.
DR. DANIELLE: And I see some people popping in and joining us because I mentioned being behind on chart notes in the title of this video. So we'll talk more about that, but before we do, I just want to give Amber some space, introduce herself and share more about her. So yeah, let's get started there.
MEET AMBER HAWLEY
AMBER: Well, hello everyone. I'm Amber Hawley. I'm a licensed marriage and family therapist by trade. I also am a podcast host of the Easily Distracted Entrepreneur and I do business consulting and speaking and training and I am an ENFP with ADHD. So the ENFP is a Myers Briggs type, which means I prioritize fun, and I'm the most introverted extrovert. Like I love people, but I also need my cave time.
But the ADHD part is really what has fueled a lot of my work in the last few years is really helping people, and I always say easily distracted, because like you said, modern entrepreneurship just really lends to everyone feeling distracted and unfocused. And there are a lot of people, especially women who are never diagnosed with ADHD or don't know. So I, you know, I work with a lot of people who don't identify as ADHD, but they're struggling, right? They're struggling to stay on top of all the things. And especially as you mentioned, the dreaded documentation.
DR. DANIELLE: As you further introduce yourself, I realized why I had the sense that I already knew you because I had listened to a podcast episode I believe that you were on with Natalie, from Biz Chix a few years ago where she really like dove into strategy with you about your business. So that's why, oh yes. Like I know all about you, even though we hadn't probably, we may have run into each other in a hotel once.
AMBER: Maybe.
WHERE TO START WITH DOCUMENTATION
DR. DANIELLE: We'll never know the answer to that. Okay. So I think the large majority of our audience is chiropractors, but we do have therapists, hypnotherapists, massage therapists, all kinds of therapists, all kinds of people who some, I would say probably the majority have the responsibility of chart notes and the rest that don't. So if you don't yay for you. Adds a whole other level of complication to the caring for people, running a business, all of those things. Right. And for those of us, I do have that responsibility. It's just, it's hard. It is hard. And it's an unfortunate situation, I think, because we just want to take care of people. And yet we have this dynamic that is so yucky for so many of us and it just keeps us in this, like I'm never doing good enough spiral to stay on top of things.
AMBER: We're like, let's all take a deep breath. Documentation.
DR. DANIELLE: Yes. For the people that this is relevant for. Well, Amber, what's the first thing that you want to say to them? I mean, they're, my brain already gets so scattered around it, all that. I'm like, oh, I don't even know where to start.
AMBER: Yeah. Well, and I think a lot of people feel that way. Right. It's hard. And the other thing I'm seeing too, which is really sad to me in professional communities like you said, whether that's a chiropractor, acupuncturist therapist, whatever, is there are people who are actually leaving the profession to do coaching because of the documentation. Like that's how overwhelming it is. And that's really sad. Right? Like it's tragic that something that is like a core responsibility is so difficult for people. And I think there are many things, many reasons why that's true.
And especially if I am speaking to neurodivergent people, like documentation tends to be one of those things that is a struggle because it's many reasons. One, because there's a legal aspect to it. Two, we may not fully understand or have a system like we're not trained to have the most efficient system.I feel like they like in school they, they give you one like one short, like maybe one day, three hours, this is how you do your notes and it's like ancillary. Right. And then the other part of it is like doing that boring monotonous stuff. That's not why we got into this to our businesses in the first place, our professions. Right? We want to, like you said, help people, we want to care for people. And we know like you can, you can logically understand the benefit of accurate documentation so that you can best serve your clients. Like we understand that. And like that's not the part that energizes us and drives us. And so it's hard. Like I just, I guess normalizing that.
And there's just so many people that are feeling overwhelmed and that usually is the one thing where even if you're really good about your boundaries with the times that you're seeing clients and how you structure things, I find so many professionals are spending their weekends or late nights catching up on paperwork. And it's draining, it burns people out.
DR. DANIELLE: Yes. Especially I think, you know, for women that have children or that have had small children because they are possibly not sleeping through the night because their children are not sleeping through the night and then they're staying up late to try to get chart notes done.
So you mentioned that you're giving a talk later today to an organization on this topic. And I was like, well, perfect. You can practice here with our audience and you'll be talking about later. What is the first thing that someone needs to do if they find themselves in a situation where they're really far behind?
AMBER: Yeah. So there's a few different things. Like the way that, like the way that I approach my work with a lot of my clients or in like my membership is I think there are foundational pieces that support us for success that are sustainable. Right? Like I'm all about sustainability. I like flexibility and creativity because you know, like the worst thing you can do for someone with ADHD is say like you have to live inside this box. Like that's going to suck. Right? But there are some structures we need there to support ourselves. And so that we're not just in the cycle of like burnout catch up burnout catch up.
So I like to start with talking about our schedule. So like our boundaries around our schedule, like how much we have on our schedule and like making space. So to specifically answer the documentation part; do you actually have space on your schedule dedicated to writing chart notes? Right? Cause that's the one first thing. And like you mentioned having young kids and I think I started my therapy private practice right after having well, not right after, I guess she was 10 months. But like after having my first child-ish, and I made so many mistakes. Like we all do, but I never even had childcare unless I was seeing clients. And so I left no space for me to like actually have, well, let alone downtime or all the other things you have to do for your business, but writing notes and stuff. And you know, she was a high-needs, she was full of energy. She never slept like she was an Energizer bunny. She was really tough. And it was my first that's always the hardest. Right?
And so it's like first, do you even have space on your calendar? You know, I love chiropractic care. So I go a lot. But most of my chiropractors that I see, they would have like a dedicated day. Like they just had the whole day off that they were doing their paperwork, which I always like, that's mad respect that you're like showing up to your office to do paperwork. That sounds awful. But do you have a dedicated time? I think that's a key. And like you said, if, if you're like fitting it in and you're, you're actually being a primary parent, like, is that time going to be interrupted? Like that's the thing. People are always asking for stuff from us. They're demanding our attention and energy.
And my biz bestie, who I started my podcast with initially Melissa McCaffery, she is a documentation expert and she primarily works with therapists, but like one of her most solid pieces of advice is if you're behind, don't start catching up, start with this week, getting on top, building it in so you have space for it, building the system and start going forward. Cause otherwise if you're behind and you're trying to play catch, you just get more and more behind. It's better to start with what's fresh right now and then develop a plan for how you're going to catch up with those notes. Like, and I think that's such solid advice.
And you know, I've had a group therapy practice for 11 years. And so I had a licensed therapist and interns that worked under me and so many turns out, had ADHD. And so like having to work with them on like, how do we get our documentation catch up? Because you know, it's a legal requirement. Right? We have to do it. But I guess I would say also like you are not alone. I think you're in the majority. It's just like, we're not talking about it because it's very shameful.
DR. DANIELLE: Yes, yes, absolutely.
AMBER: The people who are on top of their notes are talking about it.
DR. DANIELLE: Right. Yes. Because they've accomplished something that most other people haven't. I was just talking with one of my clients on Wednesday about an office that I worked with many years ago and that office was admittedly six months behind on their chart notes. They were that far behind. And I was talking to this client now in real time about this other scenario, and just like letting her know, listen, this is the worst scenario that I've seen. And if you were just a few days behind on your notes, it's really okay. Like that's doable, but to get six months behind was it felt insurmountable to them. And I also had the sense that if they were willing to admit that they were six months behind, they were probably unfortunately even further behind than that. It was probably a bigger problem than what they were willing to admit because it is such a shameful secret. Right?
AMBER: Absolutely. Cause then it's like, you're a bad doctor. You're a bad therapist. You're a bad practitioner. Like, and I mean, I'm going to say that six months behind isn't the, I don't want to say worst, but the most the longest, worst case scenario that I have heard and there are so many people that are further behind because again, there even could be this thing of like I don't even know like the right way or perfectionism comes in, like because of the, again, the legal requirement and yeah.
Often when people start to admit, they're like, well actually this and then this and they never built the system for it. And so yeah, a lot of people are, and it is so shame filled, like we're going to get judged, we're going to lose our license. You know, we always catastrophize, right? Like I used to sometimes be like, well, that's it. If I ever lose my license, I'm becoming a life coach. You know, I'm not insulting life coaching, not at all. I'm just saying like legally. I was like, I would still be able to help people just have to do it in a different way, you know? But it's hard. It's a hard thing. And yeah, if we, if we can't talk about it and not be judgemental towards people, then it just stays secret and it stays shameful. Right?
DR. DANIELLE: Yes. And I really appreciate the approach that you've offered of focusing on the now, like let's take care of creating a system to just stay on top of what we're currently doing and then fix the old problem after that. Because if you don't fix the now problem of how do I actually complete my chart notes in a timely fashion now, the going back and fixing things is never actually going to be done.
AMBER: No, no. And you, and you might like start and have some momentum and then you'll peter out and then it'll just continue. But if you, if you address them now and give yourself space to be like, look, I'm already six months or a year behind. Okay. You know, it is what it is. So let me just start now fresh today and go forward. And then you build the habit, you build the new structure. And so that way, you know, you're going to stay on top of it and then you build a plan to catch up. Otherwise it just doesn't work. We think like, that'll be a motivator and it's not.
DR. DANIELLE: Okay. Someone that's watching just said, I'm a new, new one and a half year doc. And typically behind a few days, my boss always makes me feel like I'm a bad doctor. So thanks for the reminder that it's okay. And she said that she's had a lot of stress around this situation lately.
MAYBE THE ISSUE IS YOUR ELECTRONIC HEALTH RECORD SYSTEM
This is why I wanted to talk about this because I know that it's such a thing. It's such a stressful thing for so many people. Amber, what is your perspective on EHRs being the solution. Like maybe you just have the wrong electronic health record system and you need to change to a different one. Is that really the thing?
AMBER: I'm going to say yes and no, right? Like that's a totally irritating therapist type answer. Like it depends. That's our favorite. The reason I say that is being neurodivergent, I really do see the value in finding a technology that works the way your brain works. Like if you're forcing yourself to utilize something that your brain is like I just don't get it. It's not intuitive. Like this sucks. It's whatever. Because I do talk to a lot of people who mostly I work with business owners, but I do see people because of the stress and overwhelm of all the things who are working for other people in the wellness professions and they're like, the system is horrible and I just couldn't get it. I couldn't figure it out. And that like exacerbated their problem because there was already that stuck point.
And at the same time if your EHR is good enough, I would say accept that, commit to it and let it go. Cause sometimes we'll focus on, well maybe I just need a different EHR because that it's, it's, it's called bike shedding. We're going to focus on something else. That's like easier to focus on. It's trivial won't really have a big impact, but it makes us feel productive and useful. Like, well I'm working on the problem. See, I'm looking at my technology and we're like, and that's also that shiny object. Like I'm just looking at all this other stuff instead of actually dealing with the real problem.
So there are times where yes, it does not work for you. because like I had an EHR where it, to me, it felt like it was like the super ego. Like the big brother is watching. They wouldn't let you send the super bill unless you had done the note. But like for us, like I'll have a client that comes in and they'll want a super bill so they can submit to insurance to start the insurance thing going and to get reimbursed because I'm private pay. And then it wouldn't let you do that until you did the note. And then it's like, oh my God, like you just made all my systems harder. Now I have to like make a separate on my own like super bill for a client just to like circumvent this, which just made more work and slowed me down.
So there are times where it truly doesn't work for you. But then I'm going to say like once, if it's good enough, just focus on that and figure out your system, figure out is it that you don't know how to write the notes? You are not sure that you're capturing all the important information? Like, do you need to train on that kind of stuff? Or again, are you just not leaving any space? Like you're just like, well I'll just catch up, I'll do it at the end of my eight hour workday when I'm exhausted and hungry, you know?
DR. DANIELLE: Yeah, yeah. And a bit brain dead, perhaps like you just absorbed a lot of information from people and then to kind of expect yourself to rehash it all in a professional meets the guideline sort of way isn't really a reasonable expectation either.
AMBER: No, no.
DR. DANIELLE: Okay. So outside of the EHR being a factor and you know, having the training that you need to know what is that you're documenting, what is sufficient documentation, how do you use this EHR - let's shift a little bit to the other aspect of this equation, which is the neuro divergence, right? The conditions that make it hard for us to be able to stay on task and stay focused. Where do you want to start the conversation on that?
NEURODIVERGENCE AND FALLACIES TO CONSIDER
AMBER: Yeah, I, I'm going to, I guess maybe I'll talk about a few different brain biases that first of all, all humans have, but then some that are specific to being neuro divergent that I think exacerbate the problem of just whether it's overwhelm or just that feeling of falling behind or not being able to stay on top of things. Well, I used to say this a lot too. I'd be like, if I just had a week to get caught up, like everything would be great. You know, like when I'm feeling stressed out and it's like being caught up is a total fall asleep. It doesn't exist, but I, because there's always stuff to do. However, I goal for a sense of, can I feel on top of things? And some of that is just setting realistic expectations of what we're expecting of ourselves to do like our to-do list or our schedule.
So going back to the brain biases, there's some time based ones that I see impact people, big time. Like one of them is called planning, fallacy. And that's where we, you know, part of planning, fallacy is optimism, biased, where we think like everything's going to go smoothly and it'll all work out. And so we underestimate the amount of time things take, right? Like, so if we're going to speak specifically of notes, if we don't really like critically think about it, we're like, oh, I just need to give myself an hour at the end of the day or one hour every day for my clients. And then that'll be it. We don't actually look at well one, are people going to interrupt you? Are you going to get phone calls? Are you eating during that hour? The other stuff is going to happen or social media, hello? Like, are you going to be scrolling Instagram and watch reels for 40 minutes of that hour? I mean, I would never do that.
DR. DANIELLE: Yeah. I mean, now it's real. But back in the day for me was YouTube videos, mostly Justin Timberlake, YouTube videos, but I would just, you know, someone would email me something or whatever and I'd click on it. Anit just takes you down the rabbit hole.
AMBER: I know, and I have resisted reels for so long because it's, I know first of all, my brain craves dopamine, but I know that it's like my favorite thing, like comedy dancing, music and animals. And lately the algorithm is sending me a lot of thirst traps. So I don't know what to say about that, but all of a sudden I can lose hours to reels. And I'm like, this is why I'd never wanted to start because it's too hard.
But going back to the, I mean like you shared your Justin Timberlake thing, I gotta share my thirst trap stuff. But the optimism or the planning fallacy. So we're not giving ourselves enough space and time. We have that optimism bias that, oh, everything is going to go smoothly. Nothing bad will happen. Right? Like, that's that same thing of like, oh, I'm going to be 10 minutes early for an appointment. Let me run into the grocery store and get that one thing. Because we don't think about the time it takes to get into the store. Did they actually move the item that you had? You get in line, you're always going to be behind somebody with a problem. Like we never think of that. We think of it as being smooth sailing. So that's something that impacts all humans, not just people with neurodivergence.
Another time based one though is time blindness. And this one really is very like ADHD specific or I would say neurodivergent specific where you just lose a sense of time. It's almost like time just went away. Some of that is we can hyper focus, but some of it is just like, that's how our brains work. Like the executive functioning doesn't really have a truly good sense of time. And so like my reels thing is a perfect example of that, where I say like, I've lost many, a shower window. Like I have this period of time to shower for the day. And if I don't, then I'm seeing clients like back to back. So I have no more space to do that. And I've lost it because I'm like, okay, I'm going to go shower. I go in my room and I sit on my bed and I'm like open Instagram. I'm like, what is wrong with me? And I lose the hour and I'm like, oh crap. I have 10 minutes, you know? I mean, thank God everything's virtual now. Well, for me it is, I'm sure not for chiropractors, but you know, so we can lose time and we can think like, oh, I have plenty of time to do this thing. And then all of a sudden we're out of time.
And I'm trying to think what is the last one that I talk about a lot? Oh, that's bikeshedding, which I mentioned a little bit earlier and that is like our brain's irresistible urge to focus on things to make us feel productive or, it feels useful, but we're spending a disproportionate time on things that aren't important that don't matter. And I guess I had a client who talked about this week, where they had a lot of big things to be doing. Like we had, you know, we had a structure of like, oh, this is what I have to have done by this date for this person. And it was like writing copies. There was a little resistance there. And then they spent two and a half hours trying to edit one video to put on social media.
Like, I don't know, I guess if you post on social media and make tens of thousands of dollars, that's totally worth it. But reality is like finishing your website project. So you can attract your ideal client. That's a much more useful, you know, use of your time. Right. So bikeshedding is a big one that we have to pay attention. And what I like to say about this is it's just good to know, and then not judge yourself for it, just look at it and go, oh - because I have clients will say that, like I realized I was bikeshedding and then you get to make a different choice sometimes or not. But at least you're aware of it so that you're not just like beating yourself up, like there's something wrong with me. Like I'm not cut out to be a business owner or whatever, whatever the thing is. Like there's all this negative self talk. But if we understand, my brain is wired to do that, so I'm going to have to actively work against it.
DR. DANIELLE: Yes. And I think also too, it's important for us to remember that the technologies that we're interacting with Instagram, for example, or Facebook, TikTok, whatever it is, they're all designed to get us to stay on the platform.
AMBER: Exactly. I mean, they're literally designed to do that. Like everything about it is structured to keep you distracted, to keep you on the platform.
INTENTIONAL AND REALISTIC TIME MANAGEMENT
DR. DANIELLE: Yeah. So just it's, you know, it's like, okay, acknowledging that. And then also acknowledging like what can we do to make different choices and to utilize our time differently. And to just become aware first and foremost that we don't have to be victims to the platforms either.
AMBER: Yes, absolutely. Just be intentional. Like that's where on days where I know I have a lot going on, I'm not going to go open it up because I know my chances unless I set a timer. So I know I figure my phone is always listening to me anyway. So I got all these Alexa dots for like all like the living room and all the bedrooms and stuff. And I love it cause I can listen to music, but what I also love is I constantly set timers. And so like I'll set a timer so that I don't get lost in time blindness or you know, like bikeshedding or wasting time somewhere. The timer will go off and it's like, oh, okay, stop now. So yeah, you can create structures for yourself for sure.
DR. DANIELLE: Amber, this is such a relevant and I think helpful conversation for so much of our community because you know, like you said, this is not a thing that people want to talk about, but yet it's a thing that the majority are struggling with. And in the worst case scenarios, it causes us to not even want to do what we do anymore to help people. Which is, I mean, there's so much we could say about that. The lost earning potential. But also the fact that there are so many people who actually need the help that all of us do, the work that all of us do is in high demand. And so it's never a shortage of patients or clients. That's not the issue.
AMBER: No. And the sad part is like, and I get why people move on. I mean, look at, I have too. I mean, I still, I still do see some therapy clients. It's very reduced now. It's like, people I've seen forever, but mostly, occasionally it takes someone new, but like we're also losing the expertise. So it's like the people who have been in it and have the expertise the longest, like, they're the ones like I'm done, like I'm just done with this. Or like all of these wonderful neurodivergent therapists and practitioners, you know, whatever vocation they're in, like feeling overwhelmed by that stuff and then making different choices purely because of that because there's nobody helping them create something that is sustainable for them. And it's like, we need those people. We need people that look at things differently and have that creativity and the clients need that. They need to see themselves in the people that are serving them.
DR. DANIELLE: Yes. And I think that the many neuro divergent people are actually really, really gifted healers and very connected to other people's energy and just magnificent at what they do, but they also have the greatest challenge to be able to continue doing it for the long term. So yeah, thank you again so much for being willing to talk about this today.
AMBER: Yeah. Thanks for having me. I hope it's helpful. And even that one comment from the person who's like, they make me feel like a bad doctor. It's like, that's an epidemic. And it sucks because we do that enough to ourselves. But when we have that from other people it's so hard because it's so shortsighted of what it means to be a good clinician or doctor or provider or whatever. It's not just about completing that documentation. Like there's so much more like you just said to it that, that I think it's lost. So then you're miserable. Like that sucks.
DR. DANIELLE: Yeah. None of us chose a health and wellness profession to be miserable ourselves. That wasn't the intention. For people that would like to learn more about what you do, where is the best place for them to go?
AMBER: Yeah. Well you can catch me over at the Easily Distracted Entrepreneur podcast. I do actually have a capsule podcast coming out that's associated called the Easily Distracted Therapist. Hopefully that is coming out in then like next week or so. I have a resistance to recording solo episodes. Like I could talk to people all day, but when I have to do it by myself, it's like paperwork. I'm like, Ugh, this is so boring talking to myself. So I keep pushing it off. I've recorded all these episodes. I just have to record my stupid intro, but the Easily Distracted - see now I just went down my own rabbit hole - the Easily Distracted Entrepreneur podcast.
You can go to AmberHawley.com and actually for if you're in this place of like all the things and you're feeling like, okay, I'm, I'm kind of chasing shiny objects. We do have a downloadable for you at AmberHawley.com/Well, and that's a sheet for you to go through and kind of discern, is this a shiny object or is it an awesome opportunity? Because I think that's the other thing we do is we're like overwhelmed. We're trying to grow our business or we're trying to start a new one and there's so many things going on and it's like, we're bored and we're miserable. And we feel like crap, because we're not doing our paperwork. Then we're like going to go chase shiny objects. We're like, oh, let me go do this. because that's fun. It's different, it's novel and it's stimulating.
And so sometimes you have to do that. Sometimes you need to chase the shiny. And that's okay as long as it's intentional. And, but then there are other times where by doing that, we're actually cutting ourselves off of at the foot, like our ability to really grow our business in a thoughtful and sustainable way because we're spreading ourselves too thin. So that would be a good place to check out. Awesome.
DR. DANIELLE: Awesome. Well thank you again so much.