Off Script, unfiltered.
Essays and observations from working clinicians. Mental health, broader than a diagnosis.
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Jump to what you came for, instead of scrolling. 12 topics, each linking to every essay tagged with it.
Getting On Insurance Panels: The Credentialing Game
If you’re a licensed clinician and you’ve been circling the question of whether to get on insurance panels, you’ve probably gotten a lot of advice that’s either cheerleading…
Aug 6, 2025
Medicaid for Mental Health Care in Oregon and Washington
If you’re an adult in Oregon or Washington and you’re scraping by, there’s a real chance Medicaid covers you, and a real chance it covers more of your…
Aug 3, 2025
How to Actually Appeal an Insurance Denial
Insurance denied your mental health claim.
Jul 31, 2025
Why You and Your Partner Feel Out of Sync
There’s a part of relationships that nobody really prepares you for, and it’s not the big stuff. It’s not conflict, or trust, or anything dramatic.
Jul 31, 2025How to Actually Access Your Mental Health Benefits
Insurance companies in this country have figured out a quietly profitable trick. They sell you a plan that technically includes mental health coverage, they staff a member-services line…
Jul 29, 2025
What Every Insurance Term Actually Means (And Which Ones Matter)
Insurance companies don't write their paperwork to be understood. They write it to be unfalsifiable, which is a different problem.
Jul 26, 2025
How Health Insurance Actually Works
Health insurance is confusing on purpose.
Jul 24, 2025
Solopreneur Logistics: From LLC to PC
Most clinicians who leave a W-2 job to go solo lose money in their first year, and a fair number of them don't even notice until they sit down with…
Jul 21, 2025
Licensure vs Certification: What Actually Defines Your Scope of Practice
Most of us came out of training knowing how to interview a patient, how to write a note, and how to talk a guy down off a bad week, and…
Jul 18, 2025
E&M Codes for Psych: Choosing the Right Level
Most psych clinicians are undercoding their visits, and it's not because they're being modest, it's because nobody taught them how E&M (evaluation and…
Jul 16, 2025
Stimulants Help Most People Focus. That Isn’t an ADHD Test.
The single most common ADHD diagnostic story I hear in the room goes like this...
Jul 13, 2025
Modafinil and the productivity stack
Modafinil is the drug a lot of guys in tech, finance, and the productivity-bro corners of the internet are taking off-label, often without a prescription,…
Jul 10, 2025