132 - Success Story - Dr. Jonathan D. Friedman - Baker Street Behavioral Health

May 22, 2020

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Baker Street Behavioral Health®
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Matt Coffy: I am talking to John Friedman today. He is a specialist. Your environment really supports the health and mental wellness of a lot of clients. And so maybe just give us a little backstory of the company

Matt Coffy: and I'd love to hear your side of the story. You know, just a few minutes of your, story from your origin and then let's get into the thing that we're seeing out in the, in the space. Cause we're in the epicenter here in New Jersey, both of us. so we, we have a little bit of different story than a lot of the nation has.

John Friedman: Yeah, yeah. No, we're, we're definitely right in the teeth of this thing and thanks for having me as well Matt. Really appreciate the opportunity to speak with you and speak with your audience. So to share a little more about myself and my practice as you as you're asking, my name is dr Jamie Friedman and I'm a clinical and sports psychologist. I'm also a partner in the group psychology practice here in Northern New Jersey called Baker street behavioral health. And as far as, you know, Baker street, myself and dr Joe Galasso, who was the other partner in the practice, we decided to launched Baker street at the beginning of 2019. we'd both been working together as part of a practice for several years prior and we decided that we wanted to go in a different direction. And so we started Baker street, at the beginning of last year.

John Friedman: And we've really, I've been able to establish a foothold in Northern New Jersey and develop the practice, in a, in a very fast and effective way. Since then, we've, we've expanded now to not only include, roughly a dozen clinicians and therapists, but we also have a prescribing psychiatric nurse practitioner and a neuropsychologist on staff along with a variety of different specializations. And we've done that predominantly with the traditional office model up until recently. We've wanted to get into the tele-health space for a while. The simple point is that we, we didn't have the bandwidth just necessarily with everything else we had to take care of to make that happen just yet. But with what happened with that pretty much created the need and, and, and, and fast tracked everything. So we've managed to make that transition and we're feeling quite fortunate to have telehealth as an option because I know everybody, not everybody, but quite a few people out there are struggling in industries or just slammed and locked shut and without any recourse, without any, alternatives to fall back on. Fortunately, we do have this and it's managed to, you know, keep us going and working well and able to get out there and also offer services in some instances pro bono to the community, to first responders, health care workers and so forth. And also with existing clients and new referrals just in a, in a standard way people gravitated to, to

Matt Coffy: us during this time. And we've also managed to retain the vast majority of our existing client base prior to covert. So far so good with how things have kind of shaken out for us. Have you found that the clients have accepted this rather easily and have determined that, Hey, this is maybe even better in some cases where maybe they're not as, you know, either, you know, from a physical one-on-one confrontational sort of like back, you know, the old days where you sort of sat on the couch to now it's more of counseling and really maybe they're more comfortable at home actually, you know, talking because that's big as this is really what this is about is being comfortable and letting you know the emotional aspects of this dialogue become, let's say pull out a bubble of other clients. So maybe could you talk a little bit about that

John Friedman: Yeah, I think that they're definitely, you know, a different set of pros and cons to this format than in the office, which has its own pros and cons of course. And one of them I think is that for some people they do maybe find it a little less intimidating emotionally. it gives them a little bit of a sense of space. And it also, as you're saying, if they're in their own home, in the comfort of their own home, I think that can also add to their general comfort level with getting into emotionally difficult material. And so I think some people have found it to be more comfortable. And also I would say that tends also to be the case with some of our younger clients, teenaged in particular, the ones who have grown up with this sort of technology and they're used to having their, you know, looking at screens a lot and things like that.

John Friedman: And interestingly, you know, we found an on some occasions where we might have a, let's say a 1415 year old who's more shut down, less talkative, more inhibited in the office one-on-one in the traditional way. And they tend to open up and have more to talk about and be more comfortable with this medium. It gives them, again, I think a little bit of a sense of distance that helps them feel a little bit more relaxed. That's true for some, not all. And you know, for others it's been an adjustment. But we were definitely glad that a lot of people have responded. Most people have stuck with it and you know, it's the kind of thing where we're seeing those positives and we want to be able to continue with this going forward. Not to say that we're, we continue, you know, working for dominantly through telehealth but certainly as an adjunctive and an additional option for people to make use of and not to mention the flexibility that it can provide from a scheduling stuff. Wait. So yeah, there's definitely a lot of positives as we've learned and as our clients have been learning along with us and we want to carry those forward and create, I guess you could call it a hybrid operation as we go.

Matt Coffy: Have you seen an increase in activity because of the needs that have arisen from the isolation aspects of this Because it would seem to me that, you know, we're seeing this in other areas especially, you know, we immediately were engaged with another group out in Ohio and they had been one of the other States that have been impacted quite a bit in this initial round. And they, they were telling me that there was a lot of tertiary engagement that was not necessarily coming from first responders, but from really the general welfare of the public. You know, they had found that there was a lot just being able to be visible, that there was help because the biggest thing that we're seeing, and then you probably have as done this, but you know there's a lot of online medical services like MD live and literally a panoply of them and I think initially they all got sort of oversubscribed and there was a lot of pain points of trying to communicate with someone when someone had a need. And I think the local flavor became very interesting after a couple of weeks because all of a sudden it became like, Whoa, this is now available. Maybe you could talk a little bit about that.

John Friedman: Well, I do think we're finding that having an outlet where you can see and interact with a live person outside of obviously the scope of whoever's in your, in your home is something that people have definitely been responding to and taking more and more advantage of it as time goes by as the lockdown continues. you know, when I first got into scheduling people through, tele-health initially we had a few, and I think this is true for a lot of therapists in the practice. A bunch of people didn't, well, nah, we're just, we'll hold off. We'll come back in a couple of weeks once we're back in the office within a short period of time. When they began to realize, Hey, it's not going to just be a couple of weeks and be, wow, this actually adds up over time. And we, we don't have anybody else besides spouse or, or children in the home to interact with or for that matter.

John Friedman: And the kids are climbing the walls and it's stressing out the parents and they're exhausted. They recognized, you know what This doesn't have to be hyper clinical to be a value. And so they began to recognize the value inherent in the outlet itself. Now granted, we'll still talk about things and we'll talk about clinically related material and, and strategies for how to cope with the stress, managing anxiety structure, you know, the kids' schedules and try and help manage the children in and of themselves. However, just having that opportunity to even just vent, to get some things off your chest at a time like this is pretty important as well. And I think people are responding to that and making use of it and it's, it served that good purpose.

Matt Coffy: Yeah. And I really think that in this segment of uncertainty, you know, having someone to confide in because everybody's stuck in really four walls, especially where we are. I think that seems to be one of the most critical elements is that the isolation plus the ability to, and you said vent, but I think it's more about confide in someone you know, your challenges. it's super important, especially if they're creating enough that, you know, you've had to reach out and you've had to really think like, this is something I need to address because it's becoming outside of the normal realms and, and this is where you guys really have a, you know, serious impact to help. And I think people don't realize that there is a lot of activities that are out there that are just not going to, like a lot of people are saying, you know, Hey, the glass is half full and the other half is gin. I'm like, that's not a good way to deal with this right now. Don't.

John Friedman: Right.

Matt Coffy: I think your best bet is to really, the challenges are working out, you know, how to manage this. And that's what you guys do really an awesome job at. So maybe you could talk a little bit about, you know, how you're getting the word out on what you've done to sort of give your other physicians too, make sure that they have somewhere to find a specialist like you or, or to, you know, just really think about the things that would make someone feel comfortable with engaging with you. I mean, those are the couple of things that we wanted to just cover and we'll wrap it up after that.

John Friedman: Sure. Yeah. And I would, I would concur it definitely confiding is important right now. I think it's kind of like a multichannel kind of situation in that, you know, you come and you have the outlet for however you need, whether just to be, to blow off some steam or to get some skills and strategies or to confide because yeah, it's hard when you're around the same people all the time and you know, things are coming up. You're trying to keep the peace and having someone that you trust and can get into some more personal matters at a time. Like this is definitely valuable. as far as how we've managed to go about it. Well, for one thing, we do have our website, which is www Baker street, site.com and we've certainly put it out there. We are available tele-health. We've been involved with community based efforts such as working with a coffee company to donate a lot of coffee to one of the hospitals nearby.

John Friedman: We've had several therapists who've been involved with weekly or biweekly parent support groups during this period of time as a way of keeping, well, you know, connected within different communities. We have our Facebook and Instagram presence, things of that sort of psychology today. And also again, some of the initiatives trying to get people's awareness that if they need us from the front lines, we're available. And we certainly wouldn't, weren't about to make that a, a financial situation. We wanted to be of help. And then for that matter, we've, we've really tried to maximize the time from a, from the standpoint of how our organization is growing and developing and, and also for that matter, solidifying a really strong internal culture within our practice by having a lot of different zoom meetings with people, getting our name and getting ourselves out there with other organizations, letting them know we're available, trying to make good use of the opportunity of this time to not only do some internal expansion but also again, develop our network further and keep people, you know, aware of, of us as a, as a very, valuable resource. should anyone need, need the, the help at this point.

Matt Coffy: Yeah. And that was what I was going to ask you. You know, there's a lot of different variables when it comes to counseling, psychiatric help. Maybe you could just talk about a couple of the different variables that you consistently start to apply your skillsets towards. And just the different maybe cadences you find in different segments of the market where, you know, whether it's children or child or teens or adults or drug addiction. Maybe you could just go through a couple of different variables and then we'll just, we'll kind of get to the final question I want to ask and then we'll move on to the sort of what I would call free for all, which is that we're 60 days from now. I want to ask you where you think this will be cause a lot of, I always ask that question where people will be in 60 days and I'm curious about you.

John Friedman: Yeah, I would probably have a better ability to gauge 60 days right now than certainly say six months given the uncertain nature, seasonal nature of this thing. It will it die down. We hope it will. I assume it will through the next couple of months and then through the warmer weather, summer months. But beyond that, who's to say if we might end up back in the spot again but we can certainly come to that in a minute as far as you know, how it differs depending on the population. Our wheelhouse tends to be children, teens and families and young adults. We've had, we do see adults, we'll see elderly, we'll see other populations as well. Substance abuse for example, but teams and children and families tends to be the real centerpiece of our practice. And so we have to try and figure out first of all when it comes to working with smaller children how to make this applicable to them and that sometimes changes the way in which we might usually operate.

John Friedman: First of all, we will probably, and we have done with some of our families with younger children who've been seeing us, we've kind of inverted it in the past. What we would end up doing in the office is we try and see the child for the bulk of the session and the parent would typically come in towards the end for a check in or, or some family work unless there was something a little bit more really focused in that, in which case we might do the whole session that way. But generally it's focusing on the child play therapy and things of that sort. And the parent will tag on it around the end of the session. Given the nature of this medium though we're not expecting nor would we would we want to even try to force a six year old to sit on on the doxy cam, the zoom cam, what have you for 45 minutes.

John Friedman: It's unrealistic and really wouldn't be fair to them frankly. And so instead of it being a situation where it's maybe a three fourths, one fourth with the child and the and the parent, it may be as close to 50 50 now where we're like, okay, let's do some work and check in and try and do some fun online activities together somehow to work on social skill development, coping skills and things like that. Emotion regulation, the usual things you work on with kids as they're developing and maturing. But then a lot more of the session tends to also be dedicated to working with the parents, giving them support, also working with them on how to manage the situation and also that tends to fill out, you know, the of an appointment in a productive way. So there's an adjustment we've been making there with teens as I was alluding to earlier.

John Friedman: I mean, this may have been before we started recording, but a lot of the time they tend to like it better in some ways, not exclusively. I think a lot of them will want to be back in the office, but sometimes finding it a little more relaxed and comfortable and certainly they liked the flexibility of just being able to go into their room, pop it on the laptop and there you are over and done with back at home when things end. So you're working with, that has been something we're, we're pretty flexible on the scheduling side. Some of those various variables have shifted a bit, but you know, for the most part where we're working with people on the timelines and we're able to, thankfully beyond the those variables we'll find out, you know, we still maintain the same customer friendly, client friendly, set up as far as billing and, and submitting the claims on their behalf and so forth.

John Friedman: So we'll see what happens when it comes to reimbursement from the health care providers, health insurance providers. But yeah, we're, we're, we're doing the best we can and making every effort to let people know that we're here to be supportive and when it comes to, for example, the financial variables, we've tried to be very flexible when, when needed because we understand there's a lot of pain out there right now and we want this to be as much of an added value and a reduction in stress and not something that's going to contribute to the stress. So we're, we're pretty flexible during this period of time in that way as well.

Matt Coffy: Good. That's great. And I really appreciate all the information you shared and again in the show notes we'll have all the information, how to get in touch with the practice and obviously the critical components here are really just a quick phone call or an email which we'll have as part of this session to make sure that anybody's looking for help can reach out to you. Last question. As I said before, where do you see us in 60 days Where do you see your business You know, now that, you know, we've gotten a little further down the path when I think a lot of people are, they're starting to see a little bit of blue sky and I think we even in New Jersey where we've been, I think stepped on, the hardest. Where do you see things in 60 days and we'll call it from there.

John Friedman: Yeah, we have definitely been stepped on probably the hardest. I saw a statistic and I, I didn't do any empirical calculation, but the cases in New Jersey and New York, there's a lot more volume in New York. But my instinct and just looking at the numbers is the ratio may be the highest per population base in New Jersey in the entire country. I, again, I'm not a hundred percent on that, but we've got to be very close. So it's been tough and I think people are starting to begin to cautiously breathe and exhale a little bit and they're beginning to get out there a little more. And I certainly hope and that when people get out there that they continue to make very smart decisions and wear a mask, wear gloves, and just be smart about it because it's so important to balance the need for mobility and the need to be able to make a living but also to be smart and use good judgment and at this point, so for 60 days from now, assuming people go about their business in a smart way, in a safe way, I suspect that far as the practice goes, we'll be back in the office.

John Friedman: I suspect we'll be back in the office before 60 days, but let's say 60 days out we'll be back in the office. I would imagine that it'll be some mixture though if we're a hundred percent telehealth right now, which of course is unusual, whereas before maybe we were 98% in the office, I suspect we're going to probably be more of a 50 50 split 60 days from now. I think we'll have some people that are going to be more than happy to come back in and we already have the gun. The conversation internally about how to do that safely. We've been getting masks and sanitizing wipes and we're going to make sure there's policies in place so that we're making sure everything's sanitized in between each and every session, but others are going to want to stay back and we'll work with that. We'll continue to do it this way until such time that people are feeling comfortable and confident to come back in and again, even then we'll probably want to keep this as part of our practice indefinitely because this is the future at this point regardless of the virus. I mean we're going to be more and more video and I think that's what people are going to need and want more of.

Matt Coffy: Well thanks John and I agree with you. I think we're at a new normal. There will be always now a percentage that will want tele-health just because of the experience and because of the lack of, you know, need to drive in or especially if it comes to a point where we have, you know, another situation, whether it's a weather situation or a pandemic or whatever, there's the option, which is really cool. Yeah. Thanks so much for your time today and again, for anybody who is listening to this and you're interested in working with John and his team, I will absolutely have everything that's needed in this podcast

Matt Coffy: show notes and you can certainly reach out whenever you feel like it to John and his team to make sure that you get yourself covered any of the constantly, or if you're interested in partnering with John. So thank you so much today. I appreciate it so much. Thanks for having me.

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