The productivity expectations were difficult to sustain long term, especially while balancing documentation, administrative responsibilities, and quality client care. Clinicians were required to use two separate EHR systems, which made workflows inefficient and time-consuming. One of the systems felt outdated and impractical, adding unnecessary stress and administrative burden to the workday.
The onboarding and training process also felt rushed and insufficient for the complexity of the role. Much of the onboarding work was expected to be completed prior to the official start date and compensated at a significantly lower hourly rate. Beyond the initial training day and a brief follow-up the following week, there was limited structured support before clinicians were expected to begin seeing clients immediately. Appointments started on day one, leaving little time to become comfortable with the EHR systems, workflows, documentation expectations, and overall processes.
There was also an expectation to maintain a high caseload as a “cushion” to account for cancellations, no-shows, and productivity requirements. This often resulted in overloaded schedules and made it difficult to maintain a sustainable work-life balance while still providing quality care and completing documentation thoroughly.
Schedules could also become fragmented throughout the day, contributing to burnout. Communication and support from management were inconsistent, and there was significant pressure surrounding metrics and billable hours. Overall, the workload often felt heavier than what could realistically be completed during scheduled hours.
