u/mschreiber1

I’ve been reading the posts here about the dangers of AI, and I wanted to share something I’ve noticed in my own practice—not to dismiss those concerns, but to explore another aspect of using it.
 
I use an app that transcribes session audio and turns it into a draft note. Comparing the transcript with the note has highlighted two different gaps: clinically relevant details I didn’t fully register or retain during the session, and information the app leaves out when it condenses the conversation.
 
The first has been illuminating. In my own experience, being present with a client isn’t the same as being able to recall every detail afterward. Reviewing the transcript and draft note sometimes brings my attention back to something I might otherwise have overlooked and gives me an opportunity to consider its clinical significance.
 
The second makes me cautious. I don’t think the AI “understands” the client better than I do, and I don’t treat its note as the authoritative account of the session. Comparing it with the transcript makes the omissions more visible, but it also raises a question: how much do the app’s selection and framing influence what I notice afterward? Am I returning to something meaningful in the client’s words, or being drawn toward what the software chose to emphasize?
 
I realize I could also revisit sessions by recording them and listening back, so I’m not claiming this benefit is unique to AI. For me, the practical difference is that reviewing a draft note fits into my existing documentation workflow, while listening back to an entire session would be a separate task. That convenience doesn’t resolve the concerns; it explains why this has become an opportunity for reflection in my practice.
 
Has anyone else who uses AI documentation noticed these two gaps—what you didn’t retain and what the app leaves out? How do you distinguish a useful reminder from a misleading summary, and how do you keep the generated note from shaping your understanding of the session too much?

I could be wrong but pretty sure he messed up

Hey everyone,

I'm an LCSW-R in NYC preparing to make the transition out of my agency/salaried role of 11 years at the VA and transition my small part time private practice into a full-time solo private practice via telehealth.

I’m currently in the process of getting credentialed through Alma to take advantage of their contracted insurance rates (specifically with Aetna, Optum, Cigna) and streamline the billing/EHR side of things. My target is a steady, manageable caseload of around 15–18 sessions a week which would equal
my current federal salary. I currently am a provider for most major health insurance companies.

For those of you who are currently using Alma or have used them recently:

1. Referral Volume vs. Marketing: How much of your current caseload comes directly from Alma’s directory versus your own marketing (Psychology Today, local networking, word of mouth)?
2. Reimbursement & Billing: How reliable have weekly payouts and claims processing been for you? Any unexpected issues with clawbacks, eligibility verification errors, or insurance audits?
3. Customer Support: How responsive is their support team when a billing glitch or insurance inquiry actually comes up?
4. Overall Value: Do you feel the monthly/annual membership fee pays for itself compared to platforms like Headway or doing independent credentialing on your own?

I'd love to hear your honest pros, cons, or anything you wish you had known before launching with them. Thanks in advance for sharing your insights!

Hey everyone,

I'm an LCSW-R in NYC preparing to make the transition out of my agency/salaried role of 11 years at the VA and transition my small part time private practice into a full-time solo private practice via telehealth.

I’m currently in the process of getting credentialed through Alma to take advantage of their contracted insurance rates (specifically with Aetna, Optum, Cigna) and streamline the billing/EHR side of things. My target is a steady, manageable caseload of around 15–18 sessions a week which would equal
my current federal salary. I currently am a provider for most major insurance companies.

For those of you who are currently using Alma or have used them recently:

1. ⁠Referral Volume vs. Marketing: How much of your current caseload comes directly from Alma’s directory versus your own marketing (Psychology Today, local networking, word of mouth)?
2. ⁠Reimbursement & Billing: How reliable have weekly payouts and claims processing been for you? Any unexpected issues with clawbacks, eligibility verification errors, or insurance audits?
3. ⁠Customer Support: How responsive is their support team when a billing glitch or insurance inquiry actually comes up?
4. ⁠Overall Value: Do you feel the monthly/annual membership fee pays for itself compared to platforms like Headway or doing independent credentialing on your own?

I'd love to hear your honest pros, cons, or anything you wish you had known before launching with them. Thanks in advance for sharing your insights!

Hey everyone,

I'm an LCSW preparing to make the transition out of my agency/salaried role of 11 years at the VA and transition my small part time private practice into a full-time solo private practice via telehealth.

I’m currently in the process of getting credentialed through Alma to take advantage of their contracted insurance rates (specifically with Aetna, Optum, Cigna) and streamline the billing/EHR side of things. My target is a steady, manageable caseload of around 15–18 sessions a week which would equal
my current federal salary.

For those of you who are currently using Alma or have used them recently:

1. Referral Volume vs. Marketing: How much of your current caseload comes directly from Alma’s directory versus your own marketing (Psychology Today, local networking, word of mouth)?

2. Reimbursement & Billing: How reliable have weekly payouts and claims processing been for you? Any unexpected issues with clawbacks, eligibility verification errors, or insurance audits?

3. Customer Support: How responsive is their support team when a billing glitch or insurance inquiry actually comes up?

4. Overall Value: Do you feel the monthly/annual membership fee pays for itself compared to platforms like Headway or doing independent credentialing on your own?

I'd love to hear your honest pros, cons, or anything you wish you had known before launching with them. Thanks in advance for sharing your insights!

Working Stiff (Mockumentary)
In the vein of 'This Is Spinal Tap,' a deadpan documentary crew follows a faded, VHS-era adult film legend as he undergoes a grueling "training" regimen to make one final, high-stakes comeback in the modern, fast-paced world of internet streaming.

In the vein of 'This Is Spinal Tap,' a deadpan documentary crew follows a faded, VHS-era adult film legend as he undergoes a grueling "training" regimen to make one final, high-stakes comeback in the modern, fast-paced world of internet streaming.

Do any of you have any protocol for how to inform your patients if you die? My therapist recently informed me he is seriously ill and I began wondering how I might be informed if I need medical updates he can’t provide me himself. Obviously this is a question for him but I didn’t ask him yet.

In his stand-up routines, George Carlin expressed a notably blunt perspective on having children. He specifically called it "irresponsible" to have more than one child and recommended having just a single kid simply for personal "replacement value".

He shared his thoughts on family sizes through several observations:

Just the One Child: He famously argued that having only one child is plenty, joking on stage about his logic. He would ask, "Have one. Have one child. Replacement value for yourself, that's all. Don't even replace your husband. No, he's done enough f---ing damage as it is."

General View of Parenthood: Beyond the number of kids, Carlin had a generally skeptical view of how children were treated in modern society. He heavily criticized "obsessive diaper sniffers" and "helicopter parents" whom he felt over-scheduled and over-managed their children, robbing them of their childhoods.

His Own Family: Despite his biting comedy about parenthood, Carlin was actually a father of one himself. He had one daughter, Kelly Carlin, who later became an advocate for his legacy.

How are folks using AI in their practices?