The Future of Healthcare: “We need to address the power differential between patients and providers” with Dana McNeil of The Relationship Place

Address the power differential between patients and providers. So many of my female clients tell me they are intimidated to go to see their physician because of a fear that they won’t be believed or their symptoms will be minimized by the provider they met with. Fears and worries about our health make us feel vulnerable, […]

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Address the power differential between patients and providers. So many of my female clients tell me they are intimidated to go to see their physician because of a fear that they won’t be believed or their symptoms will be minimized by the provider they met with. Fears and worries about our health make us feel vulnerable, the empathy and kindness we receive influences the confidence we have in our health care providers and creates a safe space to ask questions or be an advocate for our own health outcomes.

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Dana McNeil, founder of The Relationship PlaceDana McNeil is a Licensed Marriage and Family therapist and is the founder of a group practice called The Relationship Place located in San Diego, California. Dana’s practice specializes in couples’ therapy and utilizes an evidence-based type of couples’ therapy which is known as the Gottman Method. Dana’s practice works with all types of relationship issues from pre-marital counseling, dealing with the aftermath of extra marital affairs, partners working through addiction recovery, military deployed families, parents of special needs children, LGBTQ, and polyamorous clients.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Two experiences compelled me to enter the therapy profession. The first was my former job as a property insurance adjuster helping people after natural disasters. The second was the amazingly helpful pre-marital relationship work I did with my husband before our marriage.

My early career consisted of working for a large insurance company as a property damage claims adjuster. Part of my job was to travel to affected areas of the country in the wake of catastrophes such as hurricanes, floods, and tornados to provide on-the-ground assistance to clients whose homes had experienced damage.

As you can imagine, these clients were traumatized by their experiences. They were often in shock and some experienced guilt about having survived when so many in their community hadn’t.

Many of them also didn’t have access to mental health care.

I soon realized that before I could settle their insurance claims, I would need to provide my clients with support and empathy so they could process their shock and be able to participate in meaningful conversations with me about their property claims.

I found a great sense of purpose in listening to and validating my clients’ experiences as they shared how they had survived their trauma. I saw how helpful it was to them to debrief their feelings.

Before we were married, my husband and I had a long-distance relationship. Because of the challenges of being so far apart, we sought pre-marital counseling.

I knew that regardless of how much I loved my husband-to-be, we were going to face communication challenges, differing expectations, and conflict. I wanted to ensure our marriage got off to a strong start.

I researched the best evidence-based couples therapy methods and fell in love with the Gottman Method because it’s an easy-to-understand and structured method that teaches effective and simple communication skills that build upon one another.

I was also pleased that I could enhance my relationships with everyone in my life by using these skills.

I couldn’t find a local Gottman Method therapist who was taking clients, so we bought Gottman’s “The Seven Principles” book and Skyped with each other every Sunday as we worked through the couples exercises together.

We learned invaluable communication tools that helped us be better partners and we still use them in our relationship today.

I believe firmly in the Gottman relationship method and have found it to be highly valuable not only for myself but also for the clients I work with in my relationship and couples counseling practice.

Can you share the most interesting story that happened to you since you began leading your company?

I found out very quickly that there is a difference between a worker and a leader. I naturally fall into the worker category and always did well in the business world because of my work ethic. I assumed that I could just hire therapists who were good at being clinicians and everything would just come together. That was incredibly naïve on my part and I have really had to hone skills in learning what motivates my employees and find ways to learn what their expectations are so I can be responsive. A result of starting my practice is that I have also received a good education about the fact that other people can’t read my mind! I have worked hard to create good systems that lay out specific approaches to working in the business that can be quantified into behaviors and details about what I am looking for.

Can you tell our readers a bit about why you are an authority in the healthcare field?

As I mentioned previously, my practice utilizes the Gottman Method of couples therapy as the basis of the work we do in sessions with our clients. Because the average couple waits about six years before they seek therapy, they often need more than just a safe space to talk about their problems. The skills we teach clients in our practice has over 30 years of research to back up it’s success.

Because I have made working with couples my life work, I have developed the skills necessary to quickly assess and respond to the needs of couples who are having significant issues in their relationships that may include co-occurring issues such as addiction, affairs, and mental health issues that must be simultaneously dealt with. I find that most group practices focus on individual work and are not as experienced in dealing with the complexities and specialization of couples work.

What makes your company stand out? Can you share a story?

Our therapy practice offers a place to find support, empathy, and outside-of-the-box ways of solving problems.

We aim to break the stereotype of what therapy is supposed to be like and what a relationship should look like.

We don’t have stuffy offices as you might find in a medical practice. Our therapy rooms are warm and cozy. Clients feel like they are sitting in our living room.

We don’t have impersonal therapists who can’t distinguish clients and their situation from other clients. We excel in client care and will treat clients like the unique person everyone is.

Clients won’t feel judged by us. Clients tell us they feel relaxed and supported by our compassionate and genuine therapists. We respect all relationship types, people with all religious beliefs and from all cultures.

Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?

One of the false beliefs couples often come into therapy with is the idea that something is wrong with them because they are fighting. This assumption often keeps couples from seeking out support or new tools because of feelings of guilt or shame around the idea that they “need therapy”. I am passionate about normalizing that conflict in healthy relationships whether explicit or underneath the surface is NORMAL.

I remind my clients in our first session that they are not clones of their partner. Each person has their own thoughts, values, beliefs, family of origin, and expectations about relationships. These differences are a perfect storm to create conflict.

I acknowledge for my couples how brave they are for doing something hard and how smart they are for not continuing to do old unsuccessful patterns. I let couples know there wasn’t some class they missed in high school on what healthy couples’ communication looks like. You haven’t been taught skills anywhere in life how to do this, so therapy is where you learn them.

Most of our clients are so relieved to learn they aren’t broken or damaged, they just need some new skills and our office is the place to learn them.

What are your “5 Things I Wish Someone Told Me Before I Started” and why.

  1. Being a therapist can feel lonely and isolating-Even though I am surrounded by people and connecting with them all day long, it’s one sided. It’s important to have your own support for the things happening in your life-yes, even therapists should see a therapist and should seek out consultation groups.
  2. Get comfortable selling yourself-I don’t think I gave a whole lot of thought to how much I would have to promote myself and my skills in order to get clients. At first it felt a little boastful and less than humble when I had to tell clients about my skills and abilities when they called seeking my services. I realized that clients are reassured that you have skills and they want to know about those skills so they can feel more comfortable not only paying for your services but also in investing their vulnerability with you.
  3. You should understand the value of good SEO-I am probably the least tech-savvy person I know and I assumed because I make my living by talking to people all day, I wouldn’t need to understand anything about the IT world or how the internet works. Unfortunately, most clients want to find out about your services by looking about your website, by checking out your social media or blog postings, or your Googling you. This requires that you can at least have a semi-coherent conversation with the people you hire to make you look computer literate.
  4. Spend the money and hire a bookkeeper-I also am not embarrassed to admit that business math is not my strong suit and in order to save my sanity I have hired the most amazing and patient support people. One lesson any good business person quickly learns is “why spend hours and hours pulling your hair out when you can hire an expert who can do it easily and in a fraction of the time?” You more than make up for it by spending your time on things the owner can contribute that is in alignment with your own expertise.
  5. Work with people you love and create a connected business culture-We often spend more time at work than we do at home so by default our co-workers become part of our family. I only want to spend time with people that make me a better version of me and vice versa. There is not enough time in the world to work with negative attitudes or people who can’t be team players. No matter how much money an employee may bring into my business, if I don’t admire their character and what they stand for then I don’t want them as part of my practice.

Let’s jump to the main focus of our interview. According to this studycited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  1. I think most of us who have health insurance coverage fear using coverage because of worries that you will be cancelled or non-renewed for using it.
  2. Huge deductibles, co-insurance, co-pays, and percentages of out-of-pocket expenses that are incurred above and beyond the premiums paid for the policy itself confuse clients.
  3. Some of the best providers don’t take insurance and clients are paying out of pocket for care.

My practice doesn’t take insurance because it’s not cost-effective for us to run our practice and cover employee expenses and overhead costs with the funds many insurance companies are currently offering for sessions. Additionally, I am hesitant to accept insurance because of the paperwork involved with submission and continued documentation requests. Some insurance companies don’t provide coverage for couples therapy and require a mental health diagnosis in order to use the coverage. Having relationship issues is a normal part of life and is preventative care so it’s not something I am confident I could even find coverage for my clients who wanted to use insurance.

Our practice is not alone in this thinking. I read an article a few years ago that said only about 33% of therapists accept insurance. Group practices who have big corporate models can make a living by seeing clients in bulk. We are a small boutique practice with a focus on our clients’ experience and focusing on their individual needs.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

  1. Make everything covered-the last thing anyone who is sick or needs help should have to worry about is whether not their condition is covered by an insurance policy.
  2. More integration of eastern medicine modalities-I would love my primary care physician to talk to me about topics like mediation, acupuncture, and yoga as part of treatment plans. I am much more interested in the options I have available to me that might not include medication as a go-to.
  3. Spend time with your patients-one of the best parts of my work with clients is that I get to spend an hour at a time with them and really get to have a working knowledge about their world. So many of the prescribing providers my clients are seeing end up spending only 15 minutes every few months and are making decisions about medications without knowing the big picture.
  4. The interconnection between mental health and physical health-our bodies are sometimes sick because they reflect what is happening with our mental health. I sincerely believe as a society we need to do a better job training everyone in the healthcare system how to talk to clients about the connection between the way they handle stress and anxiety and the correlating impact it has on our physical health.
  5. Address the power differential between patients and providers-So many of my female clients tell me they are intimidated to go to see their physician because of a fear that they won’t be believed or their symptoms will be minimized by the provider they met with. Fears and worries about our health make us feel vulnerable, the empathy and kindness we receive influences the confidence we have in our health care providers and creates a safe space to ask questions or be an advocate for our own health outcomes.

Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?

The ideas I suggested could possibly be addressed by creating insurance policies that are more a la carte options that create more choices for clients who prefer to seek alternative care. Creating insurance policies that allow for more monetary reimbursement for out-of-network benefits and seeking input from individuals about the kind of care they most want to have covered in a plan is a good start.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

As you might have guessed I love psychology and self-care books. I am always learning new things about how the human mind processes trauma and attachment injuries from our childhood. I love reading the new self-help books that clients might be reading. We get to use them to compare and contrast their thoughts on what they found helpful and incorporate it in our work.

I am a huge podcast junkie and I am really enjoying the podcast called The Therapy Den because the host interviews clients about the things they wish their therapist would do in sessions to make a better experience for their clients.

How can our readers follow you on social media?

Thank you so much for these insights! This was so inspiring!

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