Voices in Health and Wellness

Frictionless Psychiatry: How Envision ADHD is Changing Mental Health Delivery with Dr Jake Behrens

• Dr Andrew Greenland • Season 1 • Episode 6

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What if psychiatric care was designed around how patients actually live and work? Dr. Jake Behrens, CEO and Medical Director of Envision ADHD, has spent a decade building just that—a telepsychiatry practice specifically crafted for busy professionals with ADHD who need effective treatment without healthcare friction.

Dr. Behrens takes us behind the scenes of his journey from institutional psychiatrist to healthcare innovator. The catalyst? Watching highly capable patients struggle not with their ADHD symptoms but with a healthcare system that forced them to miss work, schedule appointments weeks in advance, and physically collect paper prescriptions during business hours—precisely when they needed to be most productive.

The resulting practice model turns traditional psychiatry on its head. Through transparent pricing, online scheduling, comprehensive digital assessments, and membership-based care, Envision ADHD eliminates the arbitrary barriers that make consistency nearly impossible for those who need it most. "I want their focus to be on their work, on their work-life, home relationships," Dr. Behrens explains, "not on the day-to-day of how they keep up with their prescriptions."

Most revealing is Dr. Behrens' philosophy on what constitutes success. While traditional practices measure achievement through fully-booked calendars, he measures it through patient stability and minimal appointments—a sign that asynchronous care is working effectively. "The better I'm managing my patients, the more stable they are... I'm successful actually when I have a big practice but my schedule is open."

Whether you're a healthcare provider considering practice innovations, a patient frustrated by traditional care models, or a leader interested in how technology can transform service delivery, this episode offers practical insights into creating truly patient-centered care systems that benefit both providers and those they serve.

 

🧠 Dr. Jake Behrens – Founder & Psychiatrist, Envision ADHD 

Clinic Address:
Envision ADHD
1045 W. Glen Oaks Ln, Suite 205
Mequon, WI 53092, USA

Phone: +1 (262) 404-3878
Fax: +1 (414) 206-1041
Website: www.envisionadhd.com
Email: Contact via website form
Social Media: 

 

Dr Andrew Greenland:

Wonderful. So hello everyone and welcome to Voices in Health and Wellness, where we spotlight the change makers redefining patient care, clinic operations and practitioner well-being across the UK, europe and the US. Today, I'm very excited to be joined by Jake Behrens, the CEO and Medical Director of Envision ADHD, a clinic that's pioneering telepsychiatry model, specifically designed for busy professionals with ADHD. With a background in psychiatry and a deep understanding of executive burnout and focused challenges, jake brings both clinical insight and operational savvy to the conversation, so we'll be diving into a topic that's close to home for many in our field why smart practitioners struggle with work-life balance. Jake has lived both sides of this as a physician and a business leader and I think his perspective is going to be really resonate with a lot of our listeners. So, jake, thank you very much for joining our call today. Where are you calling from, by the way?

Dr Jake Behrens:

I'm in Wisconsin in the United States.

Dr Andrew Greenland:

Wonderful. Okay, so this is a truly global podcast. We're meeting leaders from around the world. But, yeah, thank you very much for joining us.

Dr Jake Behrens:

perhaps you could start by Jake telling us a little bit about your role at Envisioning ADHD and actually how you came about starting this clinic, because it is quite a niche setup and I'm very interested to know how it all kind of came about for sure and say this all comes out of, you know, going back back in residency and training and inry became more and more interested in the kind of adult ADHD space and it came from working with a lot of successful, high-functioning people in the Madison Wisconsin area Went at the university there and actually a lot of project managers actually Epic, the big health records company, is in our backyard. So a lot of project managers, high functioning people out of college coming in either transitioning care or first time really struggling and wanting to be seen more for ADHD. This is going back, you know, 15 years ago. I liked building out tools, outcome tracking tools, looking at data with people, and it was really this population that really loved taking forms on iPads, looking at their data, tracking it, rating scales and whatnot, and that's what got me into ADHD. In this particular population we saw massive reductions of rating scales. They liked looking at their data. I liked it because I could really kind of fine tune different types of treatments with them and see some pretty robust changes. And it was also a clinical niche that at least other people in my department really didn't like working with, especially in the adult space, and for me it was like wagging a white flag saying please give me more evaluations, more people to work with in this space. I identified a lot with the group, liked working with them and I ended up staying on as faculty and that was my niche. That I liked working with was adults with ADHD and over the years started to see just a lot of how. You know.

Dr Jake Behrens:

My whole goal is I want to fine tune treatment and I want people to be more productive, but I want their focus to be on their work, on the work life, home relationships, all that fun stuff. Less on the day-to-day of how do they keep up with their prescriptions, which I saw was a big bottleneck for many people, especially when project managers travel. You know, three, four days a week, they're only in town. Many of these people are only in town on Fridays during business hours and that's when they're their busiest days on campus doing their meetings. And yet once a month they have to beg the supervisors to get time off to drive downtown to see me in person or to pick up a darn piece of paper during business hours prescription and drive it to a pharmacy and, like this is not helping them. This is taking them away from exactly the things I want them to improve on. And that's where I started literally envisioning, okay, how would I want to get care, what is possible I was seeing more and more people going towards my chart was the patient portal type thing for messaging and wanting things to be done asynchronously through there. I had to keep up with messages at all times for refills, for updates, and I started to see kind of envisioning how would I want to get care. Can I create a system that is done more easier scheduling, like with online scheduling, easier messaging, things done remotely, getting into telemedicine, getting into electronic prescribing of controlled substances, which was just coming out around that time. Can I do more robust evaluations up front?

Dr Jake Behrens:

A lot of the tools that I was getting into and helping to create for other institutions when I was doing a lot of health tech consulting, I couldn't use them in my own practice. I knew it was available and I was thinking, okay, can I create a different type of model specifically for this patient population? I felt wasn't met well in the typical fee for service wait six months for an appointment, maybe, get in and wait weeks. They hear back about anything or get refills and I was following the direct primary care models that were starting to emerge around that time kind of a per member per month, all inclusive and I was thinking is this a model that might fit in here, because people need something every single month? I thought I was crazy trying to envisioning this Is it possible? But I got into looking at software what type of products are available? I can do this relatively inexpensively following more of a lean model startup start small, start cheap, fail fast, fail often. And that's where Envision came from.

Dr Jake Behrens:

Built that out, left my job.

Dr Jake Behrens:

This is one of the most difficult things to do to move to Milwaukee because of non-compete start up in a very small office space that I had a flexible lease on.

Dr Jake Behrens:

And just to validate, can this model work of really being there for your patients? You know, all inclusive, I would say message anytime, schedule anytime, wide open, so I can be there with people to help fine tune dosing and hopefully help make it as convenient as possible, while also being able to do more thorough evaluations, closer outcome tracking, setting people up with their own blood pressure cuffs from home, getting into tele, remote, electronic prescribing and whatnot. So it to me it was always like I want to build my little baby, my, my, my clinic is my laboratory where I get to bring in new technologies, new ways to interface with people and iterate very quickly. I'm very impatient when it comes to technology advances and I was so felt, so stuck in a large institution where I feel like new ideas kind of go to committees to die and get get burned out. I needed a place where I could innovate very quickly and that's where it came came from. That was 10 years ago now and now I've been building out and and adjusting as I go and true evolutionary process amazing innovation.

Dr Andrew Greenland:

So what would the patient journey look like? To let people listening? How would it look in terms of how the patient goes through the process?

Dr Jake Behrens:

I know my myself. Once again, in all of this, you kind of like know your clientele, know your niche and if you want to go after it and I always say my niche were my high functioning consultants and anything for myself and I know some of my biggest things in healthcare that had always bothered me was, and still is, the lack of especially here in the US very different in the UK, but in our country really no consistency. Every person we work with has a different set of rules, regulations based on their insurance and how it works, and there's no transparency. So everyone has different rules, restrictions, whatever, and then there's no transparency. So everyone has different rules, restrictions, whatever, and then there's no transparency. Most people don't know the price of anything until they receive said service. Then they get a bill in the mail, which to me, really bothers me. So I wanted a type of practice where people can see exactly on a website see transparent pricing, how it works, exactly what's included, click to schedule, see available times. Do this all on your own, because I know myself even for a haircut, I'm sorry if I can't just walk in or schedule it online. If I had to pick up the phone, I just know myself I wasn't going to do it. So a lot of that true online scheduling, see real-time availability right up front. No transparent pricing, everything laid out, even for how it works. Going forward to me was so important to really put my money where my mouth was. So I want patients to just be able to go to the website, see how the model works, see prices for the evaluation and then what's all included in the ongoing monthly and then, if it's like what they see, they click schedule. Now they see the appointments, they see the, the availability, probably get in within a week um get sent their invitation to the portal, have a lot of information to complete. I would say it's a gauntlet up front a lot of capturing history, easy ways for them to send other links to collect collateral information from other people that know them well, simplify the process.

Dr Jake Behrens:

A lot of different rating skills, online cognitive testing to gather ahead of time all the consents. So by the time I meet with them online, it's a full two-hour eval. I've already gathered and looked through more information than I would have had in a full-hour typical evaluation within larger institutions. And I start with that, and that's where I always find it so robust when you get to meet someone already knowing so much about them. So you get the focus on the details and more psychoeducation. So bringing up screen shares and going through everything with them their rating skills, their testing, bringing up whiteboards and really psychoeducation, drawing things out what is going on in the brain with ADHD, what are all the full menu option of treatments, from medications, therapy, coaching, exercise, diet, supplementation, further labs.

Dr Jake Behrens:

I always want to draw and go through that and that's the whole idea is just doing evaluation. Then they get to do whatever they want with it, no pressure. But if they want to start up in treatment with what we start, they can schedule with me or they can take the report, go to primary care, go to someone in network, but that's the journey the patients have and then from there I'm just one step away from their app, from their portal. To me, the patient experience is what it's all about. So I actually use a lot of software that follows more coaching and I've learned more from coaching and nutritionist software because they have more high touch interactions with their clients. So be HIPAA compliant and all, but I've learned more in that than I have in the traditional health record space, which is more transactional, billing related than it is actual connection with the patient provider. So to me, just that I am, I would say message anytime, schedule anytime. I wanna separate, I wanna help you when you need it and not just these arbitrary scheduled times, if that makes any sense.

Dr Andrew Greenland:

And everything's included.

Dr Jake Behrens:

So you say binge on me when you need it and not just these arbitrary scheduled times, if that makes any sense and everything's included. So you say binge on me when you need me. Otherwise I want to be there and available so that you know I'm just one, one step away anytime, going forward so very, very patient-centered model.

Dr Andrew Greenland:

So what does a typical day look like for you in your business at the moment? If there is such a thing, I don't know how much. Your split is between running the business versus being clinical. It sounds like you're very, very hands-on. What does a typical day look like?

Dr Jake Behrens:

well when it started. No, I started very small, organically, not working with insurance, so I knew it was going to build very slowly. But I did that so I could kind of cross titrate with other consulting locums, tendums, uh, contracting gigs, and as so I had some income coming in while I was starting small. And then, as morning camp, as I was growing my practice, I could cut down on the outside gigs. So let me kind of move.

Dr Jake Behrens:

It was during the pandemic where I really I don't trust a lot of these onsite places. That's why I shifted more towards this. So my day right now I do. I keep one day today's Wednesday. I'm in my office. I see people in person one time. If we start up for treatment to follow a lot of the restrictions with a lot of the medications here. So I see my in-person people. I call it my med startup. We've already evaluated, done everything, come up with a plan. But if they want to start, they meet me in person, get them set up with a blood pressure cuff and we start, start from there. So that's on Wednesdays.

Dr Jake Behrens:

Otherwise, people just schedule into my calendar so they see only my available times. To a Google sync with any scheduling is a godsend. So people only see my available times. It doesn't matter what I'm working in, if I have other meetings, a dentist appointment on my personal calendar, everything is synced. So people only see available times.

Dr Jake Behrens:

I don't have to manage anything. Um, but it's generally a night. I have it set. I can adjust any hours I want, but I I keep it open kind of nine to five, keep a larger lunch break in there, that's what it is generally, jumping on, zoom between follow-ups so I can just know when someone's in my waiting room jump between them seamlessly, easy, easily. But it's different in the model that it is in this kind of per member, per month type of thing where fee for service, you're successful when you're busy, when your calendar is full, that's the epitome of success For me. I say the better I'm managing my patients, the more stable they are, the more I can manage them, keep up with asynchronous type of work, refills, messaging, things I need to do. Obviously. You know I got to meet occasionally and gather data, but I want to get it. I'm successful actually when I have a big practice but my schedule is open. I mean people are taken care of. I can manage them asynchronously during my free time and it's not just all of those scheduled times. So I have, you know I'll often have large blocks of time open and to me that that's a benefit. So, yeah, I am not burning the midnight oil, I'm not doing that part.

Dr Jake Behrens:

I check in with my virtual assistant in the morning when I start. That was my one hire that I brought on. I always say that like it, to me it was almost like failure that if I have to hire someone it means I'm not using technology as well or as efficiently as I should. I brought her on because here in the States, with a lot of the stimulant shortages, the medication shortages at pharmacies, the nightmare is send a prescription, you do your refills, patients message oh they don't have it. What do I do? And we're stuck and it's just so much structure back and forth.

Dr Jake Behrens:

So I did hire a virtual assistant who will she's part of the messaging thread. Patients don't have to change, they just message one place and she'll see it. Google map their current pharmacies, start making phone calls to other local ones, find a medication, do all the backend work we have to do so we can hopefully get it from either review and get it resent to a new pharmacy as quickly as possibly and save the patient all that hassle. But I check in with her in the morning, go through things. She's been a godsend and it's coming up on probably a year and a half with her as the first and only employee that I've had.

Dr Andrew Greenland:

Otherwise, I say run things very small and lean and use technology to make your life easier yeah, that's very evident from your conversation and, using tech, it sounds like a very, very efficient operation. Like you said, very, very lean, very, very efficient. Are you swamped? I mean certainly in this country the waiting list in the health service for an ADHD assessment is probably about two years. I don't know what the situation is in the US. I guess it's obviously a different healthcare model but are you not swamped with demand?

Dr Andrew Greenland:

for this. Well, the niching down is your way of sort of controlling you. Yeah, the niche is there.

Dr Jake Behrens:

I haven't really done much in terms of like the advertising aspect, but even in there in the UK's, you're looking, that's within the Basically within the insurance model. The timeframe, you know, here I don't think it's two years, but I know when I was coming in the practice, where I saw this as a potential niche is it was, you know, at least six months, if not more, for a lot of the evaluations. Um, so I saw that was a place for opportunity and in here, obviously, yes, if, as in the uk, you can find evaluations, but if you pay out of pocket, you will get them much faster. Yeah, and that that's where this is. Yeah, yeah, so I am, I swamped. I try and keep. Once again, I haven't done advertising, I haven't been pushing that. I'm not trying to be busy. I know everyone talks about a clinic and you're, you're successful when you're busy.

Dr Jake Behrens:

I want sustainable growth. I don't want even continuous growth. I think I'm on my max number of patients where I just want to maintain where I am and I am absolutely content and happy with that, which is odd. Everyone thinks grow, grow, grow, grow, grow. You know I consult other businesses, telemedicine models and venture capital funded Everything's about hockey stick growth. That's what scares me in health care, because I don't think that's sustainable. I want a good, sustainable model I'm proud of in healthcare, because I don't think that's sustainable. I want a good, sustainable model I'm proud of and if I maintain that I'm, I think like I don't. I don't think the goal is only exponential growth.

Dr Andrew Greenland:

I think that's a frightening thing, particularly in healthcare actually, I think, if anything I'm going to be trying to like, tapering myself down until quote-unquote retirement sure, and from your perspective, what are the major shifts you're seeing in mental health care or sort of telepsychiatry right now, and I guess this is one of the specialities that lends itself very well to telepsychiatry. But, as you were in that niche, what are you seeing in the sector?

Dr Jake Behrens:

Well, sadly, it took a pandemic for all of the, so many of the leaders in the fields of institutions to finally embrace it, so there's so much pushback against it. Then the pandemic came. Then people were forced to adapt it and all these heads of places that were actively limiting it and putting the like, slowing it down, now they're claiming oh, look at what we did, we championed this. Look at what our institution did. Like no, you're the reason it didn't progress. Don't be claiming that you somehow did something great here.

Dr Jake Behrens:

But I see, even for patients, initially people were more like, so prefer seeing in person. Can I do that when people are given the option? It's amazing how many people convert ultimately to tele once they realize how much more convenient it is. But in the end, as I still think, from the provider standpoint or from the patient standpoint, people have different preferences and the best thing to do is pair people in the way that they want to work together with the providers that want to work in those ways. There's no perfect way for everybody. Different conditions, different patients, I think, and providers should have different preferences for how they want to work or to be seen, and I think what we need to be able to do is pair the right provider with the right patient far better than we normally do.

Dr Jake Behrens:

As I see, people are getting more used to the convenience of you know other service. I don't care if it's a haircut or a massage, whatever. I want to see times and schedule them. I don't want to pick up the phone. I want to go back and forth doing all of that. I think people want to be seen sooner, faster, see more transparency, and even with some rules in the US, where you have to have costs up front is something that's come up with recent rules but I think that transparency is becoming more and more apparent in what people are needing and want access to.

Dr Andrew Greenland:

Interesting. So how do you think expectations have changed for both practitioners and patients, especially in niched-focused practices like yours? Because you have a very specific niche and obviously you've got a fairly lean model and I think you've tried to make it as frictionless as possible, which I guess is something that appeals to patients. But are there any other sort of things you've noticed in terms of expectations?

Dr Jake Behrens:

Well, I think, especially in the patient. Another big thing is with now with health records and patient portals, is patients have much more of the expectation to be able to message there or some asynchronous way to somehow get some form of help, as opposed to schedule an appointment. You know, anytime you have to get two busy people together like synchronously at the same time is more complicated and they always have to ask are we forcing people to have appointments because it's medically necessary to gather information, make a decision, or is it the only way that we can build in a typical fee for service model? And I think that is something that will start to be changing as we have different ways even within insurance, different type of appointments, different ways to build, different asynchronous type of ways to gather data to make decisions.

Dr Jake Behrens:

But I think patients have this like I want to be able to message, I want to be able to get a response in a timely way. I want to, if it's reasonable, to do it in there. I don't want to have to set up this arbitrary appointment time and that was a writing on the wall I was seeing way 10, 15 years ago. Especially when people are booked out so far, you feel like oh, you have to see me to make a change, but wait, I'm booked out for three months. That doesn't help the patient in the middle and I think we'll start to see more in the moment types of ways to be able to help patients where they are, or that expectation, more immediate answers, help and decoupling the idea that care only happens at scheduled arbitrary times. I think it's not just tele location independent, but I think asynchronous time independent as well will better fit patient and providers needs is there anything else that's working really well?

Dr Andrew Greenland:

I mean, are you in your patients sort of feeding back that this is exactly what they want? Are they you're getting that kind of feedback, or is there anything else that they really like that really makes your clinic model um succeed?

Dr Jake Behrens:

I have many. I have once again a lot of times when people first with adhd and adults they look into it's when their children get diagnosed and they start learning about like, oh, like, oh my gosh, this has been me my entire life and it's I even just saw. I just did a med startup here just 20 minutes ago or so. And so woman has two kids seen, you know, treated. The kids are doing well with medications, but she's realized how much of a struggle it is to find the medications, to get refills from the clinic office, just because there's not organization, they don't have that communication. So every month it's this whole fiasco, not just to find it at pharmacies because of the shortage, but even just get the prescription sent and whatnot. And so when she sees this and she knows, you know she has the app on her phone, she can get directly to me. That way she knows to get on the portal different ways to check in. She has her blood pressure cuff at home, she has all the data she needs and she's looking forward to it.

Dr Jake Behrens:

Here I don't work with kids, so it's not like they just transition, but that's always that feedback where you meet people who have any experience with the healthcare system. The bar is so low. It is so easy to exceed expectations when our own bars are so low. And something I have is my model. I always say my goal is if I can get people back to primary care to take over prescriptions, if they're doing well, that's my goal. So I say just the message away to cancel services at any time. And I always keep that, no questions asked, just let me know, I get a cancel, get your record sent.

Dr Jake Behrens:

But I always keep the door open because it's amazing when people go back to an in-network provider primary care or whatever and they realize, wait, it's not as easy as it normally is where I just I sent a message to Jake. Within 24 hours he's gotten back to me, he's figured things out. He's fighting with insurance companies. He's making sure I'm getting the cheapest price possible with any savings program that's out there. I'm getting the cheapest price possible with any savings program that's out there. I'm a bulldog for my patients. To me that's my passion. But when they go to other places and they're like, okay, yes, it's in network, I'm not paying a monthly fee, but screw this, it's not worth my time, and I just keep the door open so people can come right back and to me it's always rewarding when they come back where they choose. This is worth it to stay with within the model and to pay it brilliant.

Dr Andrew Greenland:

Any particular challenges or things that you're finding a struggle? From an operational personal balance standpoint, it sounds like you're a very lean operation, but is there anything that's yet to be solved or things that are an ongoing challenge?

Dr Jake Behrens:

I had to hire my first real employee because someone has to physically be on the phone with pharmacies trying to track down medications. So the stimulant shortages have been an utter nightmare. A lot of the regulatory things around why I can get into, why some medications can have refills and some can't. It doesn't make any sense to me. But the biggest headache, you know, would be managing the insurance and the pharmacy side of things. You know, if you have a prescription on file and farm techs refuse to look for it and lie to patients and tell them they don't have it on file and clearly it's there for them, it amazes me how much, at least in our country, everything falls back on the patient or the provider. No responsibility or liability from the insurance company that says no or holds things up, or from the pharmacies that don't fulfill kind of what's in front of them.

Dr Jake Behrens:

And I think managing that, those landscapes, those have been the biggest headaches. So checking in in the morning with my virtual assistant saying, okay, do we get anything back, any fires to put out, and many times it's what pharmacies we have to contact to make sure that they're running a card correctly or using something correctly to get this discount or, you know, because we have to know how a lot of these pharmaceutical savings programs work. Some of them might be the only medications actually available and we can potentially get them cheaper with some of these plans. So navigating that and all the back and forth, working with reps, pharmacies, um, the insurance company itself and the patient there's so many cooks in the kitchen where we are that honestly, those are the biggest difficulties prior authorizations and whatnot. I would say treating adhd is easy. Navigating the hoops of getting someone to be able to maintain a treatment plan is, yeah, I would say it used to be maybe 30 40 of what I do. If it's not 60 to 75 of my day-to-day right now, I'd probably be lying got it.

Dr Andrew Greenland:

Um, obviously you have a lean operation. You're very much um in control of everything that's going on. You're using technology. You've got your va. Are there any particular metrics that you look at to kind of track what you're doing and sort of see how the business is doing, or any indicators that you have?

Dr Jake Behrens:

the thing that I was um. So whenever someone schedules, they see the price they pay. It's stripe is the back end and I like a lot of the analytics on there. So, especially when I was, when I was starting up and growing, would I always be following and I always track. I would even keep like basically like a journal and I still have my older ones going back, I still keep it up. I'd start like a journal entry and say the date where I'm sitting so I could bring my mind back, they reread it and I'd start. I don't care if I get into other more personal things later, but I always start my entry and it would be the metrics that I was following at the time or even still now is what's? What was my last month's kind of gross revenue? And I track this and it's graphed on a chart. So I see, am I growing from month to month?

Dr Jake Behrens:

The MRR, the monthly revenue, whatever the amount of monthly return recurring revenue recurring revenue, one of the metrics there on on Stripe, and then the total number of active patients that I had. So I'd always get into Stripe, check those and then I would follow. This is back when Mint was around. Now other services, but then just net worth, just overall net worth. Am I moving in the right direction or am I going in the wrong direction? That's a whole other bit of personal finance which I always am excited by and I would track those numbers and I always told myself, which I always am excited by, and I would track those numbers, and I always told myself, like, if I'm one that make changes almost too quickly. So I gave myself that okay, jake, you don't need to just reinvent everything or don't get afraid and say it's a failure. Let's create a model that never existed. I didn't know if this would even work and I made it okay, you're not going to make a drastic change unless you see three consecutive months of not moving in the right direction. If, like, just because you see one month go down, that could be anything. That's not enough data to make a huge pivot on. So that gave me a little bit of grace and a little bit of like okay, I don't freak out. Take a breath, and it's only after three months if I saw a negative trend that I've. Okay, that should be your cue to make a major change.

Dr Jake Behrens:

And that was really all that had come down and that took a lot of pressure off. And even to be able to look back on these entries and just see that consistent you'd see it on the graph and Stripe, but seeing it in your journal entries, that was so helpful and all your thought process always felt like what are the things I'm building or thinking about or contemplating and reviewing those that journey? What are the things I'm building or thinking about, or contemplating and reviewing those that journey? I think it was so powerful and, looking back in retrospect, I love rereading those entries.

Dr Andrew Greenland:

Okay, so where next for Envision ADHD? Where do you want to take the business in the next sort of six to 12 months?

Dr Jake Behrens:

Well, in here I'm not necessarily in growth mode right now and it's kind of odd because it's not that like I just go and all of a sudden I say I retire and I just end it. I have to get to a point and kind of then let it slowly churn itself out. So I got to think okay, when is that point where I kind of crescendo and then start decrescendoing? So I'm not trying to go active like grow, grow, grow. I'm just right now, I'm just kind of maintaining enough new people to keep up with with with kind of churn or people. I'm getting back to primary care. But the things I want to get into more is can I do more asynchronous type of things? Can I build more of like a patient journey? I kind of think of it like a sales funnel. More on a marketing side is can I meet people you know like three type of services you know learn about yourself, rating skills, educational programs that they can get in through my, basically my EHR? I can build out programs and educational tools, get them into my platform, get them started with it, learn about themselves. Maybe, you know, they can then filter down if they want to take a next, smaller, paid type of things at least get them more and more engaged. Can they order their own labs, get involved in their own supplements, dive further, even types of testing, and then at any point they can schedule the full evaluation with me, so kind of like a funnel that could lead down, choose your own adventure.

Dr Jake Behrens:

You don't have to jump the right to a full medical evaluation or medical treatment. That can people learn and start where they want to be in a far less expensive, faster, asynchronous way. But then it's not like they have to start over somewhere. Even you'll have that coupon that can immediately applies. Whatever they paid in, they can take off for the assessment. But then they'd be starting up with someone that they've already. They're already in my platform, they're in the, they have their app, they have their portal and it's just one step away if they want to go the full medical evaluation route and that type of the educational programming and additional tools that people can use on their own without having to have that.

Dr Jake Behrens:

You know I can't scale myself in my time, but I could certainly scale these other type of tools and ways of just literally gather information about yourself to learn. Maybe they could take it and use it with another provider, or even to the point that they could have some set protocols, non-medical things that they could even do on their own to lead up to the eval or full treatment, only if they want or need to so I guess like a value ladder, starting with an education piece and then they can work their way up with some online education, something that I could scale um as well, so it might be worth putting money into marketing getting that out there, because people could do it on their own and it's not just going to fill in a calendar for me, which is that's not what I'm looking for whatsoever got it, and if there's one major roadblock you could solve tomorrow, what would it be?

Dr Andrew Greenland:

I think I might know this, but I, I don't want to preempt.

Dr Jake Behrens:

I could get into everything here in this country with. I'm not saying like regulation, things are are needed, but really just aligning like how. Um well, I guess I want patients be the whole goal. With ADHD, the hardest thing we have is getting our people to be consistent and compliant. I take their treatments regularly, yet we put every roadblock in place to make it impossible for people to take their medications regularly and consistently, which I always find to be rather ironic. But if we could have a way that I can trust that if I send a person well, actually something I could get into this all the time.

Dr Jake Behrens:

I don't know why a prescription doesn't. If you're my patient, I'm seeing you why don't I? This is my e-prescribing software. Why doesn't it go to you as I don't know? If it's tied to your social security whatever, to some ID for you, then whatever pharmacy you go to, you give your information to them. They see it. It's tied to you. If you go to this pharmacy, they pull it up. You go to this pharmacy, they pull it up. Why do I have to send it to a pharmacy? And it's locked. It's stuck on this one single island, not even a chain of pharmacies, but that particular address it's tied to and if that isn't in stock or the patient's traveling, they're screwed. Call your doctor. That does not make any sense. Like, if I prescribe a med, it's to you as my patient. I don't care where you get it filled. Don't put it back on the clinician to have to reroute it. Resend it. Now I have five or six prescriptions all over town. That doesn't make any sense to me.

Dr Jake Behrens:

But that's something I could get into. Other parts of blockchain and verification of tokenization of our prescriptions, so we have a full electronic footprint of them all and more secure verification. But those are the things I could rant. I get really excited about those types of things and even here, by sound I said it's actually it's much more excitement. I always think what can we do versus just like I'll adapt to whatever the current environment is. That's what I'm. I'm here for um, but yes, the the the trouble with when patients cannot receive their prescription. Everything has to fall back on the doctor to fix it or solve it. When, in the end, is we make decisions? If we send a prescription correctly? That should be the end of it.

Dr Andrew Greenland:

Jake. This has really been fantastic, so I really appreciate your openness, the depth of perspective you brought in this discussion, and thank you very much for joining us. I know you've got a clinic that you've got to head off to shortly, but thank you once again for your time this evening, really appreciate it, and I'm sure there's going to be something in what you said that resonates with other practitioners. You have a very interesting model and I'm very interested to learn about it, so thank you again all right, thank you.