Dr. Carlene MacMillan
Welcome to the Psychiatry Tomorrow podcast. I’m Dr. Carlene MacMillan , and in each episode, we interview thought leaders in the deep end of psychiatry’s next frontier. Dive into the latest research, innovative treatments, technology, and policy development shaping the future of psychiatry. Join us on this journey to discover what’s next in mental health care so you can stay ahead of the curve. Fellow mental health futurist, Kaitlyn Rubella, talked with Ben about what it’s been like to start a Ketamine therapy practice in a small conservative town. What really stood out for me in this interview was how Denovo Therapy actually took a medical student who was getting Ketamine therapy, wanted to journal, decided to journal on his own. And they ended up using a combination of journaling as well as measurement based care, so rating scales, and turned that into a case study. Didn’t know at the time they were going to do that, but felt like a powerful thing to do. And I really want to highlight that for those of us in private practice to think more about how we can take interesting cases, take cases we think our colleagues can learn from, and actually go ahead and publish them in peer review journals, either as individual case studies or even case series.
Dr. Carlene MacMillan
Those of us that are on the frontier, we have a lot of interesting information. And if it just stays within the four walls of our office, it helps the patient, which is great, but it has the potential to do so much more good. So I hope that this inspires you to think about that. There’s been so many great moments in this interview. Ben also talks about bringing trainees to learn from academic centers. So again, just because you are in private practice does not mean that you can’t be academic, that you can’t collaborate with trainees. There’s so much that we all can do. And so I hope you’ll enjoy. And without further ado, here we go.
Ben McCauley
Ben McCauley. I refer to myself as the director of the clinic, but I’m also the owner and creator of the clinic. We started in 2019. We opened with one room, a physician and a therapist, and we were doing IVs with integration support. The vision and the goal was to create a multidisciplinary, full service psychedelic therapy clinic. So in our one room, over the course of a few months, we grew to add Ketamine assisted psychotherapy. And then we started training therapists. And at that time, there wasn’t a lot of options for how to train therapists or courses you could go to. There were a few. So we just had to DIY a therapist training program. And so we took the MAPS training in Zendo, and we took the LSD handbook that Grof made and any resources that we could get our hands on and amalgamated together a therapist training program. And then from there, we started treating people. And a lot of the people treated at the beginning were therapists, and they immediately gravitated to the work because they do really well with medicine generally. And so when they had their own experiences, they naturally asked, how can I work with clients in this way?
Ben McCauley
And so we started training therapists. And since then, we grew. We moved to a new location in 2020. Had to, of course, survive all kinds of crazy things with the pandemic. And now we have three in house therapists, four out of house therapists, four part time nurse practitioners basically that work with us, a medical director and two employees. We’ve served around 700 patients with probably thousands of treatments. Many of them get multiple. And that just includes the Ketamine and psychedelic work that we’re doing. That doesn’t include therapy clients that come to us just for regular therapy. It’d be a much larger number with them.
Dr. Carlene MacMillan
I am really interested by your growth and direction, so I would love to dive into that a little bit more. What was the driver behind more of your interest in breakthrough mental health treatments? W hat drove you from being more of what I think the public would consider more of a traditional versus where you are in really taking on novel treatment opportunities for treatments?
Ben McCauley
Yeah. Well, I think like many people in the psychedelic field, I discovered psychedelics in 2017 and had never had any illicit experiences before that or anything. Just was looking for care for myself and for loved ones and trying to find something that would work, of course. And my own experiences said, hey, this is how we can actually make a dent in our community. This is how we can change the way the society works. It’s not about changing people, it’s about healing people. So that was the original passion that drove me to want to start the clinic. And that dovetailed into looking for Ketamine for a loved one who would have needed a more legitimate model. And so we were looking at traveling and we were looking at clinics around. And there just wasn’t a good option here. And so this was in 2017 or into 2018. I started thinking about, well, maybe someone needs to open a Ketamine clinic here. And I had a mentor who’s a physician who had opened other medical businesses who I was having coffee with him. And I told him I was thinking about doing this. And he said, you should do it and you should do it, regardless of whether or not it fails, because it’ll be worth it.
Ben McCauley
The work and the things that you’ll learn will be worth it, regardless of what happens to it. And that was just the tiny little push that I needed to try. So that was around the summer of 2018. And then it took about a year to put together the infrastructure for the clinic and the medical and everything and figure out how all of that worked. And then we opened a soft open in the summer of 2019, where we treated friends and family for a discount and to work out our processes and our flow and what all those things were going to be like. And then a harder open a few months later. Everything that we did was bootstrapped. We built the clinic on a $10,000 initial investment and everything that we’ve done since then has been cash operations. So we’re really blessed and grateful that it’s been able to grow the way it is. But yeah, it’s been a lot of work, but it’s totally worth it.
Dr. Carlene MacMillan
Sounds like, too, that you saw not only a unique business opportunity, but a way to serve the community as the only. Being the only clinic of your type, was that a very specific, unique challenge that you saw along the way?
Ben McCauley
Yeah, it was really important from the beginning. You don’t know what you don’t know, but we knew we needed therapy support, and we built that in from the beginning. So it wasn’t just a medical office. But in between opening and my own personal healing journey with psychedelics, I just obsessively read everything I could get my hands on about the model of care. And so from the beginning, we wanted to start the clinic with a psychedelic therapy model of care. Now, I look back now and my ideas about what that meant were pretty naive, but at least the root was there and the heart was there to build something that was an integrated model.
Dr. Carlene MacMillan
So the name Denovo is so unique. Can you tell us a little bit about why you chose it?
Ben McCauley
Yeah. In medicine, Denovo represents new synthesis or new creation of something. And so, for example, Denovo lipogenesis is new fat making. And so when we were trying to think of what we were going to call the clinic, I really wanted to stay away from the Ketamine Clinic name because I wanted to build a psychedelic therapy practice. And so I was thinking more long term them like, yes, Ketamine is great. And Ketamine will always be a tool that we use. Even when MDMA comes out, Ketamine has a lot of value. But I wanted a name that reflected what we’re trying to do with people in their lives. And so we went with Denovo as a way to say, yet we’re trying to help partner with you to become a new creation or find a new path or do something new, become something new. Yeah. And the dragonfly actually in our businesses is very similar. It goes through multiple stages of metamorphosis. And we felt like that was a great image for how people grew and changed. And so that’s part of the reason that we went with that as a logo.
Dr. Carlene MacMillan
And tell us a little bit more about your community. What should we know about Lubbock? I’ve never been there. So how would you describe it to me as a stranger?
Ben McCauley
Sure. Yeah. Well, it’s where I’m from. So there’s a benefit there for me of knowing the people that live here and their particular prec realities and what will serve them and what will not serve them, what won’t serve them. There’s about 250,000 people here. And it’s in West Texas up north in the Panhandle, right where the Panhandle starts. And it’s referred to as the hub city because it’s the medical and economic center of the region. It’s very politically conservative, and a lot of the people here are very religious or evangelical. And so the demographics mean that what we’re doing here requires different ways of thinking about how to serve our community.
Dr. Carlene MacMillan
It sounds really unique. Who would you say or how would you describe your average patient?
Ben McCauley
A lot of people ask that. Most more women than men, but not by much. More middle aged, but not by much. This is an interesting care model and people are driven to us for lots of different reasons. People come to see us because a lot of the time they come to see us because their suffering is so great. And they may not even know what psychedelics are. As a matter of fact, we didn’t even use the word psychedelic openly in any of our marketing or documentation until this year. Because we wanted to care for people, we didn’t want people to get caught up in ideological conflicts about whether or not they would come here because of what that word might mean.
And I’m a part of that community, of course. And I’m for redeeming what that word means. But we redeem what that word means with our actions and how we care for people. So I don’t have to necessarily use the word And then other people are coming to us because they’ve heard of what psychedelic therapy is and they’re interested in what we do. And so they come in with a baseline curiosity and they want to talk about altered states of consciousness and how those can be used for healing.
But early on, I bet 95 % of the patients that we saw when we first opened were not only psychedelic naive, but even just marijuana naive, just altered consciousness naive in general. That’s changing now because the education is out in the community more and just nationally and people are catching on to what’s happening. And so more often now we’re having conversations about what the psychedelic care looks like, but it’s still probably 70 %, 30 %, 70 % still don’t necessarily know what that is or have heard of it.
Dr. Carlene MacMillan
So I want to talk more about some of your clinical leadership and then also just your leadership with your peer network. So just to ground our listeners again, what specific treatments do you offer today?
Ben McCauley
Yeah, regular therapy. And we have licensed professional counselors, marriage and family therapists, and licensed clinical social workers here that just do regular therapy, so a person can choose. We do Ketamine assisted psychotherapy. So that’s with a therapist in the room. And we see this as a therapy track for altered states work. And all of our therapists have received training in how to do psychedelic therapy. Various ones of them have been to MAPS or other trainings, including myself. I went to Ketamine Training Center. And then we offer intravenous Ketamine. And it’s important for me that people hear that we do IV Ketamine under a psychedelic model of care. So we tthat includes setting education about experience and preparation for what could happen with the experience. And it includes meaning making after the experience from a reflective modeling approach, not exactly a therapy approach. So we do open ended reflective questions after the end of their experience, and we use that to capture their experience and encourage the patient to take those notes and make meaning from them or to meet with a therapist and talk with them about that. Even in the IVs, there’s music, there’s eyeshades, it’s in a comfortable room, it’s one on one.
Ben McCauley
So we modeled our IV care based on a psychedelic model. And I didn’t know this at the time when we were opening, but it ended up being an incredible blessing that we have IVs. Because a lot of the patients that we see still carry a lot of stigma about mental health, and they don’t want to see a therapist either because of the stigma or because it’s failed them in the past. This is very common. I can’t emphasize how important this is. And IVs give us an option for treating people in a in a phenomen that they want. They respect the medical track. They may not want to go the therapy track for the various reasons. And the medical track is the modern day expression of trust in the community from an authority that they need. And it provides a sense of ritual in starting an IV that’s important for people. What’s missing in a lot of the IV clinics is the psychedelic modeling and the meeting making that needs to be applied and the cross disciplinary approach of having therapists in house also. By providing that, we’re giving people an avenue to choose that works within their own life and phenomena.
And so we see a lot of people choose that for those reasons. And then once they get a little bit of plasticity and they build some rapport with us and they’re willing to, then oftentimes, not all the time, maybe 30 or 40 % if I’m just throwing a dart, they will opt into therapy or Ketamine assisted psychotherapy later, and we’re able to give them a more comprehensive care and help them along their journey even more. But we try to meet them where they are. And that’s important for the psychedelic model because we’re trusting their inner wisdom and their inner healer to direct their path.
Dr. Carlene MacMillan
I love this aspect of applying a model and this comprehensive approach. And, Ben, we talked a couple of weeks ago. I know that you were also welcoming other therapists and leaders to your practice to talk about this and share best practices and effectiveness. Could you tell us a little bit about that?
Ben McCauley
Yeah, we have a bunch of stuff going on. One, we have clinical psychology PhD students from Texas Tech that are doing rotations with us, and we expect to have them for a few years. They’re in their second semester with us. They’re learning how to do Ketamine assisted psychotherapy sessions. This is a really huge deal to be able to offer the community more care because they’re here and they’re lovely. And then we also found out just recently that the residency program for Psychiatry at the Health Sciences Center, Texas Tech is going to let one of their residents do an elective rotation with us to learn about this. And so we’re really excited.
Yeah, thank you. It’s a really big move into the community that they’re willing to let them come. And so I’m hopeful and excited about that. I want to teach them about the psychedelic model. And of course, about Ketamine and all of the things. But the psychedelic model is really what I’m passionate about. And then also we’re doing consulting and training. And so we’ve hosted, I think, five or six groups in the last six months into the clinic where we walk them through clinic operations, is combining the therapy and the medical model into a psychedelic model, how to do caps, how to do IVs from a psychedelic model.
And then those trainings are also experiential. So anyone who comes to train with us, we provide them experiences as part of that. And we’re doing some consulting too, just around talking with people over Zoom or however, about how to start their clinic or roadblocks that they’re coming into. And this is really complicated. Of course, when you’re starting, you don’t really realize what you’re getting into. But to operate in a multidisciplinary way like this, you have to merge the therapy model with the medical model. And there’s things that are conflict there, and there’s things that are problems. But there’s also really beautiful synergy in how they operate. And we’re able to provide, I think, a more comprehensive care and a more holistic care to people because we mix the model together.
Dr. Carlene MacMillan
It sounds like you are very much pioneering what it will look like because of the inherent conflict between these two models. So I would love to hear more about that if there’s anything that you wanted to share or even maybe sharing with listeners some of those other common roadblocks that other people who are starting their own clinics may have run into. So sorry, that was a two for one question.
Ben McCauley
Yeah, you’re great. And it’s important for me to say that I’m not a therapist or a physician, actually. So that’s a big part of why this has happened to this way serendipitously, because in order to work together, we have to work cooperatively. There’s not one person who is the end all be all in charge. I can’t provide therapy. I assist in group sessions with therapists, but we make sure that there’s a therapist there, and I can’t practice medicine. And so I have to partner with people and I have to bring them together, and then I have to educate them about how their model of care, the medical or the therapy, mixes with the other one and teach them about what we’re doing. And it was a necessity to be done that way. And I think it’s really important because the innovation happens in the overlap between the two.
Dr. Carlene MacMillan
I love that. Something else I think it’s really special about your practice, Ben, is not only leading the operational side, but I also know that you have published recently clinical papers on advancing this medicine. So could you share a little bit about that?
Ben McCauley
Yeah. I came from the hospital and I worked everywhere in the hospital. And I even worked in clinical informatics. And I was an ER physician’scribe for a long time. I mean, if it was an ancillary position, I did it. And so I’m a mixed bag. I have a little bit of clinical skills and I have a little bit of therapy skills. I’m trained in internal family systems, actually, and I’m working to get certified with that. And so I see myself a little bit as the linchpin between these two models.
So because of my experience, I wrote a lot of our medical protocols. Actually, I wrote all of our medical and care delivery protocols and, of course, had to have them approved by the medical director that we have and all of that. And as a part of that, we wanted to expand the field and case studies are a really great way to do that. So in December, we published a case study about a medical student who had relief from PTSD, generalized anxiety and treatment resistant depression and suicidality. It published in Frontiers in Psychiatry in December. And it’s a really beautiful case study because it shows what an integrative model looks like, and it shows what a psychedelic model of care looks like, and it shows how the patient’s internal wisdom and healer directed the cadence and type of experience that they had and what that can mean for their mental health.
And we talk about all of that. We talk about the psychotherapy that was offered, the Ketamine assisted therapy that’s or the IVs that were offered. And this particular patient, of their own volition, chose to live tie the subjective experience of their Ketamine IVs. And at that time, course, we had no idea that we were going to publish this. So we were just thinking, well, he’s taking ownership in his care. This is advocacy for himself. And so while this might also distract from his experience, and we could have a conversation about why you might not want to do that. We also wanted to encourage him in his own care. And so we said, okay, well, let’s have a conversation about confidentiality and some of the things that would be concerned about having this record. But you can type your experiences during the treatment if you want. And it ended up being such a beautiful thing because you can read what someone’s thinking and experiencing live in a session. And there are lots of things on the internet about this is what my experience was like and people journaling that. But there isn’t anything in an academic journal like that.
At least we couldn’t find anything equivalent in an academic journal. And so we were really excited to publish it. And we wanted to show people, you can do this, you can do do it together. You can do it under psychedelic model of care, and it’s really beautiful.
Dr. Carlene MacMillan
I think that is such an interesting thing to do from a clinical perspective because I do feel like there are a lot of articles out there right now, especially outside of a clinical setting where people are publishing their experiences. And so I think having this clinically minded piece is really important for the community to have to point to in terms of setting a new for excellence. And I really appreciate the behind the scenes look at how you prepared the subject in that case for what that experience would be and how it would affect their outcomes at the end of the day.
Ben McCauley
Yeah. If you look at the study, they live journaled treatments five through eight, and their Ketamine assisted psychotherapy sessions were around treatments nine and 10. So we had four IV sessions, four IV sessions live journaled, then Ketamine psychotherapy sessions mixed in, and then regular therapy mixed in. And they had a resolution of their suicidality and PTSD within a month and almost all of their symptoms within eight months. And the paper also shows a 10 month maintenance phase that’s PRN. So as the patient needed it, they could come back for a booster treatment. I know this person now and they’re doing really well still and even participated in a men’s group cap session that we had that lasted six months. And so it’s beautiful to see that this eight month regiment worked perfectly for this person, but it was directed by them. And so we’re not saying that an eight month regiment is what everybody needs. What we’re want to ask you? Yeah. What we’re saying is that the patient is capable of following their inner wisdom, their safety, and their curiosity towards the treatment that makes sense to them at the time. And that my opinion about what that might be comes secondary to that.
Dr. Carlene MacMillan
That makes sense.
Dr. Carlene MacMillan
Switching gears a little bit. I think underpinning a lot of the work that you all have done. And I think maybe this is a good question for you with your multidisciplinary background as well is thinking about where Osmind as an electronic health record fits in with all of this too. How does it affect the way that you deliver care as an organization, as a clinic?
Ben McCauley
Yeah. Well, gosh, there’s a lot of roads there. So first of all, for Osmind, I would say the ease of use is a big deal. We don’t have to do any training. This is your note type. All the stuff is already there for you.
Dr. Carlene MacMillan
This.
Ben McCauley
Is what you fill out and our providers are able to drop into it immediately and fill it out. From a touch point and a pain point perspective, it’s really easy and wonderful to use. And there’s other things that I could say that that’s a big one. I worked in clinical informatics, I won’t say which EMR, and at a big hospital here, and it was cumbersome. It looked like someone slapped a Windows 95 UI on top of a database. It’s just gross. And Osborne was super slick and easy to use. And that was one of the big drivers for me in going with it. So that’s a big deal. And then, of course, the patient interaction piece that Osborne has with the app is a really big deal. We’re able to track people’s progress. And when things are going as expected, okay, yeah, you’re telling us that you’re doing better and your scores are showing that you’re doing better. That’s great. But when things go a little sideways or what the patient is experiencing isn’t quite matching what their scores are showing, then it gets really interesting from a data perspective. And when people are tracking themselves with the app, it’s really helpful to look at that because you can get more insight into what’s going on with them.
Dr. Carlene MacMillan
Do you almost use it as an early warning signal if a patient is declining?
Ben McCauley
It’s hard to know when that happens whether or not it’s a trend or a temporary life change. Sure. What gets really interesting is when there’s contradictory relations. So for example, their pH goes down, but their GAD goes up. Why would that happen? Well, we can have a team meeting and discuss it. Or when they’re telling us that they’re not doing better, but their scores are improving. And that gives us some really juicy material for a therapy session about expectations and subjectivity and things like that.
Dr. Carlene MacMillan
When you were going through starting the clinic and just thinking about the operational side, I’m curious if like, Osmind was in a progression of different EHRs that you tried, if it was the first one that you adopted. Can you tell us a little bit about that process?
Ben McCauley
Yeah.
Dr. Carlene MacMillan
Sure. I mean, feel.
Ben McCauley
Like, gladly. When we opened, I just wrote all of our documentation on paper. Got you. I wrote it from scratch. I worked in clinical IT, and I was like, I am not doing this for a small number of patients. We could just write it down and it’ll be fine. And so we just customized HMP templates and stuff like that and just made them for our specific purposes. But once we started to get a little bit bigger and the file cabinet started to grow, I was like, This is not a sustainable choice, obviously. I knew too much to be dangerous. And so when I started looking at EMG, MARS, I was like, No, that sucks. No, that sucks. No. One of the big problems that I ran into was they were customized for medical or therapy, and they didn’t mix the two well, and none of them knew what to do with Ketamine. And I probably did this at least six or seven times where I would sign up for a trial, create an account, look for templates. It’s a disaster. Try to find Ketamine templates. They’re terrible. Just documenting on it was cumbersome and painful.
Ben McCauley
And I was just like, I know this world and I’m not doing this. And so I went through quite a few trials trying to figure out a way to do it. And I really, I was resistant. I didn’t want to do an ad hoc bandaid duct taped version. I just wanted something clean. And none of them were. So when I saw Osmind on a conference, and I think it was the fall of 19, I think it was right before the pandemic, somewhere around there, we did a Zoom conference for psychedelics, and I saw them on there and looked them up.
And I was like, Okay, this is what I’m looking for. In running the clinic, I try to rethink anything that’s happening so I hope no one’s offended by this. But one of my mottos is don’t do what the hospital does. And so think about everything that we do from a care delivery perspective and pretend like you’ve never seen it before and then redo it. And so when I saw what Osmind was doing, I was like, These guys are trying to innovate the space and create a solution that works that isn’t so cumbersome.
And of course, when I demoed it, I was like, Yes, it was a no brainer. This is it.
Dr. Carlene MacMillan
That’s awesome. Thank you for that feedback.
So I’m going to push a little bit more, if you don’t mind. I feel like a lot of the things that we hear about just from a product perspective are the workflows being a really big one. Has the billing system changed the way that you interact with payers? What does that environment look like? Because I know it’s challenging, too, with payer approvals.
Ben McCauley
Right now, we still aren’t able to take insurance. So I don’t know if I can speak much to payer approval. Yeah, that’s fair. I would like to work that direction, of course.
Dr. Carlene MacMillan
So right now it’s more like patient billing, direct.
Ben McCauley
Patient billing? It is, yes, direct to patient. And we’ve stuck our toes into the insurance world a few times, and we have not gotten much back from them.
Dr. Carlene MacMillan
I think that’s a very big industry systemic issue.
Ben McCauley
It’s a big problem.
Dr. Carlene MacMillan
Yeah. Absolutely. You had talked earlier just about… And you can tell me if these things don’t fit together. I just don’t know the words well enough. But in that psychedelic model and interpreting the meaning of those experiences, do you use the patient journals in Osmind for that, or is that managed outside?
Ben McCauley
We encourage them to download the app and to use it. We don’t require it partially because we want to work with whatever their phenomena is they come to the table with. And so the patients that do use it have found it beneficial. And that’s been something that we’ve been able to track as a part of their care. So in the industry, the saying is, after you have a psychedelic experience, you’ll never regret journaling, but you might regret not journaling. And so I actually told a client that earlier today at one of our intakes, so that we encourage them to journal in general. And then if they use the app, that’s great because we can track it. But we don’t require them to do it. We want to work with them where they are.
Dr. Carlene MacMillan
Yeah, absolutely. That’s fair. So you had mentioned when the file candidates were getting too big, and I love that visual. Were there any other very distinct things that felt very before and after for you where you were like, this is a very significant change for the practice?
Ben McCauley
Well, I mean, going from paper, I can log in from home and I can check on people. And if we don’t have a consent form, I can just send it to them straight out of the system. And so that’s where some of my IT experience did come in is I thought a lot about what is the patient experience I don’t want to make it cumbersome. I don’t want them to come in and get a clipboard with a pen that looks like it’s been chewed on and have to fill out on a piece of paper and then you’re scanning it in. I just didn’t want to play any of that game. And so we we redid all of our consent forms, redid the formatting of them so that you could see them on a phone, maybe if that’s all you had. And then all of our stuff goes out electronically through Osmoine now. So that cleaned up a ton of just process stuff that we were doing and having people fill out. And I love that they could fill it out from home. It’s easier and nicer to fill it out from home because then when they’re in the clinic, we can just focus on what needs to happen face time.
Dr. Carlene MacMillan
Yeah. It sounds like it probably changes your life and your resourcing as well in terms of taking all that paper and then inputting all that data. Did you have staff dedicated? Was that all Ben all the time?
Ben McCauley
Yeah, it was mostly all me. I had a few people that helped a little bit part time. Just like we picked a go live, which was January of 20, and just said, I think that’s what it was. And just said, on that day, everyone’s going electronic. And then we went through and instead of just trying to put everyone in the system so that they were already there, we just put them in as they scheduled. And then when they would schedule, if they weren’t in the system and they were a previous patient, we would review all of their previous notes and just write a summary note of their care up until that point so that the provider could then just reference the summary note and then move forward from there. And then we archived all of that old stuff.
Dr. Carlene MacMillan
Got it.
Ben McCauley
Does that make sense from a go live perspective?
Dr. Carlene MacMillan
It does. Yeah. I come from the enterprise tech world, so yes, very love to go live. Go live day.
Ben McCauley
Yeah. You got to just pick a day and do it.
Dr. Carlene MacMillan
You do. And then you said, too, I just want to make sure I’m not missing anything. In terms of everybody being involved with Osmind, it sounds like no matter the role within the organization, everybody is in there managing their care and they’re managing the administrative work in the system today.
Ben McCauley
Anyone associated with Ketamine Care is documenting that in Osmind. And about a third or so of our therapists, or the ones that we have in training, are documenting their psychotherapy notes in Osmind. Because our model is so cooperative, we let the therapist choose whether or not they want to use Osmind for their private practice or not. And some of them use it more than others, and other ones don’t because it’s not what they already had. But anytime Ketamine is involved in the care, then Osmine is being used. And some of the therapy notes. And that’s a situation that’s very specific to our clinic in the sense that the way that we work together is incredibly cooperative. And so the therapists that we have aren’t employees. They run their own private practice and they’re autonomous in that. And then we work cooperatively together around the Ketamine care. And over time, that’s amalgamated us together into a really beautiful team. When I was recruiting therapists, I wanted really talented people. And I knew that in order to get talented people, I was going to have to be a little flexible with how I bring them on. And I wanted people that were trauma informed and were curious enough about psychedelics that they’d be willing to learn it and try it.
Ben McCauley
And so because of that, most of our therapists just are good enough that they’re running their own practice. But it also means that we have really talented people here.
Dr. Carlene MacMillan
Absolutely. It sounds like a best case scenario for everybody. Yeah. Thinking about that integration, do you… And if the answer is no, that is perfectly acceptable. Answer. But do you guys ever use any of the integration tools in Osmind to connect to a therapist’s preferred EMR, EHR?
Ben McCauley
No, I didn’t know about that. Oh, okay. I’m actually really curious about that. I might look into it.
Dr. Carlene MacMillan
Yeah, I’m just curious about the value of contiguous data with both sides of that integration that I know is really important.
Ben McCauley
Well, and that just speaks to how we operate. And we operate in this collaborative way. And it means that we have talented people and that we have an amazing group working here. And that’s what we needed to do in our area in order to be able to do this at all. I don’t know that that’s necessarily the best model for everybody. And as a matter of fact, I say this about a lot of the things that we do. I’m not trying to say that everyone should offer IVs in their area or that everyone should have a cooperative bottle the way that we are. It’s what’s needed for us in our own region, and it’s what’s made us successful. I’m a big advocate that people should deliver this care to their own communities. And that each place that you do that, it’s going to look a little bit different. So as far as data continuity, the therapists have access to Osmind, regardless of whether or not they use their own EMR. And so they can still look at the Ketamine clients or the interns that they have that they’re overseeing. They can still look at their notes and review them through Osmind.
Ben McCauley
And then in a perfect world, we would merge those things and eventually we might not have a choice. We might grow to an operational load where we have to merge them in order to continue. But we’re not quite there yet. And if you don’t tell them, that’s what I’m hoping. But I don’t want to scare them them. It’s important to me that they know this. I mean, we’re very close. They know that I respect their autonomy and their own practice. That’s theirs.
Dr. Carlene MacMillan
Yeah, absolutely. I feel like there’s something that feels very different between inviting somebody and then having the compliance conversation. Just thinking about your advice for other practices in terms of, I think one thing that you just shared is understand your own community and shape your treatments around them. What other advice might you have for either clinics or clinicians that are leading the charge with other novel treatments like Ketamine?
Ben McCauley
Partnerships are your friend. Partner with people in mental health that are in a different field than you. And find the conflicts and find the innovation that can come from working in a collaborative, multidisciplinary model.
It will open your eyes to what’s possible and cross train you in their model just by being in proximity with them. That’s a big recommendation for me. Knowing the community, like you said, is a big deal. Psychedelic care in Lubbock is not going to be psychedelic care in Houston. It’s not going to be psychedelic care in Florida or New York or Pennsylvania.
Every place is going to have subtly different models of what that community needs. Size, of course, makes a difference there. And choices, we’re the only choice in our area, and so we need to be pretty flexible with being able to bring patients in. If you’re in San Francisco, go, lock yourself out. You can pick which model you want to go to. The options are there, but they’re not here. And that changes how we operate. Does that make sense?
Dr. Carlene MacMillan
It does. And something that I’m hearing too is at the end of the day, you’re there and also recognizing that other clinics are there for best patient outcomes. So you’re trying to offer your community a very unique experience because you ultimately want the patients to get better is what I’m hearing.
Ben McCauley
That’s right. Yeah. The goal is healing. The goal is life. The goal is not just functionality, but thriving. Yeah. Yeah. Absolutely. That story looks different for each person.
Dr. Carlene MacMillan
And therefore, each practice at scale.
Ben McCauley
Yeah, that’s right.
Dr. Carlene MacMillan
When you think about, and I’ll ask this question two ways, when you think about the future of your clinic and the future of mental health, what are you looking forward to? What are you excited about?
Ben McCauley
Well, I’m excited about psychedelic therapy, of course. I’m excited about MDMA. I mean, come on. I’m excited about the level of people that are starting to see how amazing these treatments are and that we can change the way we think about patient care and the way that we treat people and that it can make a real difference in their lives. And that doesn’t mean that the care models that are out there now don’t have value. They absolutely have value. And they absolutely need to change. And we need to change. There’s so many people that are struggling in our community alone. If we were running at 100 % capacity with no efficiency loss, treating people with IVs and caps every day of the week, we wouldn’t see 1 % of the depression population in the catchment area. Like guys, there’s a lot of work to do.
Dr. Carlene MacMillan
Wow. That’s stunning.
Ben McCauley
Yeah. And that doesn’t include PTSD, anxiety, doesn’t include any of that. Just just depression.
Dr. Carlene MacMillan
Ben, as we wrap up here, is there anything that I didn’t ask you that you would want included in the case study or want other people to know?
Ben McCauley
Yeah. I would say if we can innovate this space in the desert in West Texas and build this a practice and make a difference in people’s lives, people can do it in their own communities. And that’s how we make changes in society.
Dr. Carlene MacMillan
Thank you. Ben, thank you so much for joining us to chat and sharing your story, your patients stories, and the story of your clinic. You have something really special happening.
Ben McCauley
Thank you. If anyone has questions, if they want to reach out, especially we’re doing a lot of consulting and onsite visits, and we’d be happy to host people that are interested in learning more. And I’m happy to visit with people about how we operate. And so they can find us on our website, denovotherapy.Com. And there’s a form there, an interest form you can fill out and just let us know what it is you’re interested in talking about. And we’ll get back with you.
Dr. Carlene MacMillan
Thank you, Ben. And we’ll also put that link directly in the show notes.
Ben McCauley
Thanks.
Dr. Carlene MacMillan
That’s it for today’s episode of the Psychiatry Tomorrow podcast. We hope you found our discussion informative and inspiring. If you enjoyed the show, why not share it with one mental health clinician in your network? Your support means the world to us and helps us reach a wider audience. And if you’re enjoying the podcast, we’d really appreciate it if you could leave us a rating and review on your favorite podcast platform. It only takes a moment and your feedback helps us to improve the show and reach even more listeners who are passionate about mental health. Thanks for listening and we’ll see you in the future.
