PATRICK CASALE: Hey, everyone. You are listening to another episode of the All Things Private Practice podcast. I'm your host, Patrick Casale. I'm joined today by my friend and colleague Jessica Gulish, who is the head of sales but wears all the hats at Spruce Health, and is now celebrating her seventh anniversary there with a startup.

And I had the pleasure of meeting Jessica in person in San Francisco last year, and hanging out, and really getting a feel for the culture of the company. And really happy to have you on here. You're a wealth of knowledge and really love that you're a part of this industry.

JESSICA GULISH: Thanks for having me. I love sharing and chatting about all things. healthcare communication.

PATRICK CASALE: Yeah, I mean, we also could do the episode on like, where to eat and drink in California, that could be a thing.

JESSICA GULISH: Absolutely. I love communicating about food and wine as well, and travel.

PATRICK CASALE: Let's see where this episode goes today. But for those of you listening and don't know who Spruce Health is in the mental health space, Jessica, why don't you tell us a little bit about what you all do and why you do it?

JESSICA GULISH: We are a patient communications software. And what that entails is anything from your business phone number or even in-office phone system. And it's a modern phone system in that it's going to be all virtual, so cloud-based, so you can access it anywhere, making it really easy to be on the go or in multiple spaces as well text-enabled.

So, we all know we love SMS. So, text-enabled both by SMS and secure messaging. We have a patient app. And we also have telemedicine. So, pretty much… Oh, and eFax is another very popular and old school… Some people are like, "Why do you even have eFax?" I was like, "Oh, you're not obviously in healthcare."

So, we kind of just handle all the different types of communication, and then what Spruce really as well is collaborating as a team around those communication so you can do it better. And then obviously, since we're only for healthcare, we think a lot about HIPAA compliance and security for all your patient information.

PATRICK CASALE: Yeah, and I love that you named that. And for those of you listening, HIPAA compliance, H-I-P-A-A, not H-I-P-P-A.

JESSICA GULISH: [INDISCERNIBLE 00:03:04].

PATRICK CASALE: Just had Liath Dalton from Person Centered Tech on here talking about HIPAA compliance. And I think we're going to take it in a different direction today because a question that comes up a lot is the texting feature and functionality, not just of Spruce, but like, should I be texting my clients in general?

JESSICA GULISH: Yeah.

PATRICK CASALE: And you can dissect that in so many different ways and lenses. But ultimately, there is a really important feature and functionality that Spruce has when it comes to secure messaging, which is different than just straight-up SMS texting. So, can you talk a little bit about why that's an important feature? What the risks are as well?

JESSICA GULISH: Yeah, well, first, you know, it's a really important feature because it's really makes it easy to communicate with your patients. And so we sometimes get bogged down by like, "I can't do this, I just give up." But really, the important thing is making sure our patients can communicate and you can communicate with them quickly. And so it's important to have a solution for texting should you want to do it and make sure you're doing it safely.

Texting is a generic term, so you can think texting, and you may think what we do with our friends and family on, you know, iMessage. Or you may think texting is secure texting because you're in healthcare and that's the only way we can do it. And what I mean by secure texting, essentially, it's just communicating over messaging, it's almost like email could be considered secure texting in a secure form or a portal. And secure just means that it's protected. It can't kind of be intercepted when you're sending it back and forth from the patient to yourself.

So, you have SMS, which is traditional, I should know what it stands for, but it's a traditional texting that's phone number to phone number. And so you have phone number to phone number SMS, then you have secure text. Then there's actually kind of been a new development that I call it link-based text that sometimes you can send a text, SMS, and it goes to the patient's number, and it's a link, you may have seen this, and then it opens kind of a secure portal. And you have to do some sort of login or credentialing. So, you're still logging, logging in, and you have to get some sort of security so that you're giving permission.

So, that's kind of the differences. I get a lot of people that will come in like, "I want secure text or I want text." And then I have to kind of dissect it, "What do you really want?" So, that [CROSSTALK 00:05:28]-

PATRICK CASALE: And I want to just go to, like you mentioned, texting makes it easier to communicate, right? So, we have to acknowledge that. We're in 2023. A lot of our clients don't want to make phone calls. I myself don't want to make phone calls, I don't want to pick up the phone. So, I think for a lot of clients, they would much prefer to be able to text freely and safely. And that creates accessibility.

And I think for ourselves, like I own a group practice here in North Carolina, and we have buttons all over our website, that's a, you know, call or text, and people text our main line all the time to get started and initiate conversations. And I think it makes so much sense because we're talking about accessibility, people who can do so discreetly, and we're also talking about for neurodivergent people who really struggle with phone call communication, and sensory needs to be able to just text in. So, we're talking about accessibility.

Here's what I see a lot of in my Facebook group, or just in general, is the lack of understanding of why secure text is important and what the risks are if you're just texting via SMS.

JESSICA GULISH: Right. Yeah, I think it's so important that the patients can do that because how many times are you in a public place or around your family, and you don't want to call to talk about your healthcare needs as well? So, it's almost like counterintuitive, you know? It's actually more private when you're texting versus the openly talking.

But yeah, you have to first decide, you know, what you want to do. Do you want to offer SMS? Or do you want to have them have an app that they message you on? And pretty much or we're very familiar with EHR portals, right? You have an EHR portal, so that is another secure method.

And with SMS, the biggest thing is it can be HIPAA compliant. And so many people don't get this. They think no way it can be HIPAA compliant. Like, I have to use secure text. No, you can use SMS, traditional phone number-to-phone number texting, and be HIPAA compliant.

What you need to do is get permissions that the patients prefer it. We've been doing this for a lot longer with traditional email, for so long. And actually, for the old schoolers listening, we've been doing this for voicemails. [INDISCERNIBLE 00:07:46] the day when you filled that paper that said, "Are you okay if we leave a voicemail on your machine?" Right?

PATRICK CASALE: Yeah.

JESSICA GULISH: Remember we had do that and you have to say yes. So, it's just getting that permissions. We want patients to be aware of what they're doing and be okay with it. And if they're not, the other component is offer an alternative. So, if you don't have a secure alternative, that's when you kind of get into trouble. So, if you offer SMS and say, "Hey, if you're comfortable doing this, go for it. Text me, email me. But if not, here's a link to an app, or use our EHR portal."

So, that's another component I see really mis, like, kind of understood. So, you want to get permissions.

The other thing is you have texting, SMS. Patients can see your phone number and either like, Patrick, your website, you say text me, or they just see a number they text it. I'm that girl. I will text a number at a restaurant just trying to change our reservation, just see if it works. Usually, it doesn't.

If you text someone, you know, that's a patient choosing to text you. So, generally speaking, if they're initiating and starting it, you're good. It's a spectrum. You don't just do something you're [INDISCERNIBLE 00:09:04]. You want to continuously make sure, you know, maybe you say to them, "Hey, I also have a secure link if you prefer to talk about this over a secure channel." And usually, those [INDISCERNIBLE 00:09:14] texting you. But you offered, you did your due diligence there, and your gut.

The second component, that's kind of sending messages back and forth, the second is at rest, that HIPAA cares about that and that means how are you storing it? How are you storing this text message? Can people that shouldn't be able to see it see it? You know, are the contacts and name that you're storing this person, you know, their name, the patient's name is PHI is it stored in a secure HIPAA compliant area? So, you have the in transit and then at the rest. And so, obviously, I'm on here Spruce, we store it all securely, and we have really great privacy settings on how you log in. You can have access controls of only certain therapists get to see certain contacts. All these things are little details that we've built. But also you should think about or just use a company, that's hard to find. So, I always say that, because I'm lazy. So, like, I just use [INDISCERNIBLE 00:10:11].

PATRICK CASALE: Yeah, absolutely. And I think those are great points. And I think that you're right that it's often overlooked in terms of like, okay, texting has to be secured through this portal or this app. And you're right, if you're offering this as an option, and the client is consenting into SMS texting and emailing without an encrypted feature, that is giving permission.

And I like that you mentioned like, giving the alternative, having an alternative option, a backup if that client's like, "No, I'm not comfortable with this." And I will say that most of our clients, like here's our process internally, client texts in, they want to start counseling services, our admin are scheduled to respond. And then they say, "Hey, we can send you a link for secure HIPAA compliant communication. Would you like to download the app so that we can chat on there?" And 99% of the time, they're like, "No, I don't really care."

So, it's like doing your due diligence and making sure that you're offering that option. And also having it documented that you offer that option. I think that's also really important.

JESSICA GULISH: Right. And I love SMS, but there is also a place for that, you know? I do find that sometimes it's nice to have a place on my phone to go for my health care, right? And versus texting, you have to kind of scroll through, you got to look for it, you have to start a new one. I mean, it's continuous thread, so it's still convenient there.

But sometimes there are offices, you know, that they're like, no, we want everything to go through the app, if possible. So, they kind of do the default. It's like, download this app. And if they don't download the app, then they offer the SMS. So, kind of like give the choices.

It's also important as a practice, you can choose what you want to do in your practice. And so don't use a system that doesn't allow that, right? So, and while talking about SMS, I also want to just make it clear that the SMS is your phone number as well. So, the patients are calling and texting the same number. So, you're seeing whether they called three times and you could just text them macro fast. So, it's all very consolidated, which is important as well, to have it all in one system so you're not missing and then if they call or text, you see the right name, because it's protected. So, can't forget about phone calls or so. They're still popular in a lot of offices.

PATRICK CASALE: Totally. Yeah, still popular. And there's still risk here. Like, if you are not offering an opting into SMS texting and the client's agreeing to that there is a lot of risk for data to be stolen or privacy to be leaked unintentionally via transmission. So, I think that's really important to know that there are risks involved if you're not doing your due diligence and giving your clients options and kind of highlighting the risks for them as well.

JESSICA GULISH: Right. I want to also touch on just texting, not just healthcare texting, if that's okay?

PATRICK CASALE: Yeah.

JESSICA GULISH: SMS regulations. So, another thing like, so in healthcare, we're used to saying like, are you okay with email? Are you okay with SMS, right? But if you've ever given your phone number out in any business saying you're okay with texting, like non-healthcare related, you've probably said like, "I'm okay with texting." You know, traditional rates apply or some kind of thing like that, that is all texting businesses. I mean, it's not just non-healthcare. Healthcare also is just regulated by SMS.

So, as consumers, I'm sure everyone listening has gotten a spam text, spam calling, obviously, we all have gotten that. But spam texting is kind of the new spam calling. And they're good. I don't know about you, Patrick, but I've got some good ones I almost fall for. The newest ones I've been seeing are like, "Hey, you know, is this Joe or something?" Like, they like make it so it's short. Have you gotten any of those?

PATRICK CASALE: I do, yeah. [CROSSTALK 00:13:54]-

JESSICA GULISH: And you fall for him and then you say your real name. And then I guess they can spam. Anyways, I can go on.

PATRICK CASALE: So, Jessica is falling for a lot of these spam texts.

JESSICA GULISH: I am not calling for a lot. You know, sometimes I feel like telling my mom, "Hey, you know, mom, watch out for these ones. I'm getting them and I was almost for them."

But anyways, so it's a problem. And so the phone industry has come up with new regulations. And every business phone system now needs to be registered. So, you need to have your tax ID, your EIN, and register your business to show you're a legitimate business and are allowed to text outbound. Outbound, obviously, is the concern, meaning, like you're texting people could be spamming, right?

PATRICK CASALE: True.

JESSICA GULISH: So, you have to register your business. And once it's approved, then you can send outbound text. But essentially, now, the regulation is you cannot send outbound text. You're going to be blocked by the major carriers if you're not a registered business, which is a huge benefit, right? So, we're going to, hopefully, reduce the amount of spam texting. But you do have to put in some work, you have to register, and you know, you're not going to be published anywhere, it's just that you're able to send outbound text.

You can actually though opt-out. So, if you don't want to send outbound text, then you don't have to do, you can opt-out, and then you don't have to do that component of the registry. There is another component that's phone calls too, so you don't get blocked as a spam call.

So, kind of new. I know Patrick, you guys have already registered with Spruce, and I don't know if you've heard any twirling of this.

PATRICK CASALE: Yeah, I was going to bring that up. So, for those of you listening, some of you in my Facebook group have actually started to mention like, "Hey, did anyone see this email notification or communication from Spruce about having to register your phone number, having to register with this database?" And then some to take it even further have said certain words are starting to flag as spam or bot texts. So, can you touch upon that?

JESSICA GULISH: Yeah, so the keyword blocking, essentially, was happening earlier. I don't exactly know if it was exactly related, but it was the first way to regulate spam text, right? Make sense? Pick a keyword, block anything that has those keywords.

Well, we quickly became part of this because a lot of the keywords you say in medicine are legit. They're not trying to sell you something or you know, so cannabis, marijuana, some of the medications even. So, we worked with our carrier partner to say like, "Hey, we're in healthcare these are okay." And on top of it, like, there's regulations, but we also have a product and we need to, you know, mass scale, figure out how are we going to safely and easily notify our customers that this was blocked, and why, and what they can do. And our processes are easy, you know? We have to build that. So, we've had to really stop a lot and build everything for this new SMS regulations for the blocking of numbers.

But generally speaking, you know, you should see your carrier, your phone service provider like Spruce should tell you why it's getting blocked, and if you just can't use that term, or if you know, we need to do something extra to register your number again. You know, something, not again, but just something we can look more into it, but it should tell you what the reason is.

Early on, it was a little chaotic, right? Because we're just getting regulated, we don't know in advance. Yeah, so hopefully, it should be fixed and it shouldn't be happening or you have to use alternative words and we're of course happy to work with anyone that's having that issue. This is not just Spruce, this is everywhere.

PATRICK CASALE: This is everywhere. If you own a business, this is just regulation that's probably becoming newer information for you, especially, if you're a newer business owner or, you know, these regulations are starting to hit healthcare, especially, hard, then it makes sense why you're going to start seeing them and questioning, "Hey, I've never seen this before, what the hell is happening here?"

JESSICA GULISH: Exactly, yeah. We're doing our best to communicate as much as we can about it as it's updated, you know, but it is for the best, right? It's going to reduce overall spamming, it's going to make sure text messages that need to get through get through.

PATRICK CASALE: Yeah.

JESSICA GULISH: And let you know, I mean, it's just bizarre, some systems aren't telling you it wasn't delivered, so… And same with calls. You're going to see call blocking as well. I believe the date kind of keeps moving, but I think it's in August that they're going to start really regulating, so…

PATRICK CASALE: Perfect. It's July [CROSSTALK 00:21:04]-

JESSICA GULISH: And make sure you register your name [CROSSTALK 00:21:07].

PATRICK CASALE: Make sure you're registering for this and paying attention to this, no matter which platform you're using, whether it's Spruce-

JESSICA GULISH: Absolutely, all-

PATRICK CASALE: … or anything else.

JESSICA GULISH: Yep, it's everybody. So, make sure you've done that. And you know, we've been communicating, so everybody should have done it pretty much at our company.

PATRICK CASALE: So, you're a small company, you mentioned to me that you're 33 people now?

JESSICA GULISH: Yep.

PATRICK CASALE: Which is significantly larger than when I met you last August.

JESSICA GULISH: Yeah.

PATRICK CASALE: But that does mean that there are growing pains, right? So, communication can sometimes be misconstrued that things can fall through the cracks as you start to figure out your processes. So, I think that it's important for people to know that when you're working with a company that's smaller in nature, you get more personalized care, you get more intentionality, you get more thoughtfulness than working with a big conglomeration. And you also have to give some grace in terms of like, the services that you're using, and vice versa as things get rolled out, and things get beta tested as well.

So, I just want to say that, because I personally don't like to ever promote brands or companies that I don't believe in. And I definitely believe in what you all are doing, because I've met you personally, we've had a lot of conversations, I've met a lot of the staff. And it's very clear that you all care about not just the mental health space, but the medical space as well. And really trying to help providers grow their practices and businesses in a way that makes sense, that's efficient, that cuts down on certain tasks that you don't need to do to really improve your processes, to protect your client information, to improve communication. And I think that's really valuable.

JESSICA GULISH: Yeah, we all feel very passionately about making sure patients can communicate to their providers, the healthcare professionals in a manageable way. I mean, it's really what it comes down to, right? People are scared to do texting. And it's like, well, if you have technology behind it to route the text to the right person at the right time or set expectations and boundaries, and we're talking about therapy, boundaries is like the most overused term in therapy ever. But not [INDISCERNIBLE 00:23:14] it has-

PATRICK CASALE: Boundaries and self-care.

JESSICA GULISH: Yes. And so, yeah, self-care. You know, at Spruce we've done a lot of webinars on things like this, making sure to take care of yourself, because then you can take care of your patients.

But yeah, we really are thoughtful about adding features when we can fully add them in a way that's easy, it's cross-platform, it's going to work across different specialties. I mean, we have to have a very flexible platform if we work with a solo therapist, a solo acupuncturist, to a 50-person clinical [INDISCERNIBLE 00:23:47] office.

So, we're so focused on independent practitioners, small business, or SMBs, as they say. We're, you know, around under 25 providers is kind of our sweet spot right now. And so we know your business. But I have to say, you know, as I talk to your growing pains, and I talk to new customers or prospects, I talk to customers, and they're telling me these things, and we're both having similar problems. You know, a couple years ago, staffing was really hard, and turnover, and we have the same growing pains as our offices, you know, we're all small businesses, essentially. So, we really empathize, also, with making it flexible, so you can add or remove teammates.

But, yeah, the growing pains, you know, we're in a really good groove right now, we understand our customer base, we're prioritizing what we need to that we hear so always give your feedback. You know, we're still doing a ton of telemedicine telephony, and the SMS thing is a big deal. It's changing kind of landscape of compilers in, especially, the healthcare market, because it's a lot of work to make sure that you know, everyone can send text messages, and make and receive calls. So, that's kind of been the biggest thing, but we're at it. We have some other stuff coming. I don't want to spoil anything. And I don't like to say it until I'm using it.

PATRICK CASALE: I will say, though, that your telehealth platform is outstanding. And that is a caveat, if you do want to use Spruce's telehealth platform, the client does have to download the app for secure communication. And it just ensures that there's a protected and encrypted telehealth call that can be made between both of your accounts. And we often default to it when our telehealth EHR system goes down because it's just so much easier and it's so flawless. So, I really want to give you a big shout-out on that because it really is a wonderful resource.

There are lots of things you can do with Spruce that people probably don't know. You came on and did a Facebook live in my group. And I was like, "Oh shit, you can do all these things." Like I'm the one promoting this and I don't even know this. Like schedule send messages, auto-responses, collecting payments, all the things that you can do to just really optimize your workflow and take away some of the admin responsibilities to just make your lives easier behind the scenes are so important.

JESSICA GULISH: Yeah, well, you mentioned telemedicine, first of all shout out, we are the top-rated easiest-to-use telemedicine app in G2, which is like awkward. So, although you do have to download the app, once you're in there it's so easy, the connection is really great, you can be on web or your app.

But the other and like not as popular telemedicine thing that we do that I think you know about but maybe not, we call them Spruce Visits, and they're asynchronous questionnaires, and we have them across all specialties, so primary care, dermatology, pediatrics, but some of the ones that we've been seeing a huge increase in using are mental health exams. So, GAD-7, PHQ-9, and the patient can fill it out, the questionnaire, on their mobile apps, with most mobile app. What I like about it is they can fill it out privately. You're not like looking at them and asking them if they've had suicidal thoughts, right? This is just, you're going to probably get a little bit more honest answers when someone's answered it themselves. And so then they fill it out and then arrives to you as a PDF, and you can put it into the chart.

So, the asynchronous telemedicine is still something that I don't think has completely had its day yet. Filling out a questionnaire about, you know, versus taking time for you to ask those questions manually, it is an efficient model. And so we still feel passionately about that. Ideally, we'd love one day to have those be custom, so you can make intake forms, but it's just not where we're at today. So, the asynchronous questions or the Spruce Visits are the telemedicine thing I love.

And then you also mentioned something else, oh, the features. Yeah, I always say go click around at any software, from one software person to non-software people out there. Go through your settings, top to bottom, click through everyone, you can't break it. And you may discover things that you didn't know you could customize. Like, we just added dark mode, pretty cool for those that like it. I'm not a dark mode, person. But I know there's a lot of people that like to switch their application to be dark.

So, you know, there's little features in there that you can always… in any software, like I'm a nerd, and I do that I love it. I love going through it all. But that's right.

PATRICK CASALE: I love it. I mean, I think it's… and I appreciate the responsiveness to feedback as well, like you all really take it very seriously about who you're supporting and what their needs are. And I think that's really important when you're trying to grow a company or startup and really ensure that the values align with the people you're trying to help.

JESSICA GULISH: For sure, we really try and get feedback. And we post all feedback. So, everybody from marketing to engineering, to sport sees what a customer said. And if anything's like weird, we're like, "Wait, we have that." Or, you know, "Let's think about that, that's easy." Or, "We can't do, that's too complicated." But we always file it, and it's there, and we know that. We all get together when we try and prioritize what we've heard the most of and what's going to make the most impactful difference to our customers and for potential new customers. And it's always interesting. I mean, our engineering team built this product, so for them to hear feedback, because they don't get to… Like I get to talk to everyone. And you know, like you tell me you loved our video platform. Like, the people that built that don't get to hear that every day. So, that's also why we post. We post the good and the bad, so they can all hear it and they can make adjustments and feel proud. We're all very proud of what we built and support.

PATRICK CASALE: And I think you should be honestly, and again, just knowing that there are these options out there for those of you who are like, "Oh, I'm using Google Voice without a BAA." And like all the things that you can get yourself into some hot water for like, I really do encourage you to make the investment into a platform where you're going to not only protect your client information, but you're also going to make your life easier. So, if you can get telehealth texting, and secured communication, and an email address, and a fax number, all in one platform, that's pretty damn good to me.

JESSICA GULISH: Absolutely, we use Spruce to support our customers. And the sales team, we use it for our own direct numbers, our sales number, so prospective clients always like text us. So, we are using it and understand what's good and bad, you know? And continue to tweak it so it's good.

But honestly, like, I can't even imagine doing my job without Spruce right now, because it's like an extra brain is what I always say. Like, I don't have to, "Did I call them back? Did I text them back? Did my colleague text them back?" Like, oh, no, it's already right here. I didn't have to think about it. So, for me it's just-

PATRICK CASALE: [CROSSTALK 00:30:55]-

JESSICA GULISH: …I didn't realize at a benefit that I would be using it so much at Spruce.

PATRICK CASALE: Totally. I use it all the time. And I'm grateful there's a schedule send feature, that's my biggest friend, because like, I'll have this idea or this thing that I need to communicate. And then I'm like, it's 1:00 in the morning, I cannot send my therapist that right now. But I can schedule it for 9:00 AM, tomorrow, perfect. So, that's also a lifesaver. I just want to say that.

JESSICA GULISH: You know, I've been demoing for, you know, seven years. And speaking of like the engineering team built all these really cool features. And some took a lot of complexity, some less. The biggest crowd favorite, hands down when I'm demoing is the scheduled message. So, to schedule a message for a later time. And it's so funny. I'm like, how doesn't regular phones have this yet? It's so convenient because you don't want to like get into it with someone at like six o'clock or 4:55.

PATRICK CASALE: Right, exactly.

JESSICA GULISH: But every time I see it, it's the reaction on the healthcare professional's face is like… and I don't know Patrick if you use that, but I use the schedule send message also as a reminders for me. So, I'll do an internal note. And I'll say like, Jesse, did they write back? Or did the lapse of, you know, like, you can do like, did we get their response? Or something, and then have it scheduled to be sent in a week or four weeks, even like four months or something like they want to add their teammates, you know. So, it's really helpful.

PATRICK CASALE: It's a lifesaver. So, there are so many helpful features and functionalities here. And, again, I can't see or speak highly enough of what you all are doing out there. And it's just really appreciated by the people who use your platforms, I hear nothing but positive feedback. And I think it means that you're doing the right thing by the mental health profession for sure. So, I really do want to give you a lot of credit. And I'm glad we've connected over the last couple of years about this.

JESSICA GULISH: Yeah, and they support. We really do care and we really want to help. So, however, we can continue to grow to support all the different communities out there, we do have a high percentage of mental health, but we also support, you know, internal med specialists. And one day, hopefully, we can help connect them more. Because when patients are on the Spruce app as well, they can be connected to all their doctors that happen to use Spruce. So, as we grow, I see that as another kind of opportunity to connect providers so, there's less duplication that actually less lack of knowing what the other's doing so we can all support each other and these patients more efficiently, because it's really about efficiency, you know, and getting to things, so…

PATRICK CASALE: Absolutely. I think that it would be awesome if you had the ability to like sign an electronic ROI to then communicate and coordinate care between people who are using Spruce, so that would be pretty awesome.

JESSICA GULISH: We have it today. So, you can securely message other clinicians that use Spruce, so kind of… and then we've been seeing an increase in, especially, for us in pediatrics, where you're going to have like, you know, parent one and parent two on a group secure message so that everybody's on the same page because sometimes one parent, it takes more of the, you know, doctor's appointments and stuff, but the other parents doesn't get to. So, when you put them on a group text together, the other person feels involved, there's more accountability. And it's just very helpful.

So, we're looking to expand that further. And you see it also in couples' therapy. It can be very helpful so they can have their one-on-one communication with their therapist, and then they have the group chat with both couples, I mean, with that couple and the therapist, so…

PATRICK CASALE: Very cool, very cool stuff. While we're wrapping up, do you want to offer the audience any tips or strategies that come to mind, and please tell the audience where they can find what you have to offer so that they can start using Spruce as soon as today?

JESSICA GULISH: Yeah. Well, sprucehealth.com. I mean, that's the one. But you know, I think we have a lot of… therapists it's a growing field, we're seeing a lot of growth, and people that are either at a group practice or you know, or larger clinic starting their own thing, while they're doing or [INDISCERNIBLE 00:35:13]. I mean, you have all these different things.

I think, you know, just do your research, you can get a number really easily, and you can then start a business, you know? And so Spruce allows you to do that and keep really good documentation.

I also coach a lot of people on making sure to capture potential clients in Spruce. Someone that calls your practice or your clinic, that's a potential revenue source, make sure to document it, you're going to forget. So, that's one other tip I'm going to just say is don't forget the sales portion and Spruce can be a lightweight CRM for you, and just capture all that data and do the work for you.

And, yes, sprucehealth.com, you can sign up for a free two-week trial there, you get a number, you can also download it in the app store, or just go to Spruce Health on your mobile phone and just get started.

PATRICK CASALE: That's easy enough for everyone to remember. And that will all be in the show notes so you have easy access to that information.

JESSICA GULISH: Oh, and if you want to email me directly, you can just email [email protected] and email our team. Or if you download the app, we have messaging in app for you, just like you do with your clients.

PATRICK CASALE: We'll have all of that information in the show notes so that you all have easy access to Jessica's information so that you can easily find sprucehealth.com, both on the website, on the App Store. And you can connect with Jessica, and she is willing to do demos or give trainings on how to use this feature, and functionality, and software. And it's really, really helpful to make you feel confident and comfortable. And also it just allows you to get your business up and running quicker than you would want it to when you have to go through all the hoops of like, where do I find the fax? Where do I find a telehealth platform? Where do I find a phone number, etc..? How do I port my phone number over from Google Voice? They can do all of those things. So, really, really helpful. I can't recommend them enough.

To everyone listening to the All Things Private Practice podcast, new episodes are out on every single Saturday on all major platforms and YouTube. Like, download, subscribe, and share. Doubt yourself, do it anyway. We'll see you next week. Thanks, Jessica.

JESSICA GULISH: Thanks for having me.