My wife is a therapist as well. She has to clock out and do documentation on the evenings or weekends to meet productivity (documenting while treating isn&#x27;t an option given her need to be hands on with patients). They also require her to overbook (i.e., book &gt;100% productivity) so that she stays above 80% in the case of no shows. I get the logic behind it, but it really sucks for her when she doesn&#x27;t get no shows.<p>They don&#x27;t care if she gets overtime (so long as she meets productivity), so that&#x27;s nice, but I really can&#x27;t understand why they don&#x27;t just go to salary or work with insurance companies to incorporate documentation into billable time. I can&#x27;t imagine the patient experience would be hurt too much by shifting from 1 hour sessions to 45 minute sessions with 15 minutes of paid documentation. If anything, insurance companies should get better documentation and that should help them combat fraud while also improving care. Granted, I think the clinic my wife works at is almost entirely built around Medicaid reimbursement and Medicaid doesn&#x27;t have many real incentives to reduce costs or improve quality of care.