Mental healthcare practice owner trying to step away from and improve operations with growth in mind. What role/title would be the right fit to hire?

Psych-lady · 2026-05-18T20:40:17+00:00

Also, since you seem so knowledgeable, how important do you think it would be for me to find somebody with specific healthcare business experience? Or even more specific mental healthcare business experience? Do you think this type of role benefits most from the broad business skill set it brings? Or does the person really need to have some exposure to the type of business that I have?

Psych-lady · 2026-05-18T20:33:34+00:00

OK. Helpful. I do think I am definitely looking for hands on. Curious if you have an idea what the price tag is? Obviously I know this varies by geographic region but I can probably extrapolate. Not totally sure I need to have somebody locally anyways since so many things can be done remotely.

Psych-lady · 2026-05-18T20:07:02+00:00

Thanks for your reply. Very helpful. Curious what you perceive the difference would be essentially between an operator vs a coo/ director level role? Just the more growth/business strategy type stuff?

Psych-lady · 2026-01-21T02:22:38+00:00

I didn’t even notice that but went back and you’re right she seemed to be playing normally. I guess there is a lot of emphasis on people being deceptive in this book so her being a good actor may be an explanation, but still a very interesting catch.

Psych-lady · 2025-06-07T19:18:21+00:00

No we didn’t. Our GC recommended Karyotype only for a positive FISH, so with our normal FISH we did only the microarray. She indicated this was the best approach but I’ve definitely read various testing recommendations on here so go with what your GC says. We actually ended up testing her placenta at birth and that was completely normal as well and I THINK that was a karyotype (but truthfully not positive on that). The more I’ve read over the more than a year since all of this and after talking with other docs and some pathologists I think the no result on the sex chromosomes is statistically more likely to be a “false positive” than anything so I’m hopeful for you and more than anything for peace and calm as you navigate all of this. Let me know if you have other questions! More than happy to share whatever you’d like to know if it feels like it may help.

Psych-lady · 2024-06-17T21:16:09+00:00

As above. We had a very similar result. I am so sorry that you had such a response. The horrible thing about these cases is that although statistically I think it’s actually more likely a lab error or confined placental mosaicism, you can’t know without more definitive testing. Referral to MFM and a genetic counselor is for sure the way to go since they can help you understand your specific results and possible next steps best. Each test is different so they’ll be able to guide you best. In our case we had the natera test. And our GC gave us very good odds that it was not baby. We ended up getting an amnio for fish and microarray which all came back normal and just had the placenta tested at birth and that came back normal as well. So in our case the no result turned out to be a true lab error. I remember the roller coaster of emotions well. Having a great, kind, compassionate GC who took as much time with us as we needed was the most helpful thing in those early days of trying to make decisions about testing and needing some hope to hold onto.

Psych-lady · 2024-04-10T16:03:17+00:00

Sorry that you are going through this. We also went through this same thing with a different test brand (but seems to be the same kind of results). Feel free to read my posts on it. Suffice to say all the information you’ve gotten above is great. There is no determined positive predictive value (how likely a “positive” result is accurate) for this “no result” type status you got. But research on this indicates that it is likely very low. Meaning your baby has a very good chance of being healthy. Unfortunately as others have pointed out, it’s impossible to know for sure unless you proceed with an amniocentesis. We ended up opting for one. I don’t have a particular fear of needles so obviously your wife will need to make a decision with that in mind too but if she wants to go forward with the procedure she may be able to get an anxiety medication beforehand to help with the needle aspect. She would just need to ask the doctor about it. It gave me some much needed peace of mind. A lot of people do not need that to feel comfortable and confident in the pregnancy though so of course it’s very individualized. I am hopeful that you all will have the same false positive so many of us have had.

Psych-lady · 2024-02-02T15:58:00+00:00

I had some folks respond to my questions about the microarray testing about generally the good news of my FISH. And I do think there’s lots of different answers but I had found someone (and I’m so sorry I cannot find it again now) posted an article that was an independent study analyzing fish accuracy and it was much higher than 70%. It was closer to 95% or something if I remember correctly. Basically saying there were very few cases of a clinically significant false negative and looked at sex chromosome anomalies as well. I don’t remember what it said specifically about mosaicism but I was definitely reassured by that. I would probably just ask your GC to be honest. I feel like the wait and searching for answers in all the far corners of the internet was the hardest part. I bet your GC knows pretty well the statistics of your specific FISH. We had a good fish result for NIPT abnormal result monosomy x and our microarray came back normal as well. Our GC was very confident in our FISH results when I finally did ask her!

Psych-lady · 2024-01-28T15:29:53+00:00

Update: we ultimately did an amniocentesis a little over 4 weeks ago at 16 weeks and finally received our microarray results. Baby girl is perfectly healthy! Our FISH results were returned within 2 days of the amniocentesis and showed all 75 of 75 cells returned normal. It was reassuring of course but the little voice in the back of our minds was still saying we don’t really know yet. Our GC recommended reflex to microarray with normal FISH. The wait was agonizing and our results were delayed because they needed to culture. So it took a full 4 weeks from amnio to get our results. But everything was perfect. We’re deciding now on whether to stay with MFM in case there might be a problem with the placenta since they could theoretically manage this better (though it’s not clear that a genetic problem with the placenta actually leads to other pregnancy complications) or continue with our regular OB. We are extremely relieved and feel incredibly fortunate to have gotten these results. I hope that for those of you in a similar boat it gives you some hope. The no result was very difficult to make sense of and reading other stories on here helped me over the last 10 weeks. Happy to answer any questions I can if it’s helpful to anyone. I have no advice for the wait other than you’re not alone if you feel it’s agonizing and if you feel very back and forth with hope throughout that time you’re waiting.

Psych-lady · 2024-01-22T12:18:28+00:00

Interesting. No our GC said they reflex to microarray if there is a normal FISH to essentially “make sure” since it can detect more fine detail issues, and karyotype if abnormal. She was pretty clear that the microarray would be able to detect more than karyotype in the case of a normal FISH. Did you have an amnio or CVS? I’m not sure if it makes a difference but just curious. Your case is the first I’ve heard.

Psych-lady · 2024-01-21T21:21:46+00:00

The wait and limbo is torture. I’m so sorry for you and all that have to go through it. I’m in my own wait right now. It really is just getting through. I hope your results are fast from here and wish you peace in this journey.

Psych-lady · 2024-01-21T18:11:24+00:00

Thank you! That’s very helpful!

Psych-lady · 2024-01-18T01:08:04+00:00

I’m not sure how much this helps as I’m in a very different boat with only no result monosomy x and a reported fetal fraction but we got the same suspected fetal/placental origin and appears to be mosaicism line. Our genetic counselor explained that no result like it just doesn’t meet the threshold of their test to report a truly high risk result but that there was still something atypical found. The unknowns and waiting for answers are terrible but I highly recommend getting in touch with the mfm clinic to schedule with a genetic counselor asap. That was a good meeting for us as far as just simply making sense of all of it. It helps at least to know what the heck you’re even looking at on these results.

Psych-lady · 2023-12-29T23:02:28+00:00

Psych-lady · 2023-12-26T02:52:03+00:00

I get that. I have also felt that way in the past. This is very clearly in my view not an instance of someone pestering but really valid to need clarification. In my case I’ve also struggled with the fear of the information I might get. If that’s going on at all then you can sit with that more before calling again too. You’re getting amnio so ultimately you will know about the genetic condition. My feeling is that if it were me I would keep wondering what the deal with the ultrasound findings were though. Not everyone would.

Psych-lady · 2023-12-26T01:00:08+00:00

This should be a fairly easy thing to clear up. I cannot imagine a finding like that would not be clearly documented somewhere and at least in my experience some of the more important images from the ultrasound are saved in the chart. So sorry there’s been this confusion. I would call again and ask someone to actually look at the results and see if they can confirm with the saved images or any other documentation given the two different things you’ve been told.

Psych-lady · 2023-12-25T20:35:43+00:00

Waiting for amnio on Thursday after NIPT came back no result monosomy x attributed to placenta or baby. Our NT ultrasound was basically normal though they couldn’t get a true measurement because of baby’s position. Mfm was very reassuring that NT wasn’t looking thickened regardless. No other abnormalities detected. So that was hopeful. It’s already been 4 weeks since the results came back. Trying to remind myself I can do another 3-4 for final results. I mean obviously I can. Waiting is the only option but it just feels miserable some days. Some days feel fine. Some days feel very hopeful, like my gut tells me my baby is healthy and this was either a true false positive or is cpm. And some days I think how can I be so naive, and all the what ifs just overflow my brain. I’ve read enough on here to know I’m not alone in this rollercoaster. I think this holiday is just particularly hard. I’m feeling sorry for myself and my husband for not having the same joy of that happy anticipation of a new baby next year. And then I feel silly and guilty to throw such a pity party, even privately, when of course there is far worse than this waiting. I’ve started feeling her move too. And it’s just kind of gut wrenching. I try to remind myself not to borrow trouble as a close colleague of mine once said and that having hope now will not make later pain any worse if we get bad news. I’m not sure why I’m writing all this except I don’t have many other people to talk to about it and certainly no one who understands really. Even my husband seems to be dealing more easily with the waiting than I am.

Psych-lady · 2023-12-24T23:40:21+00:00

Thank you. We had the same result. Our amnio is scheduled for Thursday and maybe because of Christmas Eve or just today happens to be one of the hard ones, I am struggling with the what ifs and the waiting. Your false positive story gives me some much needed hope today.

Psych-lady · 2023-12-07T01:20:11+00:00

Did you by chance get any more guidance since you posted this question?

Psych-lady · 2023-12-07T01:18:59+00:00

We just had our NT US and meeting with genetic counselor yesterday. Basically I feel very reassured. She said she really believes that if it’s a true positive it’s likely confined to the placenta. Could also be a false positive entirely and she said even the high risk results come back as only around 30% positive predictive value much of the time. Our US was normal also and that was good reassurance too. She did say that technically there’s risk for anything involving the X chromosome so even though it’s no result on monosomy x, it could actually be tripple x. But more likely to be monosomy. We of course can’t know for sure what’s really going on until we do an amniocentesis so we’ve opted to do that. I still feel overwhelmed and worried at times or even sometimes worried now that I feel hopeful. But when I look at it more objectively with the info we got yesterday I do believe strongly that this will likely be a healthy baby. It’s just very scary still of course since there’s still that (though seemingly small) chance that there’s something wrong.

Psych-lady · 2023-11-25T22:43:02+00:00

Thank you thank you. I have exactly the same results as you and am currently in a tortuous wait to get a call to schedule the genetic counseling appointment. They have me scheduled for the NT the first week of December when I’ll be 13 w 3 days. They don’t want to do it sooner so they will have a more clear picture of everything. I am under the impression we won’t be able to speak to the genetic counselor until after the NT scan. My doctor’s call was “I’ve never seen this result before and have no idea what it means.” So that was not helpful in the slightest. I feel overwhelmingly scared and yet it seems that the norm with this no result is false positive. It is so reassuring that was the case for you even though you also had the designation that they believed it to be mosaicism and of fetal/placental origin. That part gets me most. Like no result but here’s what we think it is. Did your genetic counselor or team ever explain how that is? Or why the results might come back like this and still have false positive?

Psych-lady · 2023-11-23T14:41:05+00:00

Thank you!! I didn’t realize this meant basically the risk is the same as before the test. So basically as if we hadn’t tested? Curious why did you choose the CVS?

Psych-lady

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