Letters Volume 001  ·  May 2026

Your practice has a weird twin.

It answers questions about you all day. It may be terrible at the job.

Every psychiatric practice has a front desk it never hired.

It sits in search results, directory listings, AI summaries, and a Google profile someone set up in 2019 and never touched again. It answers questions about your practice all day. Sometimes it points the right way. Sometimes it sends a person who finally worked up the nerve to call into a voicemail that no longer exists.

You usually find out by accident, when someone tells you they almost gave up looking.

An editorial illustration titled THE FRONT DESK YOU NEVER HIRED. A receptionist whose head is a search-results screen sits behind a clinic counter wearing a bow tie, with a ringing red phone and a row of mismatched directory cards.

Here is what your front desk has been saying.

One listing has the old suite number. The patient who used it last week walked into a dental office, apologized, and left.

One directory still calls you by the practice name you used before you went solo. The clinician who tried to refer to you under your current name got "no results found."

One AI answer, asked who in town treats this thing you treat, shrugged and recommended a hospital you have never been affiliated with. It said this confidently.

One profile does not tell anyone whether you are accepting new patients. The person reading it assumed no, because most of the others said no, and they were already running out of energy.

An editorial illustration titled SAME PRACTICE. THREE ANSWERS. Three wayfinding signs labeled MAP, DIRECTORY, and AI point to different doors along the same calm clinic hallway.

I point t.ROY at this kind of mess for a living. The machine is fast at finding it. It will pull every listing, every profile, every AI answer about a practice, and lay the mismatches in a row in under a minute.

I am slower than that, because I have to decide what the mess means. Mostly it means you have been doing the work and not the paperwork the internet expects from a medical office, which sounds like a moral failing only if you have forgotten that you are a clinician and not a customer-service representative for your own name.

Here is a thing you can do today, in five minutes, without anyone in IT.

Write down the five things every public version of your practice has to say the same way:

  1. Your exact practice name.
  2. Your address and phone, as they should appear everywhere.
  3. One plain sentence for what you do, written so a person at 11pm understands it.
  4. Whether you are accepting new patients, and how a referral reaches you.
  5. The three places that have to match first. Usually your website, your Google profile, and one insurance directory.

Then make those three places match what you wrote. Not perfect. Just the same.

That is the audit. It will not cost you anything. It moves more than a new website would, because the new website was never the part that was lying.

An editorial illustration titled ONE ANSWER EVERYWHERE. A checklist card on a clean desk shows five items in capitals with teal checkmarks: NAME, ADDRESS + PHONE, WHAT YOU DO, ACCEPTING?, REFERRAL PATH.

None of this is your fault.

Nobody hands a psychiatric nurse practitioner a license, a prescribing pad, and a tiny manual called How To Feed The Map Beast. You went into medicine. You got better at medicine. The internet became a job somewhere around 2014 and no one told you, and the people it rewards are not the people I would want my family to see.

You are good at the work. The work deserves a front desk that is good back. That part is fixable, and most of the fix is not technical.

If you want to know what the front desk is saying about your practice, reply with the name. I will look and tell you what I see. No pitch attached. Whatever I find is yours, whether we ever talk again or not.

Troy