My T is in private practice, so I schedule directly with her. We usually schedule appts weekly for several months at a time. At the end of that series of appts, we will schedule for the next few months. I generally have the same time/same day each week, though, unless one of us has a conflict. My psychiatrist is in a large medical practice, and my appts. with her are even scheduled directly with her. We schedule the day time together, then she messages the front desk and it gets put in the schedule that way. I wouldn't like dealing with a receptionist, though to be fair, I've never had to. Might be different if I had started out with a T who used that system. I do like the consistency of same time/same day. I might have a hard time not knowing from week to week when or if I was going to have an appt.