Usually in medical offices, the transcription person is completely separate from the reception employees. Transcription is a "skilled possition" whereas "reception" is not...therefore transcriptionists are usually a higher paid (ie: lets not waste their skill) employee. However, T offices are different. My T has no dictation to transcribe...therefore, no transcriptionist. Therapy notes are usually very different than medical records/doctor's notes.

I think I would feel uncomfortable needing to leave a message with a receptionist though. My T has direct voicemail...I don't even talk to anyone to get to her message box to leave a message. Since you have to go through the receptionist, maybe you should leave messages that don't really say anything. Something like, "I am having some difficulty and need T to call me back, urgently". Set something up wiht T so he/she knows what time frame you are meaning. If I say urgently to my T in a message, she calls back within the hour. If I say "When you have time", then she calls me back that day, etc.