Your first and future appointments
I see patients who are referred by their therapists, physicians, family, or friends, or have found me online. Many of my new patients have never seen a psychiatrist before, and don’t know what to expect. Before we schedule your first appointment, we’ll talk on the phone to discuss the kind of help you’re looking for, and whether I might be the right psychiatrist for you.
Your initial consultation will last 90 minutes. If you’ve arrived with a family member or significant other, I’ll spend most of our time with you alone, and we’ll decide together whether or not to include them in our discussion of my recommendations at the end of your appointment. We’ll discuss why you came to see me, the treatment which you’ve received so far, any past history of psychiatric illness and treatment, family history of psychiatric illness and treatment, your family of origin, major relationships, education, work history, medical history, and habits. At the conclusion of the appointment, we’ll discuss your diagnosis and develop a treatment plan. With your permission, if you were referred to me by another clinician, I’ll communicate with them following your appointment.
Most—but not all—of my new patients are ultimately prescribed medication as part of the treatment plan. The reason for this is that many of my new patients are referred for consultation regarding medication by their therapists, primary care doctors, or other medical specialists. We’ll discuss why medication might or might not be appropriate. If it is, we’ll talk about the options which are available and what to expect, in terms of both benefits and possible side-effects. When appropriate, we’ll discuss alternative treatment possibilities such as transcranial magnetic stimulation (TMS). I may request that you have laboratory tests, and that I speak with your primary care physician if they should be involved in treatment recommendations. If appropriate, I’ll recommend a Genesight test— a genetic test to determine which medications might be more or less likely to work and cause less side-effects. This test is performed in my office or at home. The details of this test appear on the laboratory’s website, www.genesight.com. If you aren’t already seeing a therapist, and doing so would be appropriate, I’ll make suggestions regarding therapy as well.
If we have agreed that you will be treated with medication, I will recommend that we meet for a follow-up appointment within several weeks. The frequency of follow-up appointments will be based upon the complexity of your problems and your response to treatment. Once your condition has stabilized on a medication regimen, we will meet at intervals ranging from every month to every six months. Follow-up appointments will last from 20 to 45 minutes.
I respect your confidentiality. If you would like your family or others to speak with me about you, we’ll arrange a conference call or an appointment, including you, to do so. If they want to speak with me to express their concerns, without including you in the conversation, I will tell them that I’m willing to hear what they have to say, but I won’t discuss information about your treatment and I will let you know that we spoke. Unless there is an emergency, or a court order requiring that I do so, I won’t divulge information to anyone at any time without your permission.