Scenario: “Why do you not take insurance in your practice? Nobody seems to be taking insurance. This really sucks. What can I do to see if this will work for me or if it’s worth it?”

Bottom Line: High-quality treatment shouldn’t be hard to find. But sometimes it is. When you find it, you’ll know it, and it’s definitely worth it, because you’re worth it!

Seeking treatment with any “out of network” provider or specialist such as myself in private practice is a personal choice. Only you can weigh the options and decide what’s best for you. Costs are a consideration, so is leveraging to find high-quality psychiatric care when you need it. For more detailed information on how to approach this, please check out my website pages under “Payment & Fees” and scroll to “Understanding the Cost of Treatment” to learn more. On these very pages, I have openly shared my own personal experiences from being on both the provider and patient side of things, sharing my candid perspectives on both worlds, in-network and out of network. Hopefully, this will help!

Yes! Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage your health care. These may be technologies you use from home or that your doctor uses to improve or support health care services. Since the onset of the COVID-19 pandemic, telehealth has become much more popular and has allowed many patients to safely receive mental health and addiction services from the privacy of their own homes. We utilize a HIPAA-compliant telehealth platform to ensure your health information remains private and protected. Save on gas, tolls, parking, and your long commute, why waste time, get treatment right from home!

Scenario: “I’m not ready to quit, but I definitely want to use fewer drugs for sure. I’m tired of being high. Are you open to working with me if I only want “harm reduction” as a way to address my substance use?”

Bottom Line: We try to work with where people are at.

Harm reduction refers to a range of public health policies and measures designed to lessen the negative social and physical consequences associated with various human behaviors. Harm reduction is used to decrease negative consequences of recreational drug use without requiring complete abstinence, recognizing that those unable or unwilling to stop can still make positive changes to protect themselves and others around them. We will work toward helping you better understand your situation, even if you are not ready for complete abstinence. You can still recover and there is always hope. Ideally, we want to see less harm, and more reduction, but let’s take it one day at a time!

Scenario: “Hey doc, I work during the day Monday through Friday. Do you have any weekend or evening appointments?”

Yes! Given the stress of the COVID-19 pandemic and erratic work schedules this has caused for many people, I do offer weekend and evening appointments. Telehealth may be a better option for addressing this as well. Glad to talk more about it and let’s make it work!

Scenario: “I’m already stable on my meds. Do you offer just 15 or 20-minute quick medication visits?”

For a complete list of services offered, please refer to the “Services” section of the website. Generally, most patients in the practice are evaluated for both medication management and psychotherapy in 30, 45, and 60-minute allotted sessions. The combination of meds + therapy visits often leads to better clinical outcomes. With that being said, we do not offer “quick med checks.” Additionally, all new patients admitted into the practice must complete an initial diagnostic evaluation first, which is used to individualize your treatment plan.

Scenario: “I definitely need to find a new psychiatrist. Mine isn’t helping. The meds don’t work. I think I’m bipolar and have ADHD. I need a fresh start. If I worked with you, can I keep my current therapist, or do I need to move everything over to your practice?”

You can absolutely continue to work with your current therapist, especially if it’s a good fit for you and you’re making steady progress! If working together in the practice as your psychiatrist, I probably at some point, with your permission, of course, may want to collaborate and talk with your therapist, in order to advocate on your behalf, provide an update on your progress in our sessions, and make sure everyone is on the same page, so that you get the best treatment outcome possible!

Scenario: “I’m prescribed Xanax by my primary care doctor and I’ve been on it for years for my anxiety. I need to see you for my ADHD and depression. Are you going to switch my meds if I come to your practice? Can you write for the Xanax too? What’s your policy on controlled substances like Xanax or Klonopin? My last psychiatrist literally fired me so my primary care doc took over.”

As an addiction psychiatrist, I am very careful with the prescription of controlled substances, especially benzodiazepines “benzos” such as Xanax, Klonopin, Ativan, and Valium. There is the potential for misuse and increased addiction risk with these medications. Some patients clearly clinically benefit from these medications and it’s been a life-saving journey for them. Others, not so much. Nothing is automatic—just because you were receiving a controlled substance prescription from another doctor does not mean I will automatically continue to prescribe it in my practice, especially if, after my evaluation, in my professional medical opinion, I feel there is more harm than good in taking it. This is evaluated obviously on a case-by-case basis.

In full transparency, as this relates to the prescription of controlled substances in my practice, I have a duty to protect you as a potential patient from harm, have a moral and ethical responsibility “yes, a real backbone” to uphold appropriate and safe prescribing, accurately assess for addiction risk and potential, and continue to protect the public and neighboring communities near my practice.

Once a controlled substance is prescribed and later dispensed by the pharmacy, two names are on that bottle: my name and the patient’s name. There is a shared responsibility. I do not take that lightly. I generally lean conservative with respect to prescribing controlled substances, as drug overdoses are a reality in the world we live in today.

Scenario: “I have been struggling with heroin and snorting some pain killers. I don’t want to go to rehab right now and they won’t admit me to detox because I’m not in full withdrawals yet. I just got a full-time job that I don’t want to lose. Can I just do this outpatient and get on suboxone (buprenorphine/naloxone)? What are my options?”

In the outpatient ambulatory setting such as with my practice, we do offer treatment specific for opioid addiction. Medications such as buprenorphine and naltrexone can be prescribed to help alleviate cravings and manage withdrawal symptoms. Medications approved for opioid addiction, specifically buprenorphine, naltrexone, and methadone (the latter, being administered through a separate specialized clinic only) each have different pharmacological properties that may assist with the detoxification and/or the stabilization process. Depending on your medical and substance use history, we can discuss which medication approach might work best, and also discuss if continuing treatment in the outpatient setting is safe and clinically appropriate or transfer to a medically supervised detox center or subsequently a rehabilitation facility, are better options. I will be able to better assess your appropriateness for treatment once a complete diagnostic evaluation has been completed.

First things first: It is certainly possible to manage opioid addiction on an outpatient basis. Oftentimes, if opioid addiction is the major presenting issue, without other significantly contributing life-threatening medical, psychiatric, cognitive issues being present, there is solid social support in the community setting or at home, and the patient is highly motivated to follow up, then outpatient detox or stabilization may make more sense and present less of a barrier to accessing life-saving treatment. You may not have to wait for that detox bed after all. Have hope, you don’t have to continue with the endless cycle of active addiction, we can and will discuss all treatment options available to you. Ask for help, and you shall receive!

Scenario: “Are you gonna make me go to those AA meetings. Is that required to join the practice? Seriously? What if that never worked for me? I don’t want to try things that didn’t work before.”

Twelve-step programs (Alcoholics Anonymous, Cocaine Anonymous, Narcotics Anonymous, Gamblers Anonymous) are a valuable and resourceful tool for many people in recovery. For many who tried everything else, it’s these life-saving programs that finally worked. For others, unfortunately, the impressions left were less convincing. The facts: These programs aren’t going to work for everybody. Nor do we require you to attend a twelve-step program when joining the practice. However, from addiction studies we do know that for those who do attend regularly, and who happen to find them helpful in some way, it certainly has helped prolong their recovery, more days sober than not. The sober support system developed by attending these programs is also a big plus for many in recovery.

Bottom Line: I suggest that, when working together on customizing your treatment plan, and twelve-step programs are a treatment option, consider being open-minded, try them out, maybe approach it perhaps in a different way, and if not helpful, then definitely find other tools that work better for you. No regrets, keep moving forward! Once again, definitely standing firmly behind our core mission statement: “One size or philosophy does not fit all.”

Scenario: “Telehealth has never worked for me. I don’t do well with virtual stuff. I like going to the office. Is that still an option during COVID?

In-person sessions are available at the office, but final confirmation of those appointments will depend on my availability that particular day. All sessions are by scheduled private appointment only. We do not offer “walk-in” hours. This is not a clinic setup. The pricing for telehealth or in-person evaluations is the same. In-person visits will be conducted based on the latest guidelines as it relates to social distancing and mask-wearing.
Dr. Patel is fully vaccinated and boosted.