Let's Cover Some
Frequently Asked Questions
How would you describe your overall approach?
This question deserves a very thorough answer. However, here’s a start.
If you’re looking for a psychiatrist, there’s a good chance you have an interest in using medication to help you, or at least you’re open to it. I share that same interest and openness, and frequently recommend the use of medication when appropriate. However, we will ideally not rely on medication exclusively. There is far too much to be gained from combining medication with non-medication approaches that are further defined below.
My foundational perspective is most resonant with what is called, “person-centered therapy,” which “operates on the humanistic belief that the [patient] is inherently driven toward and has the capacity for growth and self-actualization; it relies on this force for therapeutic change. The role of the [therapist] is to provide a nonjudgmental environment conducive to honest self-exploration.“†
From this starting point, we would likely incorporate elements of mindfulness to understand how it can help you achieve more “presence” in your life and thus decrease stress, negative self-thoughts, or anxiety. Since we are mammals who require meaningful human connection to flourish, we may explore how your early relationships impact you in the present through the lens of Attachment Theory. I broadly incorporate a “trauma-informed” approach, which means acknowledging the ways in which certain impactful experiences may be echoing into the present without our even knowing, and doing so at whatever pace is right for you (if at all). “Somatics” means using moment-to-moment awareness of bodily sensations to learn to identify and then act on the wisdom of your emotions. And finally, I find some of the core principles of the Ancient Greek philosophy of Stoicism to be very helpful (note: Stoicism does NOT mean not feeling your feelings…it’s a coherent, non-religious, 2300-year-old theory for how to achieve happiness (or what they would have called a “free-flowing life”).
Will you prescribe medication?
Yes, there’s a very good chance I will. However I will also offer you suggestions for alternatives or non-medication approaches that you can incorporate alongside medication to get the greatest possible benefit from working together. I am strongly influenced by a 2012 academic journal article titled, “How (Not What) to Prescribe: Nonpharmacologic Aspects of Psychopharmacology” (link). This article outlines in great detail what I think of as “all that stuff we refer to as the placebo effect.” The placebo effect is not meaningless; rather, it is simply all that about the experience of engaging with another human in the shared effort to help you feel better. This could refer to the sense of feeling seen/understood, empowered by asking for help and teaming up with someone who wishes to see you thrive, or “borrowing” some hopefulness and optimism from your psychiatrist to be able to imagine yourself feeling better. Just to name a few. So, yes, I will prescribe medication. But it’s in the HOW not WHAT to prescribe that sets me apart.
What if I am already on medication or already have a psychiatrist?
You may be coming from other prescribers already on one or more medications. First we’ll discuss any prior medications you have tried and whether they were effective or caused any side effects. Then we’ll look at your current regimen and consider whether a dose adjustment (up or down) might help. If you are on multiple medications we’ll consider whether simplifying your regimen could be helpful. We will put in a request for your medical records from prior providers so that we can incorporate this information into our plan.
Do you do psychotherapy?
Absolutely! I enjoy working with patients on a weekly basis for 50-minute sessions. We can focus on a particular challenge you are facing or take a more open-ended approach where the aim is to use the experience of our relationship together to help you explore perspectives and patterns that may otherwise not be apparent to you. I believe that everyone has an inner healing capacity, and my job is simply to help identify and remove obstacles to that healing that comes from within. Although my formal training is in psychodynamic psychotherapy, my approach is highly integrative drawing from a range of therapeutic techniques as described above. Researchers have looked at whether any one particular therapeutic approach is more effective than another, and ultimately found that the factor most associated with healing and growth is the nature of the relationship between patient and therapist itself.
What ages and populations do you work with?
I feel I am most equipped to help adults age 22-70, as those outside of this range often have unique experiences that might be better served by someone else. I enjoy working with LGBTQ+ identified individuals.
Administrative Matters
Do you take insurance?
I am not in-network with any insurance panels. However, if you have a PPO you may submit requests to your insurance for reimbursement subject to the allowable amount, percent covered, and your yearly deductible. Please check with your insurance to avoid any surprises. By the way, I do something that very few other providers do — I will use my software to electronically submit claims to your PPO on your behalf, saving you the step of submitting superbills. However, beyond that any insurance follow-up that may be necessary will be left to you.
What are your fees?
A 75-minute initial intake is $490. Follow-up appointments are 30 minutes for $320 or 50 minutes for $490. Therapy sessions are 50 minutes long. Believe it or not, these rates are consistent with what the market will bear in the Bay Area — and many (but certainly not all!) PPO insurance plans will cover these rates generously (you need to check with your insurance).
How can I find out how much my PPO insurance will reimburse me?
It can be hard to get a straight answer to this from your insurance. But if you take a structured approach you should be able to put it all together. First, you need to have a PPO – you can’t submit for out-of-network services with an HMO. Then, find out what your out-of-network deductible is and how far along you are in meeting that. Next, you’ll need to know your percent reimbursement rate and the “allowable amount” for each of the codes below. You will only get back the stated percentage of this allowable amount, NOT the percentage of the fee you pay me. And even then, you’ll only be reimbursed after you meet your deductible. Note that you only “earn” toward your deductible based on the allowable amount, not the amount you are charged.
Here are the codes you’ll need to ask about:
99205 (Initial Psychiatric Intake)
99214 + 90833 (30-minute follow-up)
99214 + 90837 (50-minute follow-up)
What is your cancellation policy?
I hate charging late-cancellation or no-show fees! It’s terrible because you can’t submit what you pay for insurance, so it’s all out-of-pocket. Therefore, I make an effort to be as accommodating as possible. Accordingly, I request that you cancel appointments at least 48 business-hours before our appointment (i.e. a Monday noon appointment should be cancelled before noon on Thursday). If you no-show or late-cancel, and we are able to reschedule this session by the end of the following week, I will not charge you a late fee. Otherwise, I will simply charge you 50% of what the session rate would have been.
How quickly will you get back to me?
I will make every effort to get back to you by the end of the following business day after you reach out. Please message me via the secure messaging system on the patient portal – I do check this quite regularly. If you have an urgent matter, you can leave a voicemail and I tend to acknowledge this as something sufficiently time-sensitive that you went out of your way to call, so I will attempt to be more responsive.
If you have an emergency after-hours and cannot reach me, you may go to Psychiatric Emergency Services at San Mateo Medical Center (650-573-2662) — I know the providers and staff here very well and will work closely with them if you have an emergency; they will know me by name.
What if I have an emergency?
As a solo practice, I cannot always be available. If you have a psychiatric emergency please call 911 or go to the nearest hospital.
Additionally, you may go to Psychiatric Emergency Services at San Mateo Medical Center (650-573-2662) — I know the providers and staff here very well and will work closely with them if you have an emergency; they will know me by name.
As noted above, if you have an emergency the best way to get my attention is to call and leave a voicemail, as I tend to acknowledge this as something sufficiently time-sensitive that you went out of your way to call, so I will attempt to be more responsive.