Some Office policies and procedures. 

The first appointment lasts about an hour and involves an initial consultation and diagnosis.

Subsequent appointments are between 20-30 minutes typically. 

My goal is for my patients to reach a point where they feel stable and generally "Ok".  Hopefully they do not need to see me as frequently then.  Perhaps every 3-6 months depending on the diagnosis and other factors.

A "No show fee" is charged for patients who do not notify us of changes in plans and who do not come to the appointment.   When someone does not come to their appointment this wastes the appointment that someone else could have used.  I was an engineer - I hate waste, it is in my DNA. 

Typically this office does not prescribe the class of medications called benzodiazepines which includes:  Xanax, Valium, Ativan, Klonopin, and to some extent Ambien.   Taking them daily is a little bit like having a wolf by the ears.  It is a great ride while it lasts but how you are you going to get off?  And what is the wolf's mood going to be at that point? (In psychiatry it is all about the mood.)  The safest and most recommended method of stopping benzodiazepine use is a 6 day admission to the hospital so that they can be tapered under medical supervision because if done too quickly, stopping them can result in seizures and -rarely - death.  So why would you start them in the first place?  They have also been linked to the development of dementia and depression. 

General Discussion

 As a psychiatrist my focus is on medication management but at a very broad level mental health problems can be treated in two ways:  1) by taking medications, 2) by receiving therapy.  Before medical school I honestly thought that Psychiatrist, Psychologist, and therapist were synonyms for the same thing.  Turns out they are not.  Psychiatrists have graduated from a medical school, then a residency and so generally they are authorized to prescribe medications.  Psychologists and therapists perform therapy which is what their training has focused on.  When studies have been done comparing the effectiveness of medications versus therapy the overall picture is that they are about equally effective.  Different conditions may require just therapy, just medications or usually a combination of both works the best.  But even though most of what happens at Hope and Roots is medication management I frequently recommend that people see a therapist.  The reverse is also true, therapists frequently refer their patients to a psychiatrist. 

In general my approach is pragmatic.  For example if someone has moved to the wiregrass area from elsewhere and comes to see me to establish care and they are on meds that have been working for them, I am not likely to change anything.  Unless there is a compelling reason.  (see benzodiazepines above.)

One of the things about engineering was that the problem could not be solved if you did not know what it was.  I feel the same about mental health, which in my mind leads to listening.  Where else can the information to understand the condition come from?  There are not laboratory tests currently for depression, anxiety, etc.  So I plan to listen.  This does not mean that I will do whatever a patient asks.  My conclusions can be different than theirs, but I try to gather enough information first.