Yes. I prescribe medication for medical conditions such as AD/HD, Generalized Anxiety Disorder, Panic Disorder, Bipolar Disorder, and Major Depressive Disorder.

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Yes. During the first meeting, we will talk about all the options and then we will decide what makes sense for you. I may suggest that you meet with someone else for the counseling portion and meet with me for only the medication, if I believe that he/she is a better match for you. Connecting you with the "right" counselor is important. If you already participate in counseling, I would prescribe medication and support the work with your counselor.

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I specialize in the evaluation and treatment of 18-60 year old individuals who present with symptoms consistent with:

Adjustment Disorders
Anxiety Disorders
Attention-Deficit/Hyperactivity Disorder
Bipolar Disorder without Psychotic Features
General Anxiety Disorder
Insomnia/Sleep Disturbance
Major Depressive Disorders
Obsessive-Compulsive Disorders
Panic Attacks
Panic Disorder
Performance Anxiety
Personality Disorders
Smoking Cessation

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House Call: This service option simply means that you choose whether we meet in your office, your home, or at a different location. As described in the house call section, people may choose this option for a variety of reasons, often for reasons related to privacy, personal comfort, and/or health reasons. By meeting within your home, work setting, or other location, you may be able to further protect your privacy and save time in travel.

Office Visit: This service offers you the option to meet in the comfort of an office. As described in the office visit section, you may prefer the comfort of meeting in an office because it offers a neutral and consistent meeting place away from everything. You may find that this option will offer you the opportunity to take distance from your daily surroundings, allow for reflection, and feel at ease knowing that you do not have to worry about unexpected interruptions.

Regardless of which option you select, your information remains confidential in accordance to the regulations of the profession and state regulations.

Please note that there are no randomized, clinical trials that show that mental health care needs to take place in an office setting; In fact, literature from the world of ‘telemental health’ and ‘house calls’ show that people benefit from electronic and home care service modalities.

If you still feel unsure about whether to start with a house call or office visit, I am happy to discuss the options with you. You have the option to change the setting at any time. I will also suggest a change in location, if I notice that the setting is not optimal for your care.

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Over the years, we have increasingly realized that bringing care to the home setting is often preferred and sometimes necessary. In that past, those who felt simply too depressed or anxious to leave their home did not have many choices. Fortunately, an increasingly number of professional are offering the house call option, which is making it easier for people to receive home care services.

Aside from health reasons, there are also people who simply feel too uncomfortable with office visits because of privacy concerns. One person said, "I don't mind letting people know that I am in therapy, but I don't want the waiting room to be the place where they find out without my consent."

• Did you know that there are many clinicians who currently offer house call services?
• Did you know that house calls has been around for decades?
• Did you know that there are organizations that promote and support house calls in the provision of care?
• Did you know that some clinicians offer mental health services in non-office settings?

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We can certainly explore whether medication without participating in psychotherapy/counseling makes sense for you. Some people need medication just long enough to get through difficult periods in their life; others, however, stand to benefit from both medication and psychotherapy/counseling. I am happy to share my professional opinion about whether medication, without psychotherapy/counseling services, makes sense for you.

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I am now accepting Cigna insurance and in the process of adding other insurance plans. If you are not eligible for Cigna coverage, I am happy to provide you with a monthly statement so that you can submit it to your insurance carrier. I do not take any responsibility in whether or not your insurance carrier covers your expenses. Please contact your insurance carrier to review your options before you begin treatment (See policies).

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Payment is due prior to the start of the appointment. Cash, Check, or On-line payment (On-line payment option has a minimal processing fee).

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Click on this link: Fees and Payment.

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If you miss an appointment without providing at least a 24-hour notice, the fee is $40.00 (See policies).

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There are professionals who offer house calls, though very few offer mental health/psychiatric services in nontraditional office settings. At this time, I have not found any randomized, clinical studies that show office visits are superior to non-office settings in terms of mental health care; In fact, the literature reveals that mental health treatment via internet and phone can be helpful. As healthcare reform continues to move forward, you will likely see more and more use of technology and house-based services in the field of mental health/psychiatry.

As one philosopher said many years ago,"There are three steps in the revelation of any truth: first, it is ridiculed; in the second, resisted; in the third, it is considered self-evident."

Sample web sites and citations illustrating house calls and telehealth:

House Calls

American Academy of Home Care Physicians
http://www.aahcp.org/

Doctors Making Housecalls
http://www.doctorsmakinghousecalls.com

Jay Parkinson Md
http://www.jayparkinsonmd.com

Telehealth

American Telemedicine Association
http://www.americantelemed.org/

Association of Telehealth Service Providers
http://www.atsp.org/homepage.asp

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Nurse practitioners have advanced education and clinical training in a health care specialty area such as family practice. Nurse practitioners have the authority to complete medical histories, perform physical examinations, order diagnostic tests, diagnose and order medications and treatments. Nurse practitioners must have a physician available for questions and consultation while rendering advanced medical care in California (About Us).

Nurse Practitioners practice under the rules and regulations of the Nurse Practice Act of the state in which they work.  Most Nurse Practitioners are also nationally certified in their specialty area. 

Research studies since 1965 have documented that Nurse Practitioners provide:

• high quality care;
• cost-effective care;
• an effective approach to health care; and
• care that results in a high level of patient satisfaction.

What services do nurse practitioners offer patients?

• Obtain medical histories and perform physical examinations.
• Diagnose and treat acute health problems such as mental health disorders, infections and injuries.
• Diagnose, treat, and monitor chronic diseases such as depression, anxiety, diabetes, and high blood pressure.
• Order, perform, and interpret diagnostic studies such as lab work and x-rays.
• Prescribe medications and intiate treatment interventions.
• Provide health maintenance care and annual physicals.
• Collaborate with physicians and other health professionals as needed.

Nurse practitioners do more than direct patient care. Many nurse practitioners are also actively involved in education, research, and legislative activities to promote quality health care for all people in the United States.

California Associations for Nurse Practitioners (www.canpweb.org).

American Academy of Nurse Practitioners (www.aanp.org).

American College of Nurse Practitioners (www.acnpweb.org)

Review publications about nurse practitioners at BIMBELA PUBLICATIONS (www.bimbelapublications.com).

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California Psychological Association (www.cpapsycho.org)

California Board of Psychology (www.psychboard.gov)

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If you require immediate attention, please call 911 or go to the hospital emergency department. If you need assistance between the hours of 5pm-8am, you will need to call 911 or go the hospital emergency department, especially if you need immediate attention. I will, however, attempt to return your call as soon as possible.

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