FREQUENTLY ASKED QUESTIONS
Patient Related Questions, Answered for You
WHAT IS A PA?
While an excellent, in-depth explanation can be found here, in essence, PAs are trained at medical schools, in the medical model like physicians, except on a masters time frame instead of a doctorate. PAs are fully trained & licensed to evaluate patients, diagnose, treat, prescribe, and educate, in much the same manner as a doctor or nurse practitioner. Our PAs' functional roles are virtually identical to that of a psychiatrist, and they practice under the legal supervision of one, as all psychiatric PAs must.
DO YOU PROVIDE COUNSELING/THERAPY?
We are trained and qualified to perform basic supportive counseling and utilize cognitive behavioral therapy modalities. However, if you are looking specifically and exclusively for a counselor, therapist, or psychologist to perform talk therapy *only* (who cannot prescribe), we are more than happy to refer you to several excellent therapists/counselors/psychologists in your area. Studies have shown that patients who combine psychiatric (what we perform) and psychologic (what a therapist, counselor or psychologist performs) care have significantly better treatment outcomes.
*PLEASE SEE OUR LOCAL THERAPIST LIST, LINKED ON OUR "RESOURCES FOR ALL" PAGE!*
HOW CAN I BECOME A PATIENT
If you'd like to become a patient, you will need to:
Thoroughly read, sign, and email to us our new patient paperwork and Consent to Treatment, found on our "For New Patients" page.
Please note: There are certain medication regimens that will not be compatible with our policies, so we will review this and contact you to schedule, once we ensure that we are an appropriate fit for your needs.
As you can imagine, all psychiatric offices are doing their best to navigate tremendously high patient volumes. We are human, too. Still, we are doing our absolute best to take care of *all* our patients in a timely, compassionate, yet thorough and exacting manner.
We accept all major commercial insurances, including Medicare, but we do not accept AHCCCS (AZ Medicaid).
If you have Medicare insurance, per their policies, Medicare MUST be billed as your primary insurance, regardless of whether you have a secondary insurance. We cannot guarantee that we are in network with your Medicare supplemental plan.
If you are a Medicare patient, per their policies, you must see our supervising physician for at least your initial visit. However, you may follow up with any member of our team thereafter.
We do have a discounted cash rate for such patients who still wish to see us without insurance.
DO YOU HAVE PRESCRIBING POLICIES I SHOULD KNOW ABOUT?
You should know that we obey Arizona law, meaning we cannot and do not prescribe medications for patients who are not yet legal patients of record, so we cannot prescribe prior to your initial evaluation.
We also have strict policies regarding controlled, illicit, or illegal substances, as follows:
We perform random, oral or urine drug testing on all patients being prescribed or considered for controlled substances. We will also perform random drug testing should a patient's status be concerning for risk of a substance use disorder and appear to clinically compromise the patient's safety, or our safety as prescribing providers.
Under NO circumstances will we prescribe controlled substances if you are positive at any time for marijuana or certain levels of alcohol, opioids, or other controlled substances, even if these substances are prescribed or recreationally legal. Something being legal or "natural" does NOT make it safe or healthy. PATIENT SAFETY IS OUR TOP PRIORITY!
We will NOT prescribe stimulants at the first visit, and unless/until we have confirmed that they are medically necessary. If we suspect that a legitimate AD/HD may be at play, we refer to neuropsychological testing to thoroughly and properly quantify frontal executive functioning prior to considering anything stimulant-based or controlled. All humans have attention deficits, but not all have primary AD/HD.
Under NO circumstances will we prescribe more than 30 benzodiazepines in a month. This includes medications such as Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Klonopin (clonazepam), and any other similar medication. Our goal is not to create vicious, addictive cycles; our goal is to TREAT THE ROOT CAUSE OF THE PROBLEM so that you no longer need daily rescue medications with dependence potential.
Our detailed policy is outlined in your new patient paperwork, as well as posted in our lobby, available to all patients at any time.
DO I HAVE TO TAKE MEDICATION?
Not always. Every decision for every patient is made on a case-by-case basis.
First, we spend a minimum of a full hour in your initial evaluation, where the most appropriate diagnoses are discussed, as are treatment options. We often perform extensive blood work to rule out any general medical condition that could be causing/worsening your symptoms.
We are also very holistic in our approach. Don't be surprised if you are "prescribed" a better sleep hygiene regimen, exercise recommendations, nutritional modifications, books and websites to research, referral to a counselor, or even nutraceutical supplements that are available over-the-counter or via prescription, but are not necessarily "medication."
There are some diagnoses that require pharmacologic treatment, due to the greater risk of neglecting to treat a legitimate medical condition. However, if this applies to you, all potential options will be thoroughly and carefully discussed with you, as your treatment plan is an open dialogue; one for you to discuss, understand, and agree with.
Above all, we practice conservative, methodical, evidence-based, golden rule medicine. We will make only one change at a time, so that whether something goes right *or* wrong, we know why. We will also "start low and go slow," since we can always optimize a dose, but we can never erase a negative experience. Once you're a patient, you are Pinnacle family, and we treat you as such. We always recommend what we would want for ourselves or our loved ones, if the roles were reversed.
HOW CAN I GET MY QUESTION ANSWERED IF IT'S NOT LISTED HERE?
Please give us a call! We are more than happy to help answer any questions you may have, as you ensure that we are a good fit for your personality and your goals. We wholeheartedly believe, "Finding the right provider is just like dating: you don't have to marry the first one you meet!" Whether it's a good therapist, PCP, or psychiatric provider, the "right fit" is of the utmost importance. The more comfort and confidence you have in your providers, the better your treatment outcome will be!
Thanks for asking!