Zev Wiener, MD
California In-Home Telepsychiatry
Frequently Asked Questions
-What are some potential advantages of telepsychiatry?​
-What are some potential disadvantages of telepsychiatry?
-How do you deal with the aforementioned potential disadvantages?
-Is there anyone for whom telepsychiatry is not appropriate?
-What conditions do you treat?
-Are all visits conducted via telepsychiatry?
-Do I need to be physically located in California to participate in telepsychiatry?
-What are the hardware requirements? Is there any setup involved?
-What are your rates? Do you accept insurance?
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-What is "telepsychiatry"?
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Telepsychiatry is just like traditional “in-person” psychiatry, except that instead of traveling to my office, our meetings are held using videoconferencing, where we see and speak with each other by computer over an internet connection (a secure medical platform that is somewhat similar to programs like FaceTime or Skype for doctors). You are located in your home or office, and I am located in my office. Telepsychiatry is fully legal in the state of California, and is already being used extensively in medical practices.
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-What are some potential advantages of telepsychiatry?​
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Telepsychiatry, when used in the appropriate context, offers considerable convenience and a number of potential advantages relative to traditional office-based settings:
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. Greater privacy (no hallways, lobbies, or waiting rooms with other patients)
· Saves time (eliminating the drive to and from appointments)
· Saves money (saves on gas money, parking fees, babysitting fees, etc),
· Allows for continued treatment when out of town
· After-work and weekend hours are more available
. Allows patients with mobility challenges to be seen
· Some patients report that they feel more comfortable discussing sensitive matters from the familiarity of their home environment as opposed to in a doctor's office.
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-What are some potential disadvantages of telepsychiatry?
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Telepsychiatry is not for everyone. Some potential disadvantages may include:
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· I am unable to physically intervene in emergency situations
· While most medications may be legally prescribed via telemedicine, California law prohibits the prescription of certain medicines known as "controlled substances" (such as Xanax, Ativan, Ritalin, Adderall) via telemedicine without a prior in-person visit
· Some individuals may feel that certain intangible elements of the "in-person" connection are lost when conducted via videoconference
· Telemedicine requires one to have a private space available during the appointment
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-How do you deal with the potential disadvantages listed above?
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· Regarding emergency situations, I require every patient to provide his or her location and an emergency contact number prior to our sessions. In the unlikely event of an in-session emergency, I will utilize that information to coordinate rapid emergency assistance via 911
· Regarding controlled substances, in the event that I feel that one of these controlled medications is indicated, we will either arrange for an “in-person” visit, request that your primary care doctor provide the prescription (I will contact your doctor), or I will recommend switching to a different psychiatrist
· Regarding concerns about the potential loss of the "in-person" connection, my patients have not seemed to find this to be an issue. Many of them have remarked repeatedly, "it really feels like you're actually here." That being said, if you find that there are elements of connection that are lacking, you might consider choosing an “in-person” psychiatrist
· Regarding the need for an accessible private space, people who do not have any private space in their home generally schedule appointments at times when they anticipate others to be out of the house, or they schedule their sessions from their private office at work. If there are no other solutions, patients will occasionally use their smartphone and have a session from their (parked) car
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Is there anyone for whom telepsychiatry is NOT appropriate?
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· I do not generally recommend telepsychiatry for individuals with chronic self-injurious behavior or chronic suicidal ideation, or for individuals with eating disorders (e.g., anorexia, bulimia). Telepsychiatry may or may not be appropriate for individuals with psychotic illnesses (e.g., schizophrenia), depending on the specific nature of their illness.
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-What conditions do you treat?
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· I work with people struggling with depression, anxiety, bipolar disorder, insomnia, post-traumatic stress disorder, obsessive compulsive disorder, attention deficit hyperactivity disorder, schizophrenia, and autism, among others.
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-Are all visits conducted via telepsychiatry?
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· It depends on the situation, but when possible, I will encourage my patients to come to my office in Beverly Hills for an initial visit. Subsequent visits are conducted remotely using telepsychiatry.
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-Do I need to be physically located in California to participate in telepsychiatry?
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· Yes. As of now, I am only able to work with patients who are physically located within the state of California. This may change in the future, so please feel free to check back again.
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-What are the hardware requirements? Is there any setup involved?
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· No technical experience or special equipment is needed. All you need is a private room, a computer with a good internet connection, a webcam, and speakers. A smartphone can work, too, though I don't recommend this when possible. If you have Google Chrome or Firefox web browsers (both are available for free download), no further setup is required; just type in the website address of my waiting room.
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· If you do not have those browsers, it is still very easy for us to meet, with less than one minute of total setup time. Simply visit VSee to download and install the VSee videoconferencing program, and we can use that platform to meet.
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· ​If you have any difficulties with either of these options, I would be glad to walk you through it over the phone.
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-Is telepsychiatry secure?
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Your privacy is of utmost importance to me. I use HIPAA-compliant encrypted videoconferencing technology which is specifically approved for medical professionals (feel free to visit doxy.me to read more). Otherwise, your personal information is guarded exactly as I do for my in-person patients, with full adherence to HIPAA privacy regulations.
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-What are your rates? Do you accept insurance?
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Please email me via the "Contact" page (feel free to write anonymously if preferred) to inquire about rates.
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Although I am not presently "in network" with any private insurance panels, I am glad to supply you with a "superbill" that may be submitted to your insurance (especially if you use a PPO) for a potential reimbursement for "out of network" coverage.