What Is Concierge Psychiatry?

Washington, DC • Maryland • Virginia

Concierge psychiatry is a membership-based model of psychiatric care. Instead of booking individual appointments within an insurance-based system, a patient joins a practice that deliberately keeps its panel small, so that the psychiatrist has time for longer evaluations, closer follow-up, and direct communication between visits.

The term is used loosely, and practices differ considerably. Understanding what the model is, and what it is not, makes it easier to judge whether it fits a particular clinical situation.

What Membership Typically Includes

Most concierge psychiatry practices combine some version of the following:

A comprehensive initial evaluation, usually longer than a standard intake
A defined number of follow-up appointments within an annual or semiannual membership
Secure, direct communication with the physician, with stated response times
Priority or flexible scheduling
Coordination with therapists, primary care physicians, or other treating clinicians, with the patient’s consent
In-person and telepsychiatry visits

The details matter more than the label. Response times, appointment length, and who actually answers messages vary from one practice to another.

What It Is Not

Concierge psychiatry is not a different kind of medicine. The diagnostic standards, the evidence base, and the clinical judgment are the same as in any careful psychiatric practice. What changes is continuity: the same physician follows the course of treatment over time, with enough access to adjust it when circumstances change.

It is also not emergency care. A membership practice is an outpatient service. It does not replace crisis services, emergency departments, or inpatient treatment when those are needed.

Who Tends to Benefit

The model is most useful when the clinical picture is complex and the cost of delay is high. Examples include:

A diagnosis that remains uncertain, or several diagnoses that plausibly overlap
Several previous treatments that have produced incomplete or inconsistent results
A medication regimen that has become complicated and needs careful review
Mood or anxiety symptoms that intersect with alcohol or other substance use
Substantial professional responsibility, where concentration, sleep, and judgment must be protected while symptoms are treated

High outward functioning does not mean low complexity. People who continue to perform well at work can be managing significant symptoms privately, and a model built around continuity allows changes to be noticed and addressed earlier.

Questions Worth Asking Before Choosing a Practice

Who conducts the evaluation and the follow-up visits?
How long is the initial evaluation, and what does it cover?
What are the actual response times for messages, and during which hours?
How many follow-up visits are included, and what happens if more are needed?
Does the practice coordinate with your therapist or primary care physician?
What is the plan for urgent situations outside office hours?
Is telepsychiatry available, and in which states is the physician licensed?

Clear answers to these questions say more about a practice than its description of itself.

Concierge Psychiatry in This Practice

Dr. Venera R. Miller, MD, FAPA, FASAM, is a double board-certified psychiatrist and addiction medicine physician affiliated with Sibley Memorial Hospital and Johns Hopkins Medicine. Her Executive Concierge Psychiatry program serves high-functioning professionals in Washington, DC, Maryland, and Virginia, in person and by secure telepsychiatry.

Learn about the Executive Concierge Psychiatry program

This article is for general education and is not medical advice.