Please read this document carefully. It contains important information about Elise Scott, M.D.’s professional services and business policies. Strong communication is the foundation of effective care, so please let Dr. Scott know at any time if you have questions or concerns about your treatment.

Psychiatric Care

Standard psychiatric treatment involves diagnostic assessment, medical evaluation, psychoeducation, medication management and medical monitoring, lifestyle interventions, and supportive therapy. The initial assessment is usually completed in the first or second appointment and serves to guide the treatment plan. On occasion, it may not be possible to complete the intake until outside records or additional specific evaluations are obtained. Upon completion of the assessment, Dr. Scott will collaborate with you to provide personalized recommendations and answer any questions you may have.

Dr. Scott will recommend the time frame for follow up appointments based on your specific treatment and clinical concerns. This time frame reflects the frequency of assessment required to provide appropriate care. Thus, if you need to cancel an appointment, it will be important to reschedule in a timely manner. If Dr. Scott determines that there has been insufficient follow-up to safely continue the current medication(s), they may decline to renew a medication or provide only a partial refill pending attending an appointment.

Dr. Scott’s priority is to provide you with services to help you reach your goals, but please remember that no clinician can guarantee any particular outcome. Dr. Scott will work with you to develop a treatment plan and will regularly collaborate with you in discussing treatment progress. You have the right to agree or disagree with her recommendations. However, due to the varying nature and severity of problems and the individuality of each patient, Dr. Scott is unable to predict the length of your therapy or to guarantee a specific outcome or result. You have the right to discontinue treatment at any time.

Psychotherapy

The combination of medical and non-medical interventions is a core philosophy at our practice. Psychotherapy and psychotherapeutic tools are often incorporated in every appointment.

Psychotherapy may involve discussing challenging aspects of your life, leading at times to strong feelings such as sadness, guilt, anger, frustration, and/or loneliness. However, this short-term discomfort is often part of the process of long-term healing. Research consistently shows that psychotherapy leads to improved mental and physical well-being, stronger relationships, solutions to specific problems, and significant reductions in distress.

You may choose to obtain psychotherapy with an outside provider or with Dr. Scott. In some cases, Dr. Scott may not feel equipped to provide the specific type of psychotherapy that will best meet your goals. In this case, she will refer you to an outside psychotherapist that may be able to meet more frequently or sub-specialize in unique skills.

If you are working with an outside therapist, you are encouraged but not required to complete a Release of Information form to enable Dr. Scott to communicate and collaborate with your outside clinicians.

Initial Psychiatric Evaluations

The first step of treatment is an Initial Psychiatric Evaluation. This evaluation may require multiple sessions to establish the goals of treatment (your treatment plan). One of the goals of these initial sessions is for us to decide if this is a good pairing to provide the services you need. Thus, completing an initial evaluation is not a guarantee of a medication prescription or continued treatment with this provider. If continuing treatment with Dr. Scott is not recommended, she will discuss the reasons and alternative options for treatment.

Before attending any appointments with Dr. Scott, it will be required to complete any pre-evaluation forms or documents, including this agreement. Without a documented consent to receive psychiatric care with us or awareness of our practice’s policies, Dr. Scott is unable to provide you with any medical services.

Follow Up Appointments

After the initial psychiatric evaluation(s), there are typically two different kinds of appointments. If medications are recommended and therapy is being received elsewhere, 25 minute follow-up appointments will be scheduled to monitor your clinical status and response to treatment. These appointments will be required to continue prescribed medications. Early in the course treatment, appointments may be as often as every 2-4 weeks, though as you stabilize these can be extended to as long as 3 months between appointments. In more complex cases or when receiving therapy +/- medications, 50 minute follow-up appointments are more appropriate. Dr. Scott will always collaborate with you on the treatment plan as this is a shared decision-making process. Attending appointments and following through on mutually agreed upon treatment is vital for you to have your best outcome.

Medication Refill Policy

Dr. Scott will make every effort to ensure that you have enough medication to cover you until your next scheduled appointment by prescribing an appropriate number of refills at your visit. Please be aware that controlled substances have specific regulations regarding their use and more frequent visits may be required since they do not allow for a refill element in their prescription. Some examples of controlled substances include stimulants and benzodiazepines.

If something is accidentally missed by Dr. Scott and needs to be refilled between appointments, you will not be charged for the time involved. However, if you run out of medication due to missing/cancelling an appointment or neglecting to reschedule, you will be billed for any refills that are requested between appointments. We prefer that patients request their own refills and reserve the right to ignore pharmacy-generated requests as these are often sent in error. Please allow up to 2 business days for refill requests. Also, we strongly encourage you not to wait until you are out of medication to request a refill.

Controlled Substances

Prescription medications are classified as either controlled or non-controlled substances. Most psychiatric medications fall under the non-controlled category. However, some psychiatric prescriptions like stimulants or benzodiazepines are classified as controlled substances regulated by the Drug Enforcement Administration (DEA) due to their potential for misuse or dependance.

Dr. Scott may prescribe controlled substances in situations where the possible therapeutic benefits outweigh potential harm. To reduce the risk of harm and prioritize patient safety, Dr. Scott may require you to sign an additional agreement. This includes agreeing that you will not take any controlled medication except as prescribed, you will not self-adjust the dose or administration frequency, you will not seek additional controlled substances prescriptions from other prescribers, and you will not share or sell the medication.

Patients may also be asked to obtain either a urine or blood drug screen prior to any controlled substance being prescribed. Random such testing is also obtained at different intervals throughout treatment. Completion of such screens is ultimately the personal and financial responsibility of the patient these medications are prescribed for. Such screens help to determine the presence or absence of controlled substances. Testing negative for prescribed controlled substances or positive for additional controlled or illicit substances not prescribed by Dr. Scott can be considered a breach of the controlled substance policy and grounds for immediate discontinuation of the drug prescribed and/or from the practice.

Monitoring of controlled substances is maintained through the Prescription Drug Monitoring Program (PDMP). As is required by law, Dr. Scott obtains, reviews, and monitors this database prior to prescribing controlled substances.

Contact Between Appointments

Messages or any general communications will be typically replied to within 2 business days.

Communications outside of scheduled appointments are meant for a brief, important, and simple purpose that can be reasonably addressed in 5 minutes or less. Dr. Scott prefers to make all important clinical decisions during an appointment. If your message requests a medication change or a clinical decision, you will likely be asked to schedule an appointment to discuss it further so that it may be given full attention. Furthermore, if a message or phone call involves a task that requires a time significantly over the 5-minute framework, you may also be required to pay an associated fee.

Patients are welcome to email or text us directly. By agreeing to communicate via text/email, you assume a certain degree of risk of breach of privacy beyond that inherent in other modes of traditional communication (such as telephone, written, or face-to-face). We cannot ensure the confidentiality of our electronic communications against purposeful or accidental network interception. As a result of this risk, patients are highly encouraged to contact Dr. Scott through secure message rather than by phone or email. This way of communication is the safest, most direct, and easiest method to keep track of communication and ensure that needs are responded to promptly.

Emergencies

Elise Scott, M.D. does not provide on-call, emergency, or crisis services. If you or a loved one are experiencing a life-threatening or mental health emergency, please call 911 or the National Suicide & Crisis Lifeline at 988. In such situations, you may also go to the nearest emergency room.

If you think that your concern poses any risk to you that is time sensitive, including a medication reaction, or if you think you might require urgent psychiatric inpatient assistance or hospitalization, please do not wait for a response from Dr. Scott. Call 911 for transportation to your local emergency room.

Referrals or Termination of Treatment

The length of your treatment and the timing of the eventual termination of your treatment depend on the specifics of your treatment plan and the progress you achieve. It is a good idea to plan for your termination in collaboration with Dr. Scott. She will discuss a plan for termination with you as you approach the completion of your treatment goals.

However, you may request to end or transfer treatment to another institution at any time. We encourage you to discuss this choice with Dr. Scott in advance so that you can be assured of having as much pertinent information as possible when you make your decision. We can offer referrals to assist you to find another provider who will help you continue your treatment.

As mentioned above, an initial decision to continue treatment with Dr. Scott is not a guarantee that she will be able to continue to provide services under all circumstances. If your treatment needs change or if you disagree about your care, it is possible Dr. Scott will recommend additional or alternative provider(s). Under these circumstances, Dr. Scott may refer you to a second provider for adjunctive treatment, or recommend your care be transferred to a clinician or practice more appropriate to your needs.

Recommendations to transfer care typically occur when the specific treatment needs are outside Dr. Scott’s areas of expertise, treatment recommendations that may not fit the outpatient or telehealth format, or because of patient non-adherence with treatment recommendations, appointments, or financial obligations. Examples of treatment needs that may not be appropriate for telehealth include significant substance misuse, development of medically unstable conditions, psychiatric conditions requiring frequent hospitalization, and/or emergency appointments. Non-adherence may include not following through on agreed upon treatment recommendations, repeated missed or cancelled appointments, and/or misuse of prescription medications.

If the decision is made to transfer or terminate care with Dr. Scott, she will provide short-term treatment (30 days or less) while you arrange to transfer your care. Suggestions will be provided for other treatment options. Depending on the reasons for the recommendation, appointments with Dr. Scott may be required during the transfer process. The time period of coverage during transfer may be shorter if the recommendation is considered urgent. If there is a concern that your situation is unstable and/or unsafe, it may not be appropriate to continue the previously established treatment during the transition period.