Psychiatric second opinions in Washington State

When a second opinion makes sense

People in other areas of medicine get second opinions routinely and nobody considers it disloyal. In psychiatry it happens far less often — partly because patients worry about offending their provider, and partly because it's rarely offered. But psychiatric diagnosis is complex, frequently revised over time, and consequential: the label drives the treatment, and the wrong label can send years of care in the wrong direction.

Common reasons people seek one:

• A diagnosis that never quite fit, or that was made quickly
• Several medication trials without meaningful improvement
• Being on multiple medications without a clear rationale for each
• Suspecting something was missed — bipolar spectrum misread as unipolar depression, ADHD confused with anxiety or a sleep disorder, trauma underneath a mood diagnosis
• Wanting to understand options before agreeing to a significant change
• Considering coming off a medication and wanting an informed assessment first

What we actually do

A second-opinion consultation is a full diagnostic evaluation with a specific question attached: does the current formulation hold up? We take an unhurried history, review your records and prior treatment trials, look at the physical and metabolic factors that commonly get skipped, and consider whether anything has been missed or mislabeled.

You leave with a clear assessment in plain language and written recommendations you can take back to your existing provider — not vague reassurance, and not a sales pitch for our practice.

You are not obligated to switch

This is the part worth stating directly: a second opinion here is a standalone service. Many people have a good relationship with their prescriber and simply want an independent perspective to bring back to them. That's a completely legitimate use of this visit, and it's often the best outcome — your existing provider gets useful information, and you get clarity.

If you'd rather continue care with us afterward, you're welcome. But nothing about the consultation is designed to push you there.

What to bring

• A list of every psychiatric medication you've tried, with doses and roughly how long — this is the single most valuable thing you can prepare
• Any records, discharge summaries, or testing you can access
• Recent lab work, if you have it
• What you're actually hoping to understand or decide

Don't worry if your records are incomplete — most people's are. We work with what's available.

Getting started in Washington

Consultations are conducted by secure video anywhere in Washington State, for adolescents and adults. Most major insurance is accepted, and out-of-pocket rates are available — see our insurance page or read more about our second opinion service. You may also want to try one of our free self-assessments beforehand; they're scored privately on your own device.