The Expert Second Opinion
A one-time, in-depth psychiatric consultation by telehealth for adults in California
For complex cases: a diagnosis that has not been settled, treatment that helps but not enough, or a medication list that needs a second look. The consultation brings a careful evaluation, a review of your records and labs, and a written report with diagnostic and medication recommendations. You return to your own clinician with a clear plan, or, if you prefer, we can discuss ongoing care.
How it works
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Before we meet, I review your prior records, recent labs and full medication history.
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A comprehensive psychiatric evaluation by secure video: your symptoms, your history, your medical conditions and every treatment you have tried.
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A second session to go over the findings and agree on a plan.
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A written report with diagnostic and medication recommendations, for you and, with your consent, for your physician or therapist.
Diagnostic clarification and medication optimization can be completed in as little as ten days. When deprescribing is involved, the process takes two to three months.
What the consultation can address
Diagnostic clarification and treatment optimization
For adults who have seen several providers without a clear answer, or whose treatment helps but not enough. The evaluation leads to a clarified diagnosis and specific recommendations to optimize the medication plan: doses, timing and combinations, adjusted step by step.
Pharmacogenomic (genetic) testing consultation
Many people ask whether a genetic test such as GeneSight or Genomind could explain why medications have not worked or have caused side effects. The results are most useful when they are read against the full picture: the diagnosis, every medication tried and your medical conditions.
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First visit, 75 minutes: a review of your diagnosis and medication history. The GeneSight or Genomind test is ordered at this visit, and you complete it at home.
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Second visit, 75 minutes, one to two weeks later: we go over the results together, and you receive written recommendations for you and your prescriber.
The test is billed to you separately from the consultation.
Deprescribing
For adults who worry that they take too many medications. Each medication is reviewed: what it is doing, how it interacts with the others and whether it is still needed. Where appropriate, you receive a plan for gradual, supervised reduction, coordinated with your other physicians. Please do not stop or change psychiatric medications on your own.
Perimenopause and menopause: depression, anxiety and sleep
Changes in mood, anxiety and sleep during perimenopause and menopause are common, often dismissed, and frequently mistaken for something they are not. The evaluation sorts out what is hormonal, what is psychiatric and what is situational, coordinates with your gynecologist or primary care physician, and builds a plan that treats the real problem without over-medicating it or dismissing it.
Psychiatry in chronic illness and major medical interventions
For adults living with chronic medical illness, or preparing for or recovering from a major intervention such as an organ transplant or heart surgery. The evaluation pays close attention to how psychiatric medications interact with your other treatments, and coordinates with your medical team.
What you receive
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A written report with diagnostic and medication recommendations
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A copy for your physician or therapist, with your consent
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A clear plan to carry forward with your own clinician
Good to know
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Visits take place by secure video, for adults 18 and older who are in California at the time of each visit.
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The consultation is self-pay. Fees are sent to you before you schedule.
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Not included: emergency or crisis care. Substance use disorders are not the focus of this practice.
“My experience with Dr. Cartwright has been very pleasant. I was treated in Mexico for anxiety and depression and the medication regime that I was given made me feel worse... following her expertise and guidance I can now say that I am doing a lot better.”
G.
How to Get Started
Request a consultation through the contact form, and you will hear back within one business day.
Prefer to talk it through? Call (858) 255-0084
Referring a patient? Information for clinicians