u/Hebbianlearning

I'm a neurologist who sees many patients who also need (usually geriatric) psychiatric care. It is nearly impossible to get them to a local, in-person psychiatrist in less than 3 months, sometimes closer to 6. Meanwhile, there are numerous telehealth companies (e.g. Mindpath, Headway, Talkiatry) that seem to have no trouble hiring psychiatrists to work for them, and patients can get seen in a matter of days to a few weeks tops.

My questions: why is this such a popular model for you all; that is, why is it better than working for a brick-and-mortar clinic/hospital/health system? How am I supposed to make a referral? Do I just trust that my 75 year old with a h/o bipolar disorder who now also has mild dementia is going to be seen by someone with the appropriate training and expertise (that is, is someone doing triage on the company side, or do they simply assign the patient to the doc who's next up on the list?) What happens if someone needs to be hospitalized; do any of these companies have a relationship with a specific hospital, or do they just say "go to your local emergency room?"

Anyway, you get the idea. I don't want my patients to wait 3-6 months when they're in extremis, but I am very hesitant to refer them to one of these companies. Should I be wary, or are they better than they seem?

My cat has an adrenal tumor causing hyperaldosteronism. She is 11 and may or may not also have low-grade T-cell lymphoma (+PARR on a single node but no intestinal wall thickening and no IBD symptoms at all). I'm being quoted $10-12K as an estimate for adrenalectomy plus exploratory lap. at 2 different referral hospitals. We do not have pet insurance and that cost is unachievable (esp. after nearly $3K in diagnostic costs). What I don't know is whether this is typical/customary for this type of surgery or if I might find someone/someplace for half that price if I look further afield of our location (suburb of Raleigh, NC).

Not a request for medical advice, just a product purchase.

My cat just got put on amlodipine for hypertension, but the dose may or may not be enough. He wants me to bring her in every week for awhile to get a bp reading, but she gets super stressed in the car, plus he wants $60 every time. So, I'd like to check it at home, but the "gold standard" ones cost well over $1000. Can anyone recommend one that's reasonably accurate and less than, say, $300?

Are you kidding me? In what alternate universe is a 2 bdrm/2 bath, 1500 sq.ft condo apartment unit worth even half of this asking price, even if it is new construction? https://www.zillow.com/community/south-creek-chapel-hill/460911058_zpid/

What am I missing? This is south Chapel Hill, not Boston or NYC.