November 19, 2025
Why Your Psychiatry Practice Isn’t Filling Its Schedule!
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Written by
Osmind
Why Your Psychiatry Practice Isn't Full (And What's Actually Working in 2025 and 2026)
Dr. David's voicemail tells new patients not to leave messages because he can't call them back. He's been overfull for 15 years in Chicago—cash-only, no website, no advertising.
Meanwhile, 200 miles west in Ohio, psychiatrists fight over patients.
You hit 70% capacity and stay there. Wait times in your market are 3-6 months. Both can't be true unless something is broken at the system level.
We recently asked psychiatrists and PMHNPs in the Osmind Psychiatry Collective what's blocking their schedules.
The bottleneck isn't demand. Over 50% of U.S. counties have no practicing psychiatrist at all. The adult psychiatry workforce is projected to be 43-74% short of needed supply by 2037.
The problem is how referrals flow, how you're positioned online, and whether you've built systems to handle growth.
Mary, a psychiatric nurse practitioner in Virginia, kept hearing about 6-month hospital wait times. She had 2-week availability, 15 minutes away. The hospital never called. So she started calling them—monthly. "I just remind them I'm around the corner and have openings," she said. That became her primary referral source.The system defaults to the path of least resistance, which is rarely you.
Here's how to change that:
10 Patient Acquisition Strategies (Ranked by Impact vs. Effort)
1. Set Up Google Business Profile
Time: 30 minutes | Cost: Free | Impact: High
Why this matters: When patients Google "psychiatrist near me" or your practice name, your Google Business Profile is what appears first.
How to do it:
- Go to business.google.com and claim your listing
- Add photos, hours, accurate address
- Select categories: psychiatrist, child psychiatrist, interventional psychiatry
- List if you offer telehealth
- Encourage patient reviews (check state licensing board guidelines first)
What success looks like: Patients find you through Google Maps searches without ever visiting your website.
2. List on Psychology Today
Time: 1 hour | Cost: $29.95/month | Impact: High
Why this matters: Psychology Today drives 34.81 million monthly visits and was the most-mentioned directory in our Psychiatry Collective discussion. Practices in competitive markets report 5-15 new patient inquiries per month from their Psychology Today profile, with highly visible providers in urban areas seeing even higher volumes. At $29.95/month, that's roughly $2-6 per qualified lead—significantly cheaper than Google or Meta ads.The key is active profile management. Update your "accepting new patients" status monthly. The more current your profile, the higher you appear in search results.
How to do it:
- Create profile at psychologytoday.com
- Make bio keyword-rich (mention specialties, treatment approaches)
- State your niche clearly (interventional psychiatry, perinatal, adolescent)
- Say if you take insurance (avoids wasting time on non-viable inquiries)
- Mark yourself as "accepting new patients"
- Update regularly when capacity changes
Multiple practitioners reported this as their #1 source of new patient inquiries.
3. Call Hospital Discharge Coordinators Monthly
Time: 2 hours/month | Cost: Free | Impact: High
Why this matters: Hospitals have waitlists. You have availability. They just don't know about you.
How to do it
- Identify hospitals within 25 miles of your practice
- Call discharge planning/social work departments monthly
Use this script: "Hi, I'm [name] at [practice]. I'm around the corner from you and have availability within 2 weeks. Just wanted to make sure I'm on your radar for appropriate referrals."
- Follow up every month when you have capacity
Mary (Virginia PMHNP): "I call the local hospital regularly to remind them I have availability within a 2-week window."
If you only have time for 3 things this week, do these:
1. Google Business Profile (30 min, free)
2. Psychology Today ($29.95/month, 1 hour)
3. Call 3 hospitals (2 hours)
Once you've made yourself findable, the next step is building institutional relationships that generate consistent referrals.
4. Contact College Health Centers
Time: 1 hour setup, 10 min/month maintenance | Cost: Free | Impact: Medium-High
Why this matters: Universities near you have built-in referral systems you can tap into.
How to do it:
- Identify colleges/universities within 30 miles
- Contact student health centers directly
- Ask to be added as a community referral resource
- Many have systems that prompt you monthly to update availability
- List all services you offer (general psych, ADHD, anxiety, interventional)
Mary, a psychiatrist in Madison, Wisconsin, contacted James Madison University's student health center and asked to be added as a community referral resource. Now she receives a monthly prompt to update her availability. "That's where my college student referrals come from," she said.
5. Schedule Lunch-and-Learn Presentations
Referral sources need to trust you before they send patients. Face-to-face builds that faster than any directory listing.
Who to target:
- Primary care physicians
- Therapist group practices
- Hospital social workers
- Community mental health centers
How to structure it:
- Offer to present on TMS, ketamine, Spravato, or your treatment approach
- Bring lunch for their team (budget $10-15/person)
- Focus on: what treatments you offer, who's a good fit, how to refer
- Leave business cards and referral information
- Keep it to 30-45 minutes
Multiple practitioners in the Psychiatry Collective mentioned this as their top strategy for building direct referral relationships.
Lunch-and-learns work for local referrals. But patients searching online for specific treatments—TMS, ketamine, Spravato—need to find you too. Most don't even know these treatments are legal in the U.S.
6. Get Found Online: SEO for Interventional Treatments
Patients are searching for TMS, ketamine, and Spravato. Most don't know these treatments are legally available in the U.S.
Darcy, a psychiatrist in Arizona, emphasized this gap: "Particularly for ketamine and TMS, people are actively searching. Many don't realize ketamine is available legally in the U.S."
Create content around specific searches:
- "TMS for depression in [your city]"
- "Ketamine therapy vs. traditional antidepressants"
- "What to expect during Spravato treatment"
- "Is ketamine therapy covered by insurance?"
The ratio that works: 90-95% educational content, 5-10% soft call-to-action.
Answer the questions patients are actually searching for. The goal isn't to sell them in the blog post. It's to establish yourself as the local expert so when they're ready, you're the first call they make.
Also consider:
- Therapy Tribe ($299 one-time website build + monthly listing fee): Multiple practitioners mentioned strong ROI for both website quality and directory listing
- Other directories: List anywhere patients in your market actually search (check your Google Analytics to see where traffic comes from)
Read also:
-Building Your Private Psychiatry Practice: Prospective Patients (Part 2)
-Establish Your Psychiatry Private Practice Online: What to Put on Your Website
At this point, you're no longer constrained by visibility. You're constrained by your own time.
7. Pre-Screen Patients For Fit
High no-show rates often indicate poor patient-practice fit, not patient flakiness.
Create a HIPAA-compliant intake form that asks:
- What insurance do you have? (Is it accepted?)
- What treatment modalities are you interested in?
- Are you willing to commit to a treatment course (e.g., 6-8 weeks of TMS)?
- What's your availability for appointments?
Use responses to pre-screen before offering appointments. Set expectations upfront about your cancellation policy.
What success looks like: Your no-show rate drops and your conversion rate improves. Practices using structured pre-screening report 30-60% conversion from inquiry to booked appointment—the higher end correlating with better screening questions that filter for insurance compatibility, treatment readiness, and scheduling availability.
8. Automate Data Collection
Traditional intakes involve 30 minutes of interrogation before you can have an actual conversation.
David, a psychiatrist in Chicago, described the problem: "If I could improve my efficiency without losing my mind holding all these stories in my head, I could probably see more patients."
Options for automating intake:
AI-powered intake tools:
- Tools like Async Health conduct AI-powered intake interviews before the appointment
- Patients answer questions via conversational interface
- You receive a structured report before your first session
- Lets you spend appointment time on clinical conversation and informed consent instead of data collection
Measurement-based care assessments:
- Use your psychiatry EHR to send PHQ-9, GAD-7, and other assessments before the appointment
- Review results ahead of time to front-load clinical thinking
DIY approach:
- Have patients complete assessments manually
- Copy results into an AI tool (ChatGPT, Claude) for preliminary analysis
- Review AI-generated summary before appointment
The math: Clinical intake typically takes 30-60 minutes. AI automation handles the structured data collection: patient history, symptom checklists, basic screening questionnaires—before you're involved. This saves 15-20 minutes per patient (about 25-40% of total intake time). Over a month, that's 5-10 hours reclaimed if you're doing 20-30 intakes. What do you do with that time? See 10-15 more patients per month, or spend those minutes on clinical thinking instead of documentation.
When You Need Leverage: Hiring and Scaling
You've fixed visibility. You've streamlined intake. Now you're turning away 5+ patients per week and have been consistently booked for 3+ months. This is when you need leverage.
9. Hire Your First Psychiatric NP or PA
The math: 1 psychiatrist + 1 NP = 1.9x capacity (not 2x management overhead).
David, the Chicago psychiatrist, reflected on this after 15 years of solo practice: "All the smart people I know have practices with people they supervise. I started doing TMS at 58."
When to hire:
- You're consistently booked 3+ months out
- You're turning away 5+ patients per week
- Your voicemail says "don't leave messages"
Before you hire:
- Document your intake process
- Define level-of-care expectations
- Establish communication protocols
- Set escalation procedures
During onboarding:
- Plan for 3 months of close supervision
- Block dedicated time for weekly case review
- Start them with lower-acuity patients
- Gradually increase complexity as they demonstrate competence
The biggest mistake is hiring when you're desperate and hoping they'll figure it out. Create systems first, then hire into them.
Coming soon: Hiring and Retention Guide for Interventional Practices.
10. Build a Collaborative Care Model
Hiring a therapist or case manager is cheaper than hiring another prescriber and provides better patient care than therapy-only referrals.
Matt, a psychiatrist working in residential treatment in Los Angeles, described how this worked at Stanford's STEP-BD program. Non-medical providers saw patients 2-3 times per week for measurement-based care. They administered the Beck Depression Inventory, Young Mania Scale, and other assessments. They provided empirically supported therapy like Family-Focused Therapy.
The psychiatrist reviewed notes, adjusted medications, and held occasional team meetings. Two or three psychiatrists could be effectively supported by these non-medical providers.
How this works in private practice:
- Hire a therapist/case manager before you're ready for a full NP
- They see patients 2x/week for measurement-based care and therapy
- You see patients less frequently for medication management
- They handle routine monitoring; you handle prescribing and complex cases
- Total cost: $40K-60K annual salary vs. $80K-120K for an NP
This model works especially well for practices focused on interventional treatments where patients need ongoing support between TMS sessions or ketamine treatments.
Understanding Your Market: Regional Variations
Different markets require different strategies:
Frequently Asked Questions
Q: How much does Psychology Today cost and is it worth it?
A: $29.95/month. Most-mentioned directory that actually drives inquiries with 34.81 million monthly visits. Worth it for most practices.
Q: Should I take insurance or stay cash-only?
A: Depends on your market. Undersaturated markets: cash-only can work. Oversaturated markets: insurance credentialing may be necessary to expand addressable market. Test and adjust.
Q: How do I get hospitals to refer to me?
A: Call discharge coordinators monthly. Use this script: "I'm around the corner from you and have availability within 2 weeks." Persistence matters—they won't find you otherwise.
Q: What's the fastest way to get new patients?
A: Google Business Profile (free, 30 minutes) + Psychology Today ($29.95/month, 1 hour setup). These are table stakes that work immediately.
Q: Should I invest in paid ads (Google/Meta)?
A: Only after you've maxed out free/low-cost options (Google Business Profile, Psychology Today, hospital calls, college centers). Paid ads work but are expensive. Use 90-95% educational content, 5-10% soft CTA.
Q: How do I reduce no-show rates?
A: Pre-screen for fit using HIPAA-compliant Google Form. High no-shows often indicate poor patient-practice fit, not flaky patients. Also: don't book too far out (urgency fades after 2-3 weeks).
Q: What if I'm in a small town with no hospitals nearby?
A: Focus on: Psychology Today, Google Business Profile, SEO for your specialty, and building relationships with local PCPs and therapists through lunch-and-learns.
Conclusion
The 70% capacity paradox is a systemic problem.
Referral networks prioritize internal pipelines. Insurance panels funnel patients to therapy-only. Patients don't know what treatments exist. Operational inefficiencies eat your time.
But practitioners who are thriving aren't waiting for the system to fix itself. They're:
- Calling hospitals directly every month
- Listing on Psychology Today and Therapy Tribe
- Hiring before they feel "ready"
- Using practice operations partners and tech to reclaim intake time and revenue
- Building referral relationships through lunch-and-learns
Need help scaling your interventional practice? Partner with Osmind. We proactively remove bottlenecks, recouping your time and revenue.
Questions or want to share what's working in your practice? Join 2,400+ clinicians in the Osmind Psychiatry Collective where we host bi-weekly clinical coffee chats.
Connect with forward-thinking peers, advance your practice, and attend expert events. Join the Psychiatry Collective today.
