Why Your Psychiatry Practice Isn't Full (And What's Actually Working in 2025 and 2026)

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You hit 70% capacity and stay there. Wait times in your market are 3-6 months. Something doesn't add up.

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We asked psychiatrists and PMHNPs across the country what's blocking their schedules. The bottleneck isn't demandl; it's how referrals flow, how you're positioned online, and whether you've built systems to handle growth.

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Quick Reference: Your Action Plan

This Week:

☐ Set up Google Business Profile (30 minutes, free)

☐ List on Psychology Today ($29.95/month)

☐ Call 3 hospital discharge coordinators

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This Month:

☐ Contact local college health centers to update availability

☐ Schedule 2 lunch-and-learn presentations at referring practices

☐ Audit your pre-screening process for no-shows

☐ Review your website SEO for interventional treatments

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This Quarter:

☐ Start hiring process if you're consistently turning away 5+ patients/week

☐ Explore AI intake tools or measurement-based care automation

☐ Build content library around your specialty treatments

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11 Patient Acquisition Strategies (Ranked by Impact vs. Effort)

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Strategy 1: Set Up Google Business Profile

Time: 30 minutes | Cost: Free | mpact: High

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Why this matters: When patients Google "psychiatrist near me" or your practice name, your Google Business Profile is what appears first.

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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)

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What success looks like: Patients find you through Google Maps searches without ever visiting your website.

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Strategy 2: List on Psychology Today

Time: 1 hour | Cost: $29.95/month | Impact: High

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Why this matters: Most-mentioned directory that actually drives patient inquiries with 34.81 million monthly visits.

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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

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What success looks like: Multiple practitioners reported this as their #1 source of new patient inquiries.

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Strategy 3: Call Hospital Discharge Coordinators Monthly

Time: 2 hours/month | Cost: Free | Impact: High

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Why this matters: Hospitals prioritize internal referrals even with 6-month waits while you have 2-week availability.

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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

- You're not being pushy—you're solving their problem

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What success looks like: Mary (Virginia PMHNP): "I call the local hospital regularly to remind them I have availability within a 2-week window."

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💡 Quick Win Combo: Start Here if You're Overwhelmed

If you only have time for 3 things this week, do these:

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1. Google Business Profile (30 min, free)

2. Psychology Today ($29.95/month, 1 hour)

3. Call 3 hospitals (2 hours)

Do these three. Everything else can wait.

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Strategy 4: Contact College Health Centers

Time: 1 hour setup, 10 min/month maintenance | Cost: Free | Impact: Medium-High

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Why this matters: Universities near you have built-in referral systems you can tap into.

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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)

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What success looks like: Mary: "James Madison University sends me a monthly prompt to update my availability. That's where my college student referrals come from."

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Strategy 5: Optimize SEO for Interventional Treatments

Time: 4-8 hours initial, 2 hours/month ongoing | Cost: Free-$500/month | Impact: Medium-High

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Why this matters: Patients actively search for TMS, ketamine, Spravato but many don't know these treatments exist legally in the US.

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How to do it:

• Create blog content around specific searches:
  • "TMS for depression in [your city]"
  • "Ketamine therapy vs. traditional antidepressants"
  • "What to expect during Spravato treatment"
• Use 90-95% educational value, 5-10% soft call-to-action
• Answer questions patients are searching for
• Update your website with treatment-specific pages

Darcy (Arizona): "Particularly for ketamine and TMS—people are actively searching. Many don't realize ketamine is available legally in the US."

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Strategy 6: Schedule Lunch-and-Learn Presentations

Time: 2-3 hours per presentation | Cost: $50-200 for lunch | Impact: Medium-High

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Why this matters: Referral sources need to trust you before they send patients—face-to-face builds that faster than any directory.

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How to do it:

• Target referring practices: PCPs, therapists, hospital social workers
• Offer to present on TMS, ketamine, Spravato, or your treatment approach
• Bring lunch for their team (catering budget: $10-15/person)
• Focus on: what treatments you offer, who's a good fit, how to refer
• Leave business cards and referral information

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Multiple practitioners in the Psychiatry Collective mentioned this as top strategy for building direct referral relationships.

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Strategy 7: List on Therapy Tribe

Time: 2-3 hours | Cost: $299 website build + monthly listing | Impact: Medium

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Why this matters: Quality website builder plus directory listing drives patient inquiries.

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How to do it:

• Go to therapytribe.com
• Purchase website build package ($299 one-time)
• Complete your provider profile
• Maintain monthly listing presence
• Update when services or availability change

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Multiple practitioners mentioned this as providing strong ROI for both website and listings.

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Strategy 8: Create Pre-Screening System

Time: 2 hours setup | Cost: Free | Impact: Medium

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Why this matters: High no-show rates often stem from poor patient-practice fit, not patient flakiness.

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How to do it:

• Create HIPAA-compliant Google Form on your website
• Ask questions that filter for fit:
  • Insurance accepted?
  • Treatment modalities interested in?
  • Willingness to commit to treatment course?
  • Availability for appointments?
• Use responses to pre-screen before offering appointments
• Set expectations upfront about cancellation policy

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What success looks like: Reduces no-show rates by ensuring patients understand what you offer and what's expected.

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Strategy 9: Hire Your First Psychiatric NP/PA

Time: 40+ hours over 3 months | Cost: $80K-120K annual salary | Impact: High (but only when ready)

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Why this matters: 1 psychiatrist + 1 NP = 1.9x capacity (not 2x management overhead).

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How to do it:

• Start when you're consistently turning away 5+ patients/week for 3+ months
• Block time for thorough interview process
• Create systems before hiring:
  • Document your intake process
  • Define level of care expectations
  • Establish communication protocols
  • Set escalation procedures
• Plan for 3 months of close supervision during onboarding

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(Chicago psychiatrist, overfull 15 years): "All the smart people I know have practices with people they supervise. I started doing TMS at 58. Why the hell not?"

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Strategy 10: Implement AI Intake Automation

Time: 2-4 hours setup | Cost: $200-500/year | Impact: Medium (efficiency multiplier)

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Why this matters: Traditional intakes = 30 minutes of data collection before actual conversation.

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How to do it:

• Explore tools like Async Health for AI-powered intake interviews
• Alternative: Use measurement-based care tools in your psychiatry EHR
• Have patients complete PHQ-9, GAD-7, assessments before appointment
• Review results ahead of time to front-load clinical thinking
• DIY option: Manual copy of MBC results → AI analysis (ChatGPT/Claude)

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David, Psychiatrist: "If I could improve my efficiency without losing my mind holding all these stories in my head, I could probably see more patients."
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Strategy 11: Build Collaborative Care Model

Time: Ongoing | Cost: $40K-60K annual salary for therapist/case manager | Impact: Medium-High (for scaling)

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Why this matters: Cheaper than hiring another prescriber, provides better patient care than therapy-only referrals.

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How to do it:

• Hire therapist/case manager before you're ready for full NP
• They see patients 2x/week for measurement-based care
• Administer Beck Depression Inventory, Young Mania Scale, assessments
• Provide empirically supported therapy (Family-Focused Therapy, etc.)
• You review notes, adjust medications, hold occasional team meetings

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Matt (psychiatrist in residential treatment, LA): Describes Stanford STEP-BD model where non-medical providers supported 2-3 psychiatrists effectively.

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Understanding Your Market: Regional Variations

Different markets require different strategies:

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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.
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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.
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Q: When should I hire my first NP?

A: When you've been consistently booked 3+ months, turning away 5+ patients/week, and your voicemail says "don't leave messages." The math: 1 psychiatrist + 1 NP = 1.9x capacity.

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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.

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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.

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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.

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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).

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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.

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The 70% capacity paradox is a system problem.

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Referral networks prioritize internal pipelines. Insurance panels funnel patients to therapy-only. Patients don't know what treatments exist. Operational inefficiencies eat your time.

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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 AI tools to reclaim intake time
• Building referral relationships through lunch-and-learns

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Start with one strategy. Implement it. Move to the next.

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Need help scaling your interventional practice? Partner with Osmind. We proactively remove bottlenecks, recouping your time and revenue.

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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.