What happens when a psychiatrist gets tired of a broken system | ft. Vera Prisacari

What we covered

• Vera's path from an immigrant family in Moldova to a board-certified adult psychiatry practice in Minneapolis
• The friend's near-exit from medicine that pushed Vera to leave the traditional insurance system behind
• How she built ADHD Alliance of Minnesota as a flat-fee, private-pay practice — and what that actually costs a new patient
• Common misconceptions about adult ADHD, including why symptoms can go undiagnosed until college or perimenopause
• Her stance on AI as a daily-use tool, and the emerging research on AI reinforcing paranoid thinking in vulnerable patients
• Why the biggest challenge in her first five months has been visibility, not clinical demand

Moments worth your time

"Is it going to be me in two years?" Vera describes watching a friend, only a couple of years ahead of her in psychiatry, nearly leave the field entirely because the system wouldn't let her practice at the standard she believed in. It's the moment that pushed Vera toward private practice.

The pricing, stated plainly. No hidden fees, no insurance maze: "here's $500 for a new appointment, 200 for monthly follow-up. That's all it is."

Getting found by AI, not just Google. Five months into practice, Vera's patients are increasingly arriving through a channel she didn't build for: "Patients are telling me they found me through AI bots... they ask, who's the best psychiatrist dealing with ADHD in Minnesota, and I'll come up with a list."

The guardrail she watches for. Vera flags real concern about how AI chatbots can validate paranoid thinking in vulnerable patients rather than challenge it — a risk she thinks about even though she doesn't treat psychosis directly.

In their words

"I saw so many things wrong with it, so many things not working, and so many times I tried to speak up and improve the process and my feedback was not making a difference."

"I'm rewriting the rules. I'm saying, look, let's simplify it. I'm a physician. I know what I'm doing. I have all the credentials. Just come talk to me."

"If you are not getting that quality care from whoever your provider is now, ask for a second opinion. Advocate for yourself."

Who should watch this

If you're a new or newly independent practitioner who's confident in the clinical work but stuck on how patients actually find you, Vera's experience is directly relevant — she's living the exact problem in real time. If you've ever wondered whether AI search and chat tools are actually sending patients to real practices, her answer is a firsthand data point, not a theory.

Put it to work

Vera's patients are finding her by asking AI assistants "who's the best [specialty] in [city]." Spend ten minutes this week: open ChatGPT, Claude, or whatever assistant you use and actually ask that question about your own specialty and city. See what comes back. If your practice isn't in the answer, that's a concrete, fifteen-minute-diagnosable gap — not a vague marketing problem.

Getting found this way isn't luck — it's a system, the same way Vera's flat-fee model and intake process are systems she built on purpose. If you want a clear map of what's standing between your practice and that kind of visibility, book a Practice Growth Map.