Practice Stories
Psychiatrist · founder, ADHD Alliance of Minnesota
A Minneapolis psychiatrist who left the insurance grind to build a flat-fee ADHD practice — and is now getting found by patients through the very AI tools she once wondered about.
Dr. Vera Prisacari's family immigrated to the United States from Moldova when she was ten. "Most people think it's not even real till you look it up," she says of her home country. "It's so small." The move brought a mindset that stayed with her long after the uncertainty of those first years passed: "that scarcity mindset of, am I going to make it to the next day or next year, am I going to have enough food on the table."
There was no grand plan. She majored in biology and nutritional science at Iowa State, changed her major more than once, studied abroad, and kept getting the same feedback from mentors: you're good at this, you should consider medical school. She didn't feel ready to believe it. "I had that imposter syndrome," she says. "But I applied anyway." What followed was less a vision than a sequence: get into med school, pass the boards, get through residency. "It was never like a whole vision of this is where I'm going to end up," she says. "It was always just, let's just focus on the goal in front of us."
The turn came from watching the system up close — and watching it nearly break someone she admired. Vera describes speaking up inside a traditional practice setting and hitting a wall: "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." The insurance reimbursement rules, the productivity metrics, the barriers between a patient and basic care — she watched them wear down a friend of hers, a psychiatrist only a couple of years ahead of her in the field. "I cannot provide this subpar care," her friend told her. "I cannot compromise on my values." She was talking about leaving medicine entirely. "All of that training, education... just leaving medicine," Vera says. "Just really sad." It forced a question Vera couldn't put down: "Is it going to be me in two years? Am I going to quit? And I don't want that."
So she built something different. In January 2026, Vera opened her own practice, ADHD Alliance of Minnesota — private pay, no insurance, no referral maze. "People are so used to having to think that healthcare has to be complicated," she says. "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." The pricing is stated plainly, no fine print: "here's $500 for a new appointment, 200 for monthly follow-up. That's all it is. There's no hidden costs." And there's no gatekeeper between her and the person who needs her. "Not an assistant, not a call center, not another triage," she says. "I'm the real person there."
Her focus is adults with ADHD — a population she says gets systematically underestimated. The condition doesn't disappear after childhood, she explains; it often gets masked by structure, a watchful parent, a rigid routine, until that scaffolding disappears and the symptoms surface for the first time in college, or in perimenopause, when hormonal shifts can unmask ADHD in women who spent decades quietly compensating. "They maybe were compensating with using external structure," she says. "They were writing things down in planners... and it's not until menopause that... they're like, actually, I think I've had this all along."
Five months into private practice, Vera is candid about what's actually hard: not the clinical work, but visibility. "The biggest hurdle right now is getting my name out there," she says, "because people don't expect for a new person to show up." Old habits point patients toward whatever's familiar — the primary care referral, the in-network name — even when it isn't serving them. She's watching that habit shift in real time, and the channel surprises even her. "A lot of patients are telling me they found me through AI bots," she says. "They ask, who's the best psychiatrist dealing with ADHD in Minnesota, and I'll come up with a list, and they're like, okay, let me reach out to them."
She's unambiguous about where she stands on the technology itself. "I'm definitely pro," she says. "AI is here to stay. It's not a question of if it's going to be around. It's how do we use it as a tool that's valuable." She sees it the way she saw Photoshop as a teenager — something the human brain eventually learns to read critically, spotting the tells, adjusting its trust accordingly.
Vera doesn't pretend the technology is without risk. She points to emerging research on AI chatbots reinforcing paranoid or delusional thinking in vulnerable patients — a population she doesn't treat directly, but one she reads about with real concern. "An AI bot is going to be validating," she says, describing how a chatbot might respond to someone spiraling into paranoia, "and it's going to say, well, here's, you know, maybe you should close your windows, close your blinds." She isn't sure yet where the guardrails need to sit, only that they matter. What she is sure of is simpler, and it's the message she leaves people with: "If you are not getting that quality care from whoever your provider is now, ask for a second opinion. Advocate for yourself." The right fit, she says, is what actually determines whether someone gets better — "make sure that you can trust them, that you can relate to them, that you like them. That's who has the best outcomes."
Hear the rest of how she's building it, in her own words, in the full conversation.