Why shrinkMD
Why choose shrinkMD? The honest case, including who we aren't for.
Every online psychiatry practice says they're different. This is the specific, verifiable list of what shrinkMD does differently, why it matters clinically, and who shouldn't choose us.
Medically reviewed by Shariq Refai, MD, MBA, FAPA, board certified psychiatrist · Last reviewed August 1, 2026 · Editorial policy
First evaluation $295 (nurse practitioner) or $395 (psychiatrist). Optional membership $49/month. Same clinician over time.
The short version
What makes shrinkMD different, in one paragraph
shrinkMD is a small, physician-led online psychiatry practice for adults. Your first visit is a full 45 to 60 minute evaluation with the same clinician you'll see at every follow-up. Prices are published; there's no insurance to bill and no surprise statement. We don't prescribe controlled substances (no stimulants, no benzodiazepines), so we're not the right practice for everyone. For the patients we do fit, this model is the reason people stay in care and get better.
You won't wait months
1. Timely access, in days rather than months
Most patients trying to see a psychiatrist wait weeks or months. HRSA reports that a majority of U.S. counties have inadequate psychiatric coverage. shrinkMD is built to see new patients quickly in the states we serve, without insurance credentialing delays or panel gatekeeping. If your state is active, you can typically be seen within days once intake opens.
You won't repeat your story
2. The same clinician, every visit
Large telehealth platforms rotate patients across a panel of prescribers. That's efficient for the platform and worse for you, because the person seeing you today isn't the one who wrote the initial plan. At shrinkMD, the clinician who evaluated you is the clinician who follows up with you, appointment after appointment. That continuity is what makes real psychiatric treatment possible.
Your first visit isn't a med check
3. A 45 to 60 minute first evaluation
Accurate psychiatric diagnosis takes time. Your first visit at shrinkMD is a full 45 to 60 minute video visit that includes current symptoms, past treatments, medical context, family history, sleep, substances, and what daily life actually looks like. That's roughly 3 to 4 times the length of a typical rushed intake, and it's what allows a clinician to make an accurate diagnosis instead of a reflex prescription.
You'll know the price before you book
4. Published pricing, no surprise bills
Every price is on the site before you commit. Initial evaluation: $295 (nurse practitioner) or $395 (psychiatrist). Follow-ups: $110 to $215 depending on member status and clinician type. Optional Serenity Squad membership: $49 per month, first month free, cancel anytime. HSA and FSA funds work. Superbills are available on request for possible out-of-network reimbursement. No copay-then-surprise-statement months later.
See the full pricing breakdown, worked reimbursement examples, and membership details.
We don't play insurance games
5. No insurance billing, on purpose
Billing insurance forces short visits at high volume, prior authorizations that delay medication changes by weeks, and diagnostic codes that follow you into insurer databases used for life-insurance underwriting. shrinkMD is cash-pay so the visit length, the medication decision, and your privacy are shaped by clinical judgment rather than reimbursement rules. Full explanation on why we don't accept insurance.
Responsible prescribing
6. No controlled substances, no exceptions
We don't prescribe stimulants (Adderall, Vyvanse, Ritalin), benzodiazepines (Xanax, Klonopin, Ativan), or other controlled substances. If you need those medications, we're not the right practice for you and we'll tell you honestly. For patients who don't need controlled substances, this policy also means shrinkMD isn't shaped by the volume of controlled-substance seekers that dominate some online psychiatry platforms. See the full policy.
Physician-led model
7. Founded and directed by a board-certified psychiatrist
shrinkMD was founded and is medically directed by Shariq Refai, MD, MBA, FAPA, a board-certified psychiatrist practicing since 2013, dual board-certified in psychiatry and in sports and performance psychiatry, and a Fellow of the American Psychiatric Association. The practice's clinical standards are set by a physician, not a growth team.
From Dr. Refai
"I built shrinkMD because the way most psychiatric care works isn't working. People with treatable conditions wait months to be seen, get fifteen-minute med checks, and rarely see the same clinician twice. That's a logistics failure, not psychiatry. shrinkMD is the opposite pattern: full evaluations, one clinician who knows you, transparent pricing, and clinical decisions driven by what will help you rather than what a plan will approve. If that's the care you want, we're it. If it isn't, we'll tell you honestly."
Shariq Refai, MD, MBA, FAPA · Board Certified Psychiatrist, Founder of shrinkMD
Who this is for
shrinkMD is probably right for you if
You're 18 or older and physically located in Maine or Nebraska (or an approved state as they open). You want a real evaluation and ongoing medication management for depression, anxiety, bipolar spectrum, OCD, insomnia, PMDD, postpartum depression, or a stable psychotic disorder. You want the same clinician across visits. You're comfortable paying cash for a psychiatric practice that publishes its prices. You don't need controlled substances.
Who this isn't for
shrinkMD is probably NOT right for you if
You're in a psychiatric emergency or active suicidal crisis. Call 988, call 911, or go to the nearest emergency room. You need stimulants for ADHD or ongoing benzodiazepine therapy. You need child or adolescent psychiatric care (we're adults only). You're in a state we haven't opened yet (join the waitlist and we'll reach out when we do). You have strong in-network psychiatric coverage and don't mind the tradeoffs of insurance-based care. You need Medicare, Medicare Advantage, or Medicaid billing (we don't accept government plans, even as private-pay). If any of those describe you, we honestly aren't the right fit, and the care-finder page can point you toward what is.
Real patient reviews
What patients actually say
"Best psychiatrist I've ever had in my 30 years plus of working with psychiatrists. He actually talks with me and listens."
Verified patient
"I trust him more than I've ever trusted any doctor. Easy to talk to and doesn't shove you off. Absolutely the best I've found in all my years of living."
Verified patient
"Prompt, intelligent, and great at what he does. A 15 on a scale of 1 to 10."
Verified patient
Individual experiences. Outcomes vary. Care is personalized to each patient.
The five care options
shrinkMD is one of five paths. Here's the honest menu.
If you're comparing options, this is the full menu. shrinkMD isn't the right answer for everyone.
- 1. Your primary care doctor: for common depression and anxiety, first-line medication management by your PCP is often the fastest and lowest-cost option.
- 2. A therapist: if talk therapy is the fit. Find one through Psychology Today or your insurance panel.
- 3. An in-network psychiatrist: if you have psychiatric coverage and don't mind waits or in-person visits.
- 4. shrinkMD: cash-pay telepsychiatry in Maine and Nebraska. Best for continuity, transparent pricing, non-controlled care, and 45-60 minute first evaluations.
- 5. Crisis? Call or text 988: shrinkMD is scheduled outpatient care, not emergency care. Emergencies route to 988 or the nearest ED.
Founder disclosure: Dr. Shariq Refai founded shrinkMD and The Shrink Network. We show the full care-routing menu on every page suggesting clinical evaluation because you deserve to know your options, not because we're required to.
“I could not ask for a better psychiatrist. He genuinely cares about my well being and mental health.”
Individual experiences. Outcomes vary. Care is personalized to each patient.
Frequently asked questions
Good questions, clear answers
Why should I choose shrinkMD over Talkiatry, Cerebral, or Brightside?
shrinkMD is smaller and physician-led. First visit is 45 to 60 minutes, you see the same clinician every time, prices are published, and we don't prescribe controlled substances. Larger platforms have national scale and insurance networks that shrinkMD doesn't. See our full side-by-side comparisons: Talkiatry, Cerebral, Brightside.
Is shrinkMD worth the cash-pay price?
It depends on what you're comparing to. If you have strong in-network psychiatric coverage and don't mind rotating clinicians and short visits, in-network psychiatry usually costs less out of pocket. If you have a high-deductible plan, or if in-network options in your state have months-long waits, cash-pay at shrinkMD often works out similar or better. See our reimbursement estimator for worked examples.
Are shrinkMD's clinicians actually board certified?
Yes. Dr. Refai is a Board Certified Psychiatrist (ABPN), verifiable in the ABPN diplomate directory. All shrinkMD clinicians are licensed in the state where they see the patient. Credentials are listed on Dr. Refai's bio and the team page.
What if shrinkMD isn't the right fit for me?
We say so honestly and point you elsewhere. The five-option care-routing menu at the bottom of this page is the honest menu. If you need controlled substances, we route you to a practice that manages them. If you're in crisis, we route you to 988. If you need in-network care, we route you to your plan's directory or Psychology Today.
How do I get started?
shrinkMD is opening in Maine and Nebraska first. Join the waitlist and we'll reach out the day intake opens in your state. Other approved states (Florida, Georgia, Texas, California, New York, Virginia, Indiana, Hawaii) open as clinicians are licensed.
Ready to be seen by a psychiatrist who has time for you?
Join the Maine or Nebraska waitlist. We'll reach out the day intake opens in your state. First evaluation $295 (NP) or $395 (psychiatrist). Same clinician over time. No controlled substances.
Get StartedAlready know your state is active? Skip to the waitlist.