Last revised 10July2021.
If you’re a patient who has seen me in the past three years, and we have a valid address on file for you, you should have received a letter in mid-March about my retirement effective 31January2022. Naturally, it has raised some questions.
Can you refer me to a doctor who is like you?
In a word, no. One reason we created Sacramento Medical Oasis, Inc. was to fill a niche that nobody else was in. I was the first person to graduate from UC Davis’ combined training program in family medicine and psychiatry, and doctors who do both are still pretty rare. In addition, I have over ten years of experience with opioids and chemical dependency. There just isn’t anyone around whom I can recommend with the same kind of training and who is taking private-pay patients for a reasonable fee.
There is no doctor who is going to “take over” caring for all my patients. We exist because we feel that the doctor–patient relationship is special, and we can’t just move in a new doctor-widget to provide the same kind of care you have been getting from me.
But I don’t need someone with all your special training. Is there anyone you can recommend?
Again, probably not. Even if I knew someone who might meet your needs, chances are that they won’t be on your insurance panel. Paying cash for most medical services would cost much, much, much more than what I have been charging. The average salary for a psychiatrist in this region is about three times what I make. Now that health insurance is widely available (it wasn’t when we opened eleven years ago), you really should have insurance and you will probably need to use it.
The other sad truth is that most of the psychiatrists I know (few) and respect (fewer) are older with mature practices, which means they aren’t taking new patients and/or are getting close to retirement themselves anyway.
So what do I do about getting a new doctor?
First, identify what you need. If you are taking pain medications, you’ll probably need a pain management doctor. Very few primary care doctors are willing to prescribe opiates for ongoing pain anymore. If I’m taking care of your primary care needs (managing your blood pressure, diabetes, weight management, and the like) you should definitely find an internist or family doctor to provide that care. In fact, most insurance programs pretty much require that you have an assigned “primary care provider” (PCP) in order to get referred for specialist care. If I’m treating you for mild to moderate depression, many primary care doctors can continue to prescribe antidepressants and you can find a psychotherapist to help with the psychosocial issues (ask Amy for a list of therapists we know). If I’m treating you for schizophrenia, bipolar disorder, post-traumatic stress disorder, anxiety disorders, or other complex psychiatric conditions, you are probably going to need to find a psychiatrist.
Next, get a list of doctors from your insurance company. They should provide one to you quickly; most have downloadable lists on their web sites. Call ones who are convenient to you and see if they’re actually taking patients with your insurance. (For years, several insurance companies listed me as being on their plans, even though I never signed up with them. It pays to check.)
After you get an “in-network primary care provider,” start asking for referrals for your specialty care. I believe that there’s a law that says your insurance company has to get you an appointment with a specialist within 15 business days (four days if the need is urgent). Unfortunately, many plans put pressure on participating PCPs to limit or delay referrals, and the time limit is too often simply ignored, so allow several months to get your referrals in order.
Can I get a copy of my records from you?
Always. Perhaps even better, if you are on any unusual or controlled medications, I can also give you a letter explaining to any new doctors why you’re on those medication and how you have done with them. Just ask, but give me a few weeks’ notice and make your request well before the end of the year. It takes time to do such things properly.
Is Medical Oasis closing?
No. Sacramento Medical Oasis, Inc. will remain open. Patients who see Sonny Cline won’t be affected, and we will likely be bringing in a new physician in the future.
Can I see Sonny Cline once you’re retired?
Maybe. Sonny’s practice is already pretty full. He does not have the training or background to prescribe chronic opiates (pain medications), so don’t even ask. His philosophy on benzodiazepines (Valium, Xanax, Klonopin, and the like) is very different from mine, so he wouldn’t be appropriate for any patients who are on chronic, ongoing benzodiazepines (even if you are currently trying to taper off of them).
Can you refer me to a psychiatrist who takes Medi-Cal?
Medi-Cal gives all the money earmarked for mental health in Sacramento County to the County government. If a private psychiatrist bills Medi-Cal for mental health, Medi-Cal won’t pay them. If you are on Medi-Cal, you either have to pay cash for psychiatric care or go through the County system. Contact the Sacramento County Adult Access Team at 916-875-1055 for more information.
What are you doing after retirement?
Well, first off there’s a tent on an island beach with my name on it. After that, there are some writing projects I was working on that I put on hold for medical school, residency, raising children, and medical practice. I’ll likely pick those up again. I will also likely do some consulting in the areas where privacy, IT, medical practice, opioid use disorder, and patient advocacy intersect. Mostly, though, it’s about having time away from the demands of insurance companies and regulators and employers and pharmacies.