Why Am I Seeing Two Different Doctors for Medication and Therapy?

Many people in mental health treatment end up with two separate providers: a psychiatrist or nurse practitioner who handles the medication, and a therapist who handles the talk therapy. The two often do not communicate, appointments are scheduled separately, and the patient becomes the link between them, relaying what one said to the other. This is the standard model, but it is not the only one, and for many people it is not the best one. A psychiatrist is trained to provide both medication and therapy, and some do. When one provider handles both, the two sides of treatment inform each other and the coordination burden disappears. At Empathy Therapy, Dr. Mark Chofla provides both, so patients see one board-certified psychiatrist for the full picture rather than splitting their care across two offices.

Empathy Therapy is a telehealth psychiatry and psychotherapy practice built around empathic therapy, where genuine connection, careful listening, and integrated care are the foundation of every patient relationship. Dr. Mark Chofla, DO, is a board-certified psychiatrist who completed his undergraduate education at the University of California, Davis, his medical training at Midwestern University College of Osteopathic Medicine in Arizona, and his psychiatry residency and internship at the University of Southern California (USC). He has also served as a Professor of Psychiatry at the University of California, Davis Medical Center and School of Medicine. Dr. Chofla provides psychiatric medication management and formal psychotherapy for adults, adolescents, and children, and executive life coaching for adults, across California, Oregon, Washington, Arizona, Alaska, New York, and Florida via telehealth. New patient intakes are 75 minutes. Follow-up appointments are 45 minutes. New patients are typically seen within days, not weeks. Evening appointments are available for patients in New York and Florida.

Why the Two-Provider Model Became Standard

The split between medication and therapy is not based on what works best clinically. It grew out of how insurance reimburses psychiatric care.

Over the past several decades, insurance paid relatively more for brief medication appointments than for the longer sessions therapy requires. A psychiatrist could see several patients for medication checks in the time one therapy session takes, and be paid more for doing so. The economically rational structure became psychiatrists handling medication in short visits while therapy was referred to lower-cost providers.

The result is the model most patients know: one provider for the prescription, another for the talk therapy. It is so widespread that many people do not realize a single psychiatrist providing both is even an option. It is, and every board-certified psychiatrist is trained to do it.

What the Split Costs a Patient

The two-provider model works acceptably for some people. For others, it introduces problems that are easy to miss until you experience the alternative.

The coordination gap is the main one. The prescriber does not automatically know what surfaces in therapy, and the therapist does not know what the medication is doing. Unless the two providers actively communicate, and often they do not, no one holds the whole picture. The patient carries the information between them.

Decisions get made with partial information. A medication is adjusted without knowledge of what the therapeutic work is revealing. The therapy proceeds without knowing how the medication is affecting mood, sleep, and energy. Each provider optimizes their piece without seeing the other.

The patient repeats themselves. A difficult history gets told twice, to two people. Progress in one setting has to be summarized to the other. The work of connecting the two falls on the person least equipped to do it, the one seeking care.

One patient described the difference one provider made on Healthgrades:

"I have had a hard time finding a psychiatrist. Dr. Chofla challenges me when it is needed, but it always feels respectful and grounded in a real understanding of what I am going through." — Patient on Healthgrades

What Changes When One Provider Does Both

When the same provider handles medication and therapy, the structure of care changes.

There is no coordination gap, because there is no second provider to coordinate with. What surfaces in therapy directly informs the medication decisions. What the medication is doing directly informs the therapeutic work. The provider sees the full arc rather than one slice of it.

The relationship is continuous. The same person knows the history, the patterns, and what has been tried, at every appointment. Nothing has to be reconstructed or relayed.

Treatment is coordinated by design rather than by effort. For conditions where medication and therapy work best together, and there are many, having one provider deliver both is not just more convenient. It is more effective.

At Empathy Therapy, Dr. Chofla provides both. The 75-minute intake allows a complete evaluation. Follow-up appointments are 45 minutes, long enough for genuine therapeutic work rather than a brief medication check.

One patient described that on WebMD:

"I've been seeing Dr. Mark Chofla for a few months now, and I've been impressed with his ability to listen and provide thoughtful feedback. He has a calm, professional demeanor that immediately puts you at ease. He takes the time to thoroughly understand your concerns before offering solutions. He doesn't rush through appointments, which I really appreciate. While no psychiatrist can work miracles, I've noticed meaningful improvements in my mental health under his care." — Patient on WebMD

When One Provider Makes the Most Difference

For some situations, integrated care matters more than others.

People with more than one condition benefit from a provider who sees how each affects the others, so treatment for one accounts for its effect on the rest.

People whose previous split care did not work well, where the prescriber and therapist never quite aligned, often find that a single provider resolves the friction they were experiencing.

People who find retelling their history exhausting or retraumatizing benefit from telling it once, to one person who holds it going forward.

For patients who need only medication, or only therapy, a psychiatrist who offers both can still provide exactly that, and can adjust without a referral if the need changes.

One patient described the outcome on Vitals:

"Dr. Chofla is one of the best medical professionals I have been to. I have progressed under his care and expect to continue to do so. He sincerely cares about his patients' well-being." — Patient on Vitals

Private Pay, Superbills, and How Costs Work

Empathy Therapy is a private-pay, fee-for-service practice. Insurance is not accepted. The same insurance economics that produced the two-provider split are the constraints a private-pay practice operates outside of, which is what allows one provider to deliver both medication and therapy in appointments long enough to do both well.

Patients receive a detailed superbill after each appointment, which can be submitted to insurance for potential out-of-network reimbursement. Many patients with PPO plans recover a portion of their costs this way. Dr. Chofla's office can provide guidance on that process.

One patient described the value on Vitals:

"This is a place you go to get better. Dr. Chofla was so very helpful. He got me stable. He seems expensive and you get what you pay for here." — Patient on Vitals

Dr. Chofla provides telehealth psychiatry and psychotherapy for patients across California, Oregon, Washington, Arizona, Alaska, New York, and Florida.

The information in this article is intended for educational purposes only and does not constitute medical advice, diagnosis, or treatment. If you are experiencing a mental health emergency, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.

Frequently Asked Questions

Can one psychiatrist handle both my medication and my therapy?

Yes. Psychiatrists are trained to provide both. At Empathy Therapy, Dr. Chofla personally provides medication management and formal psychotherapy, so both are handled within one clinical relationship.

Why do most practices split medication and therapy between two providers?

Largely because of how insurance reimburses psychiatric care, which favored brief medication visits over longer therapy sessions. The split reflects that economic structure, not what works best clinically for every patient.

Is integrated care better than seeing two providers?

For patients who need both medication and therapy, one provider removes the coordination gap and makes treatment decisions with the complete picture. Whether it is right for a given person depends on their situation.

Does Empathy Therapy accept insurance?

No. Empathy Therapy is a private-pay, fee-for-service practice. Patients receive a superbill after each appointment for potential out-of-network reimbursement.

How long are appointments?

New patient intakes are 75 minutes. Follow-up appointments are 45 minutes.

How quickly can I be seen?

New patients are typically seen within days, not weeks.

Which states does Empathy Therapy serve?

Empathy Therapy serves adults, adolescents, and children across California, Oregon, Washington, Arizona, Alaska, New York, and Florida via telehealth.

Are evening appointments available?

Evening appointments are available for patients in New York and Florida. The fully telehealth model means patients across all seven states can schedule without commuting.

How do I get started?

New patient appointments can be booked directly at www.empathytherapy.com. You can also review frequently asked questions at www.empathytherapy.com/faqs or call 888-832-9635 with any questions before booking.