For therapists and counselors
A prescriber you can recommend without handing your patient to a platform.
Every patient who comes through this page sees the same person: Karel Winner, DNP, PMHNP-BC, at the first visit and at every visit after it. There is no marketplace behind this site and no rotating panel. Dr. Winner has worked in medicine for two decades and holds degrees in several medical fields. The first evaluation lasts a full hour, and follow-up visits last half an hour. A therapist can read his record here, and a patient can book from here, with nothing in between.
PsychMed Partner is a Solutions Psychiatry site written for therapists. It describes the prescriber and explains how patients reach him. It is not a referral program, and there is nothing to join or sign. The site for patients is PsychMed Care. Practice details, locations, and insurance are on Solutions Psychiatry.
The record, at a glance
Two decades in medicine
A career that began in podiatric medicine and diagnostic imaging, continued through acute inpatient psychiatry, and arrived at advanced psychiatric prescribing.
Six degrees
An honours degree from the University of London, nursing degrees from Alverno College, two Vanderbilt degrees including the clinical doctorate, and a psychiatric nursing master's degree from the University of Tennessee.
Seven years in a Level I trauma center
Registered sonographer and vascular technologist at California's largest county hospital, where he also taught sonography.
One prescriber, no panel
Every patient sees Dr. Winner himself, at the first visit and at every visit after it. There is no rotation and no substitute.
The prescriber
Training that spans medicine, not only psychiatry
Degrees in several medical fields
Dr. Winner's education began in podiatric medicine in England, where he earned an honours degree from the University of London. He went on to train in diagnostic medical sonography, to earn nursing degrees at Alverno College, to complete a Master of Science in Psychiatry and Mental Health Nursing Practice at the University of Tennessee, and to earn a clinical doctorate at Vanderbilt University.
Twenty years in medicine
Before this practice, he spent seven years at California's largest county hospital, a Level I trauma center, working as a registered sonographer and vascular technologist and teaching the sonographers who followed him. He later worked in acute inpatient psychiatry before moving into advanced nursing practice. It still shapes how he prescribes. Laboratory results, sleep, and physical health are part of the psychiatric picture for him, not an afterthought.
Doctoral training and board certification
His clinical doctorate, the DNP, is from Vanderbilt University, which also awarded his Master of Science in Nursing Education. His psychiatric training at the University of Tennessee underlies his board certification as a PMHNP-BC. He founded Solutions Psychiatry. His NPI is 1477238004.
Unhurried, careful prescribing
The intake evaluation lasts a full 60 minutes, and follow-up visits last 30 minutes. Medications are changed one at a time, at doses chosen for a stated reason, supported where the picture calls for it by targeted laboratory work through LabCorp and by GeneSight pharmacogenomic testing. A medication that is not working is reviewed on its merits, not supplemented by default.
For the protective therapist
The questions behind the recommendation, answered directly
Who will actually see my patient?
Dr. Winner himself. This is an independent practice, not a platform, and there is no panel to be assigned from. The prescriber a patient meets at the first visit is the prescriber they see every time.
Will medication be rushed?
No. The first visit is a full-hour evaluation, and no medication is started or changed without a reason. The patient hears the reason. Changes come one at a time, and a regimen that is working is reviewed on its merits rather than disturbed by default.
Will my patient understand the plan?
Yes, and this is a deliberate strength. Dr. Winner holds a graduate degree in nursing education from Vanderbilt and has taught at graduate level. He explains treatment plans in plain language as he makes them: what each medication is for, what would count as it working, and what to watch for. Patients who understand their plan are the ones who stay on it.
Will cost or distance undo it?
Fees are on this page, insurance is checked before the first visit, and visits are by video in 34 states + DC. A recommendation does not fall apart when the patient goes to book.
Prescribing philosophy
How medication decisions are made
A medication decision here starts with the whole picture: the full medication history, what has helped and what has failed, and the physical factors that imitate or aggravate psychiatric symptoms. Where the picture calls for it, that includes targeted laboratory work through LabCorp, covering thyroid function, B12, folate, vitamin D, iron, and metabolic and inflammatory markers, and GeneSight pharmacogenomic testing when a patient's history suggests that standard choices may not behave standardly. Supplements receive the same scrutiny as prescriptions. Where they are part of the picture, they are reviewed for dose and interaction and sourced through Fullscript, not waved through as harmless extras.
Treatment moves one change at a time. Each change has a reason, and the patient hears it. Medication choices are made with the patient, not handed down. He explains the options, the likely benefits, and the trade-offs, and the patient has a real say in what is prescribed. If a medication is not working, it gets a structured review. If it is not helping, it is reduced or stopped. He starts medication carefully, reviews it honestly at each visit, and stops what is not working. That approach comes from the rest of his career, and it is the approach on every case.
Value and access
Known costs, wide reach
The service on offer is medication management only, and its costs are stated before anyone books. Self-pay fees are $350 for the 60-minute intake evaluation and $250 for each 30-minute follow-up visit. Most insured patients pay a copay instead, typically $0 to $40 per visit, and the practice verifies the exact amount before the first visit. Therapy remains with the patient's own therapist throughout.
The patients who use this service are usually starting medication for the first time, dissatisfied with a regimen that has stalled, or looking for a new prescriber after a move or a retirement. A patient who would rather receive therapy and medication from a single clinician can find combined care at the full practice at psych.us.
Meet the prescriber or read the FAQ for the details behind this page.
Practice details
Locations, states, and insurance
Locations
Solutions Psychiatry has offices at 220 Montgomery St, Suite 600, San Francisco, CA 94104; 276 Fifth Ave, Suite 605, New York, NY 10001; and 5900 Balcones Drive, Suite 100, Austin, TX 78731. The offices are not walk-in locations. Visits are by video, and in-person visits are arranged in the patient's state when federal or DEA rules require one.
States
Medication management is offered by telehealth in 34 states + DC. Medicare patients are seen in Arizona, California, Colorado, Texas, and Utah. Medicaid patients are seen in Oregon and Wyoming.
Insurance
The practice works with Aetna, Cigna and Evernorth, UnitedHealthcare and Optum, Blue Cross Blue Shield plans, Oscar, Oxford, Carelon, and Providence, among others. Coverage is verified before the first visit, so a patient knows the cost before the intake.