Rethinking the First-Visit Prescription
Psychology Today
by Joel L. Young M.D.February 25, 2026
AI-Generated Deep Dive Summary
Behavioral health has long followed an unwritten rule: prescribe medication during the first visit. This practice, driven by patient expectations, system productivity demands, and employer pressures, often leads to rushed decisions rather than thoughtful care. The article challenges this norm, emphasizing that prescribing should not be treated as a checklist item but as a clinical judgment that requires careful consideration.
The current model places immense pressure on clinicians to diagnose and treat within a single session. This approach is akin to expecting a cardiologist to make a diagnosis after just one conversation without any testing—a standard that would never be applied in other medical fields. The reality is that the first visit has become an impossible task, asking providers to gather extensive patient history, assess risk, synthesize symptoms, and decide on treatment—all within 30 to 60 minutes.
The article proposes a different approach: slowing down the process to prioritize assessment, context, and clinician autonomy. By restructuring the initial visit as an opportunity for understanding rather than rushing toward a prescription, clinicians can build trust with patients and gather comprehensive insights. This shift would allow for more precise care, turning
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Originally published on Psychology Today on 2/25/2026