About the practice
About Solutions Psychiatry
Solutions Psychiatry is a telehealth-first psychiatry practice with offices in San Francisco, New York, Austin, Beaverton, Ogden, Alexandria, New Orleans and New Orleans. It is the practice of one clinician, Karel Winner, DNP, PMHNP-BC, and it is deliberately small: every patient works with the same prescriber from the first Comprehensive Initial Appointment onward.
Most psychiatry practices organize themselves around a single building. This one is organized around a single relationship. Visits happen by secure video across 34 states and Washington DC, and the seven offices give the practice a local home in the cities where many of its patients live. Whether you arrive from across town or across the country, the standard of care, the fee schedule, and the person on the screen stay the same.
One practice, two ways in: therapy and medication care at psych.us is the full practice, and medication management only at PsychMed Care is the dedicated prescribing door. Locations, insurance, fees and booking for both live on this site.
Why two doors
Different needs deserve different front doors.
People come to a psychiatry practice with different jobs to get done. Some want psychotherapy, or therapy and medication handled together by one person who holds the whole picture. Others already have a therapist they trust, or want no therapy at all, and need a prescriber who will focus entirely on getting the medication right. Forcing both groups through one identical doorway serves neither of them well.
So the practice keeps two doors and one foundation. Behind both doors you find the same clinician, the same chart standards, the same insurance verification, and the same phone number, (800) 303-3221. If your needs change, moving between doors is a conversation, not a new Comprehensive Initial Appointment with a stranger. Nothing about you gets retold from scratch.
One clinician
Continuity is the model. Your prescriber knows your history, your prior medication trials, and what you said last month, because he was there for all of it.
Time in the visit
Comprehensive Initial Appointments run a full 60 minutes and Follow-up Appointments run 30. Psychiatric decisions made in five minutes tend to be the ones patients pay for later.
Nothing hidden
Fees are published on this site. Insurance is verified before the first visit. Records and messages live in systems built for health care, not in email threads.
The clinician, briefly
The person behind the practice.
Karel Winner, DNP, PMHNP-BC, earned his doctorate at Vanderbilt University and completed his psychiatric training at the University of Tennessee. He brings two decades in medicine to a practice built around careful prescribing, real therapy, and the patience to adjust treatment until it fits the person taking it.
This page is about the practice as an organization. His full story, training, and approach to care live at the full practice site, where he introduces himself properly.
Meet Karel Winner · NPI 1477238004
How we work with you
Practical details, settled up front.
Getting started
Booking and intake forms run through IntakeQ at either door. Practice hours are Monday, Tuesday, Thursday and Friday, 7:00 to 19:00 Central, and Saturday, 7:00 to 13:00 Central; the practice is closed Wednesday and Sunday. Patients reach the office at (800) 303-3221, by fax at (541) 508-4525, or by email at [email protected].
Who this practice serves
Adults and older teens, ages 17 and up, in the 34 states and Washington DC where the practice delivers telehealth care. Medicare patients are welcomed in Arizona, California, Colorado, Texas and Utah, and Medicaid patients in Oregon and Wyoming.
Standards we hold
The unglamorous parts, done properly.
Privacy by design
There is no contact form on any of this practice's websites. Booking, intake paperwork and patient messages run through IntakeQ and Spruce, systems built for health care, and the practice email is a HIPAA-covered Google Workspace account. Your information travels the way medical information should.
One chart, both doors
Whether you start with therapy, medication management, or both, your records live in one place and your clinician sees the whole record. Switching doors never means re-explaining your history to a new provider.
Honest limits
This is an outpatient practice, not an emergency service. The crisis resources linked in the footer of every page are staffed around the clock by people equipped for emergencies, and we will always point you to them first when safety is the question.
Questions before you book?
New patient Comprehensive Initial Appointments run 60 minutes. Follow-up Appointments run 30. Booking happens on IntakeQ, and every plan is verified before the first visit.