Ensuring Patient Education and Access to Care With Hybrid Treatment Models

In this video, Steven Krozer, PMHNP-BC, MSN, BSN, APRN, discusses how clinicians can effectively establish strong therapeutic relationships and offer patients the highest quality of care when using hybrid models of treatment. Featured as a New & Emerging Voice at Psych Congress Elevate 2025, Krozer offers practical strategies to ensure collaborative decision-making and patient education in both virtual and in-person settings, and highlights some of the key benefits of adopting a hybrid care approach. 

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Read the Transcript

Steven Krozer, PMHNP-BC, MSN, BSN, APRN: Hey, good morning, my name is Steven Krozer and I'm a psychiatric nurse practitioner from Greenville, South Carolina. I'm a CEO and founder of an outpatient mental health practice called iTrust Wellness and have a background in different types of practice as well. I've worked inpatient at a residential facility, I've worked outpatient at a state facility for mental health, and currently I'm also pursuing a technology company where we're developing clinical tools that are going to equip and power providers to practice mental health at the highest degree. Join me today and learn a little bit more about what we have to share.

Psych Congress Network: In your experience, how can providers explain psychiatric medication strategies—especially for complex conditions like bipolar disorder, schizophrenia, or depression—in ways that foster trust, adherence, and informed decision-making? 

Krozer: At our practice, we actually have posters on the wall, and this is for our inpatient appointments. Of course, nowadays, I'd say about 75 to 80% of our follow-up visits are virtual in nature. So, what we've done is created a PDF handout that we screenshare to share with our patients that are virtually connecting with us for the appointments. We've created a neurotransmitter poster that shows, “Here's what serotonin looks like, here's what norepinephrine looks like, here's what dopamine looks like,” and so on. We basically point to those different neurotransmitters that the medications are impacting as we have that discussion with the patient. What I’ve found is more visual content leads to more therapeutic conversation and really from there enhances the clinical trust that I have with the person. 

I think the old style and maybe an older model of practicing psychiatry was [the clinician thinking,] “I am educated. I know what I'm talking about. Let me share my experience and make a decision for you.” But I think where practice is moving nowadays, our patients are more informed than ever—they can go on Google prior to the sessions and look at different types of medications that they might like to participate with. I think you really want to have a collaborative care model when we're making a decision, and that collaborative care model, usually using visuals like the neurotransmitter poster that I have shared, really allows us to have a better and more in-depth conversation and really fosters that trust. 

Other tools that we have at our disposal such as genetic testing provide an objective measurement, an objective analysis. Going into a very cerebral conversation, the more hardline data that we have to share with the patient, that this is how we're making our informed clinical decision, I think that strengthens the therapeutic trust between the provider and the patient.

PCN: What are some of the potential benefits vs barriers to care in hybrid models of treatment?  

Krozer: I think nowadays most of our follow-ups are going to be naturally gravitating towards virtual, especially if the patient is getting better over time. What we try to do as a practice is within the first 30 days of establishing care, we usually invite patients to come in for an in-person appointment. What we like to do is get a baseline weight, vital signs, urine drug screen. We really like to make sure we establish that in-person relationship within the first 30 days of treatment. Then our standard for care in our practice is 1 in-person visit over the course of the annual calendar year, so we can still maintain that therapeutic relationship with the in-office presence of that patient. 

Now, of course, some patients choose to come in every single time in person, and this is oftentimes patients that maybe are not as technologically savvy, maybe they're older, maybe they just really want to sit across a desk from one of our providers and just have a humanistic conversation because I think mental health is one of those specialties that sometimes that in-person visit is still so necessary and it's just so helpful for establishing that care. 

But over time what we realize is that patients really opt for the convenience of the virtual visit. So instead of taking that 2-hour window off of work and driving all the way to the office and coming to meet with one of our providers, the patients are opting to take a lunch break and take a 15-minute or a 30-minute break out of their day. They don't have to take any time off work. They don't have to worry about telling their boss or their manager why they're doing that. So this telehealth option has been really instrumental for increasing access to care, especially for those patients that are farther away from practice. I'd say the farthest we've had somebody come and drive to see one of our providers has been upwards of 3 hours. Where we live in South Carolina, we are located in a metropolitan area in Greenville, but there are very rural counties and towns that are just outside of that Greenville Metropolitan area, like I said, sometimes 2 hours or 3 hours away from where our providers are located. So telehealth gives this great opportunity of access, gives this great opportunity of convenience, and from our clinical experience, we don't see any degradation in terms of clinical quality.

Thank you everybody for listening in today. I think psychiatry is going to be a really cool industry to follow over these next coming years between all of the research that's going on with psychedelics and all of the technology that's coming into the space. I'm excited to join the Psych Congress Elevate this year as a New & Emerging Voice, but also to just represent the future of where we're going to bring mental health as we start to conceptualize it in a modern world. So thank you for listening, thank you for all you do for your patients, and we look forward to continue to bring you some great educational content.

Steven Krozer, PMHNP-BC, MSN, BSN, APRN, is the founder and CEO of iTrust Wellness, a leading outpatient mental health clinic based in Greenville, South Carolina. A board-certified Psychiatric-Mental Health Nurse Practitioner, Krozer specializes in psychiatric medication management across a broad range of conditions, including depression, anxiety, ADHD, bipolar disorder, and PTSD. He earned his Master of Science in Nursing from Vanderbilt University and has built his clinical practice around evidence-based, measurement-driven care.

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