Dr. Risley discusses his experience finding a psychiatrist and navigating the mental healthcare system from the inside as a patient. He describes founding the Sacramento Medical Oasis with his colleague to offer more accessible and affordable patient-centered care without the barriers imposed by insurance companies. The Oasis provides an alternative for patients who want a different experience than the county system by allowing for a direct relationship between doctors and patients.

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When I went to look for a doctor, here I was on the inside, about as inside as you could get, and I felt the same anxiety. You
end up making a lot of calls. There is a shortage of psychiatrists. It is hard to find someone who is taking new patients. Here I
was on the inside and it was an intimidating, expensive, scary system. Imagine what it must be for someone who has no con-
nections? My co-conspirator, Sonny Cline, and I have similar backgrounds. We are both trained in primary care as well as psy-
chiatry. At the Oasis, we believe strongly that we have something to offer people and people have something to offer us.
That is what it is all about. We have a relationship with the patient, we don’t have a relationship with the insurance companies.
At the Oasis patients are invested in their own care. We try to keep our rates as low as possible, but it is still a significant
amount of money. They are buying it, they are the customer. They have certain rights to expect that people with private
insurance or the county system don’t feel that they have. A consumer will go to the doctor and say “well I really want this,”
and the doctor says, “well, the insurance company isn’t going to pay me for that, so you are not going to get it.” I often say it
is like having an insurance executive there in the room with you when you are getting an exam. We have people who come to
the Oasis with insurance because they like the one on one, people without insurance come here because they don’t have a lot of
options. I have a couple people who have followed me from the County and say it’s worth $79 bucks a month to not have to
deal with the appointment system and not to have to worry about getting a different doctor every time. Some people think I
am really critical of the county system, and actually I am not. I have worked in that system since 1997, and I think it is re-
markable what they do with the resources they have, but there is a huge bureaucratic overhead. We are different from the
county system, but we can never be a substitute. We just provide an alternative for some.
Gail: What do you think the future of psychiatry looks like?
Risley: There will be a lot more accessibility to Mental Health Services and our knowledge of the brain will greatly increase.
We know so much more about the brain than we did 15 or 20 years ago, and it is still nothing. It is a growing field. We used to
say that when people got sick, that they have “fever.” Now we look at fever as a symptom of a larger problem of different
illnesses. So I think the day will come when we look at depression or anxiety or psychosis as symptoms of a broad spectrum of
illnesses instead of taking one treatment modality.
Gail: What brings you the greatest joy in practicing medicine?
Risley: What brings me the greatest joy is seeing people who have resigned themselves to being sick, turn a corner and ex-
perience a sense of empowerment. To see them make a positive change is never just about their medication. It is never just
about getting a therapist, it is never just about finding a resource like the Wellness Center. But it is a combination of using
many opportunities and resources. Then one day they wake up and say, “I am a human being, I am a productive person, and I
can bring joy to others.” They come here and they tell me that. Then I realize that I have been a part of that transforma-
tion. What can you do in life that brings more joy than that?
Dr. Risley is the first graduate of the combined residency program in family medicine and psychiatry at UC Davis. He is
a former assistant clinical professor and physician diplomat at UCD. In addition to practicing psychiatry at TCORE, he
integrates family medicine and psychiatry at Sacramento Medical Oasis, Inc (www.sacmedoasis.com).
Interview conducted by Gail Erlandson, MA.
Gail has a Master of Arts Degree in Pastoral Ministry from the University of San Francisco and a Bachelor of Arts Degree from
the University of Portland in Interdisciplinary Studies. Gail taught at Loretto High School for eleven years and has served on
staff at Loaves and Fishes. Gail is a mentor at the Wellness and Recovery Center North.