Circle Medical Online Therapy Review

As of 2017, 24% of Americans didn’t have a consistent primary care physician (PCP). Given that life expectancy increases 51.5 days for every 10 additional PCPs per 100,000 people, this is a blight on the American healthcare system. The state of mental health care is even worse, with one out of every five adults experiencing a mental illness but less than 50% of them receiving mental health care. These are the problems that Circle Medical is trying to solve.

Circle Medical aims to make quality care ”more accessible than ever” by providing primary telehealth care for a wide variety of conditions, including diabetes, migraines, gender-affirming hormone replacement, and (pertinent to this review) anxiety, depression, and attention deficit hyperactivity disorder (ADHD). Unlike most online therapy and psychiatry companies, Circle Medical can prescribe controlled substances, such as stimulants for ADHD, which makes it stand out in this arena. 

Circle Medical’s potential to provide primary care while also addressing mental health could enable it to enhance access to both kinds of care. However, this is only true if it can adequately address all of the conditions it aims to treat. Using a client interview, a survey of 105 users of Circle Medical, and in-depth research, this review will delve into whether Circle Medical can truly deliver on its promises and whether it is a safe treatment option for anxiety, depression, and ADHD.

What Is Circle Medical?

Circle Medical is a primary care company affiliated with the University of California, San Francisco (UCSF). Brent LaRue, George Favvas, and Jean-Sebastien Boulanger founded Circle Medical in April 2015 to reshape the primary care system. Circle Medical initially tried to provide medical care via temporary clinics at over 100 different companies, but couldn’t financially sustain the practice. Circle Medical partnered with UCSF a year and a half after opening its first permanent clinic in San Francisco. As soon as the COVID-19 pandemic hit and the world went virtual, Circle Medical’s practice exploded, leading it to open an office in Canada in July 2021. 

While Circle Medical does have two in-person offices in San Francisco, it provides most of its medical care virtually. Circle Medical does not specialize in mental health care. Its mental healthcare providers appear to be entirely comprised of general practitioners who also treat mental health conditions. Although general practitioners can prescribe medication for mental health issues, it’s better to seek mental health care from a mental health professional if possible.

“Just like you would go to a cardiologist for heart problems or a gastroenterologist for stomach problems, it’s always best practice to go to a mental health professional for mental health problems,” explains Hannah Owens, LMSW, Verywell Mind's mental health editor. “Any specialist is naturally going to be far more knowledgeable about their specific area of expertise than a general practitioner would be.” That being said, Circle Medical’s services can fill the gap for people who need assistance with mild to moderate anxiety, depression, and ADHD who perhaps cannot otherwise access mental health care.

Despite its rapid growth, Circle Medical doesn’t have a large reputation. It has little impact across its social media accounts. Its largest following, of more than 6,900 people, is on LinkedIn. Given the company’s unique care model and the fact that it offers prescriptions for controlled substances, it wouldn’t be surprising if it started making headlines. But for now, it is a small player in the giant industry of virtual mental health care.

What Services Does Circle Medical Offer?

In addition to its general primary care offerings, Circle Medical provides medication management for anxiety and depression as well as ADHD evaluation and treatment. If you need talk therapy, you can receive it through a partnership with Octave, an online therapy company. 

Intake appointments are a half-hour long. Follow-ups are 20 minutes each. While this may seem short, the former patient I interviewed said, “the initial appointments were long enough to discuss the diagnosis thoroughly.”

Who Is Circle Medical For?

Circle Medical offers medication management for those with anxiety, depression, and/or ADHD. It does not treat anyone under the age of 18. It also does not accept patients who:

• Are taking or seeking benzodiazepines (e.g. Xanax) for “other treatment”
• Have a severe mental health condition (such as bipolar) and/or have required mental health hospitalization in the past
• Have tried three different medications for anxiety and/or depression and couldn’t tolerate the side effects
• Are taking or seeking opioids for “other treatment” 

It is unclear what the company means by “other treatment,” though the website does mention in a different section that those on or seeking a benzodiazepine should learn more about the company and its services before signing up.

How Much Does Circle Medical Cost?

You pay on an appointment-by-appointment basis. An appointment for anxiety or depression costs $100. If you’re seeking treatment for ADHD, the first appointment is $149 and the required second appointment is $100. Each monthly follow-up is $100. You can also message your provider between appointments for free. 

This cost is lower than many other psychiatric services. For example, an initial medication management evaluation plus one follow-up appointment at Talkspace costs $249. Of Circle Medical users we surveyed, 61% said they found the service “affordable” or “very affordable.” While this isn’t exceptionally high, it is above average compared to other companies in our survey. 

This pricing may be out of reach for those struggling to make ends meet, but it is far more accessible than many other medication management services.

Does Circle Medical Take Insurance?

Yes. It accepts a few HMO plans for California residents and the following PPO plans:

• Anthem Blue Cross Blue Shield
• Aetna
• Blue Shield of California
• Cigna
• Health Net
• Humana
• UnitedHealthcare

It does not accept Medicaid and can’t treat patients with Medicaid even if they pay out of pocket. 

Accepting insurance does make the company more accessible than many others because patients with insurance will only have to pay a copay. However, the fact that it doesn’t treat patients on public insurance is discouraging and means that it cannot assist those who may need it the most.

Does Circle Medical Offer Discounts?

Circle Medical does not currently offer any discounts.

Navigating the Circle Medical Website and App

Circle Medical’s website holds no hidden treasures but is easy to use. Most of the key information can be found through a searchable FAQ section and on the pages of each condition it treats. Each condition page features a timeline of the treatment procedure. For example, the ADHD page features a visual near the bottom showing that you need to book your first appointment and then download the app, and only then can you meet with a doctor. It also describes the procedure for controlled substance prescriptions (more on that later). 

That being said, the website doesn’t provide much actual information. There isn’t a blog or any other type of mental health information center. Its social media is sparse. (As of this writing, the YouTube channel has five videos.) Furthermore, while Circle Medical offers talk therapy through a partnership with Octave, it only lists this information on its anxiety/depression page. This is odd because Octave also treats ADHD, and research supports talk therapy as an effective treatment for ADHD.

Circle Medical’s mission is to "create the technology that enables quality, delightful primary care for everyone on the planet.” While this appeared fairly outlandish to me since Circle Medical has yet to provide care for people in all 50 U.S. states, 69% of our surveyed users rated the mission statement as good, very good, or excellent.

Does Circle Medical Have an App?

Yes, and users must download the app in order to access Circle Medical’s services. It is the only way to reach a provider for virtual appointments and communication between sessions, view appointment summaries and lab results, and create your HIPAA-compliant electronic health record. The app is available through the iOS and Android stores.

How Do You Sign Up for Services at Circle Medical?

Signing up for Circle Medical is a streamlined process. You start by choosing which condition you want to be seen for, enter your ZIP code, and then choose an appointment time from a calendar. This is also the point when you choose your provider. 

When I entered my ZIP code, I was presented with four providers. One was a family doctor, another was a geriatrician, and the other two were nurse practitioners. Their bios each spoke about why they were passionate about practicing medicine, their hobbies, and what they think a productive relationship between provider and patient looks like. None of them specialized in mental health. Furthermore, only one of them appeared to be a person of color. 

I also made a frustrating discovery when I experimented and said I was looking for gender-affirming hormone replacement therapy (HRT) instead of mental health treatment. After choosing HRT, the scheduling page appeared and presented me two of my four original provider options. As a transgender person, I want to receive mental health care from someone comfortable working with trans people and familiar with HRT, especially since HRT can impact your mood. The website should have a way to filter out providers who are less familiar with transgender healthcare. 

That said, when I interviewed a former Circle Medical patient, they said that the sign-up process was easy and that ultimately they were happy with their provider, saying, “my provider was a nurse practitioner with eight years of experience. She was very helpful and understanding.”

Considering the providers available, it is important to remember that, while primary care can be a helpful source of mental health care when mental health symptoms are not severe and other mental health-specific options are not available, sometimes a specialist is required.

How Do Mental Healthcare Sessions Work at Circle Medical?

The nature of your first few appointments will depend on whether you’re seeking therapy for anxiety, depression, or ADHD.

Anxiety/Depression Treatment

If you're being treated for anxiety and/or depression, your first appointment will be a video call between 15 and 30 minutes long. During that session, the provider will evaluate whether medication is a good option for you. If so, they will send the prescription to the pharmacy of your choice for you to pick up. The app allows you to book follow-up appointments and reach out to your provider via the chat feature. The process is straightforward. However, “while a session lasting fifteen to thirty minutes might be appropriate for follow-up psychiatric appointments whose purpose is medication maintenance," says Owens, "this hardly seems like enough time for an initial diagnostic session, or a session in which medication is determined to be the right path and figuring out which medication would be best for the client.” 

If you choose to receive talk therapy through Circle Medical's partner, Octave, you will be paired with a therapist within 10 days of your first appointment.

ADHD Treatment

The process of receiving ADHD treatment from Circle Medical is more complex. While the sign-up process and your first appointment will be identical to the anxiety/depression process, the next steps are a bit more complicated. After that first appointment, you will be asked for the contact information of an institution that can send your medical history and evidence that you've had an annual wellness exam within the past year. Within 24 hours, you will then have a second appointment where the provider will go over your medication options as well as a more detailed treatment plan that will likely involve more frequent required follow-ups.  Like those receiving treatment for anxiety/depression, those with ADHD can book follow-ups and contact Circle Medical through the app. 

While this process may be tedious and expensive, it's actually good that the company is so thorough. Other online ADHD care providers, such as Done, have been subject to legal scrutiny because they provide stimulant medications, which are highly controlled substances, to almost anyone who asks. This is unsafe because these medications can lead to substance use disorder as well as psychotic episodes and heart problems. Circle Medical's lengthy process shows that it prioritizes patient safety over its bottom line. 

An important caveat is that while the website says that you can contact your provider through the app, the person I interviewed said that they were only able to contact customer service and never spoke to their provider directly between sessions.

What Happens If I Miss a Session at Circle Medical?

Circle Medical's missed appointment policy is fairly generous. You can cancel an appointment up to 24 hours before it starts without any consequences. If you do so later than that, don't show up, or show up more than 10 minutes late, you are charged a $50 fee.

Switching Providers at Circle Medical

It is unclear how to switch providers at Circle Medical. The website provides no information about this, and the person I interviewed who used the service only saw one provider. Furthermore, when I reached out to customer service regarding this, no one replied.

However, 21% of users we surveyed reported that it was easier or faster to switch providers at Circle Medical than at other companies they tried; in addition, 33% of users switched once, 24% switched two or three times, 8% switched four or five times, and 7% switched five times or more. When asked about the process of switching providers, 44% reported that they searched through every available provider and picked one themselves, 43% searched through a limited selection of providers and picked one, and 13% said they were assigned a new provider.

Pausing or Canceling Therapy at Circle Medical

Canceling your Circle Medical treatment is easy. According to the person I interviewed, they just had to send a message to customer service via the in-app chat feature, though this is different than what the website says about using the chat feature to contact your provider.  My interviewee was also able to receive all of their Circle Medical records so that they could provide them to their new doctor. However, there is no information about pausing or canceling services on the Circle Medical website.

Quality of Care and User Satisfaction

The users we surveyed were overwhelmingly satisfied with Circle Medical's care. Sixty-one percent said that they would be with the same Circle Medical provider a year later. This is huge compared to the 40% average among other virtual mental health companies. Additionally, 78% of users said that they would be likely or very likely to recommend Circle Medical to a friend or someone like them. They also like Circle Medical better than its competitors, with 84% saying that they liked it better or much better than other online therapy companies they used in the past. 

That being said, the fact that Circle Medical only works with primary care providers inherently limits the quality of care it can provide. As Owens puts it, "While primary care physicians and nurse practitioners can technically prescribe basic psychotropic drugs like antidepressants, it is best to see a mental health professional for symptoms of mental illness if at all possible. Primary care providers might not have a holistic understanding of the causes and presentations of different mental health conditions,” she explains, “and also might not be as aware of things like side effects, drug interactions, or alternative treatments."

Therefore, you should be mindful when choosing Circle Medical’s services and be ready to seek a specialist if you are not improving or struggle with medication side effects. This might mean you need a higher level of care with an actual mental health professional.

Privacy Policies at Circle Medical 

Circle Medical's privacy policies are far better than most websites. While it does track your IP address so that it can see which part of the websites are most frequently used, it doesn’t collect any of your personal data as you use the site. Furthermore, it does not share any of your information unless it is doing so for healthcare reasons—such as if you ask your doctor to send your medical records to another provider. It protects your data using, in its own words, "industry-standard SSL-encryption." Its policy also states that cookies often collect data on users, but these can be turned off by the user. And, as a medical practice associated with a hospital, it is HIPAA-compliant. 

The only downside to the privacy policy is that Circle Medical will aggregate information that is not personal or identifiable and share with third parties. Generally, it appears you do not need to worry about your privacy while using Circle Medical unless it is hacked.

Circle Medical vs. Its Competitors

Circle Medical's main competitors are companies like Amwell and Teladoc. All three are general telehealth companies with mental health services rather than online therapy companies. Unlike Circle Medical, however, these companies usually match you with a specialist rather than have you meet with a primary care doctor regardless of your needs. For example, Teladoc has both talk therapists and psychiatrists. This enables it to provide you with all of your mental health care without partnering with a separate company, it also means that you are seeing someone you know is qualified to treat mental health disorders. Another upside to companies like these is that they can often treat children and teens—for example, Amwell sees children ages 10 and up. It is important to remember, however, that certain more severe mental health conditions, such as schizophrenia or suicidal ideation, cannot be treated through telehealth, even by a psychiatrist. 

Circle Medical is superior to these competitors in a few ways, however. First off, without insurance, Circle Medical is cheaper. A single initial psychiatry consult at Teladoc costs $299 and $279 at Amwell. While this is cheaper than Circle Medical's ADHD initiation, neither of the companies offers controlled substances and therefore generally don't treat ADHD. Therefore, their prices are exorbitant compared to Circle Medical's initial $100 for an appointment to treat anxiety and depression. The other downside is this lack of ADHD care. While many companies prescribe stimulant medication recklessly, Circle Medical's thorough process appears to prevent unnecessary prescribing. This makes it one of a very small number of telehealth companies that can safely treat ADHD.  

Our surveyed users rated each of these companies highly, though across the board Circle Medical mostly ranked slightly lower than these competitors. In terms of overall rating, 91% of Circle Medical users thought its services were good, very good, or excellent, compared to 88% of Amwell users and 97% of Teladoc users. While 73% of Circle Medical users were able to find a provider who met most or all of their needs, 87% of Amwell users and 80% of Teladoc users felt the same. Additionally, 86% of Circle Medical respondents rated its providers’ qualifications as good, very good, or excellent, while 94% of Teladoc users and 91% of Amwell users were equally happy with the qualifications of the available therapists at those companies.

Final Verdict

The person I interviewed stopped using Circle Medical because their pharmacy stopped accepting prescriptions from Circle Medical and they wanted to see a specialist in person. While they were happy with the care they received at Circle Medical, they did acknowledge that the psychiatrist they ended up meeting was more "rigorous" about exploring medication options than their Circle Medical provider. 

This experience points to the nature of a service like Circle Medical. It is one of the better options for online medication management. It takes great care when prescribing controlled substances, is associated with an established medical system, and accepts insurance. However, a primary care provider is not going to be as thorough as a therapist or psychiatrist is, and pharmacies often don't accept prescriptions from online providers for controlled substances. This doesn't mean that Circle Medical can't provide effective mental health care—it can. But mental health specialists are a better choice when seeking mental health care, just as a nephrologist is a better choice for treating kidney problems than a general practitioner. When choosing Circle Medical, be sure that its limitations don't preclude it from meeting your needs.

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences.

Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service's quality of care, client-therapist communication options, session length, subscription offerings, client privacy protections, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend it.

When possible, we signed up for the companies to get a sense of how this process worked, how easy to use the platform is, and how therapy takes place at the company. We also interviewed a former user. Then, we worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers.