Phone sessions can be useful and can accomplish many of the goals of a regular session (whether in-person or by telepsychiatry). However, a phone session cannot substitute for telepsychiatry for the initial evaluation. The first session is essential to develop a differential diagnosis (a list of the most likely conditions affecting the patient) and treatment plan. Being able to see the patient as well as listen to her is important for the initial evaluation. At Principium, initial evaluations must be by telepsychiatry or in-person.