The recent federal conviction of Done Global’s CEO, Ruthia He, and its clinical president, psychiatrist David Brody, on November 20, 2025, has spotlighted longstanding issues surrounding virtual ADHD prescribing. A jury in San Francisco found both leaders guilty of conspiring to distribute Adderall and other Schedule II stimulants, along with charges of health care fraud and (in He’s case) obstruction of justice. As per the Department of Justice, Done Global amassed over $100 million in revenue by facilitating the distribution of more than 40 million stimulant pills, frequently disregarding fundamental principles of psychiatric practice.
For numerous clinicians, the verdict merely reaffirmed what had been evident for years: Done Global symbolized not the potential of telehealth, but its most foreseeable downfall.
Telehealth itself holds the capacity to be transformative. It broadens access for patients who once faced geographic, financial, or stigma-driven barriers. When employed responsibly, it fosters continuity, flexibility, and enhanced follow-up, which are vital components in behavioral health. Yet the Done model represented something entirely different. It operated as a subscription-driven stimulant pipeline, motivated by algorithms, advertising, and quantity. Clinical judgment, when applied at all, seemed to be regarded as an impediment to revenue rather than a necessity for safety.
Federal investigators characterized a framework designed to offer “easy access” to stimulants under the pretense of convenience. The firm’s “auto-refill” feature enabled patients to receive monthly stimulant prescriptions via automated emails, with minimal or no clinical engagement. Certain nurse practitioners were reportedly compensated up to $60,000 each month to renew prescriptions absent a meaningful examination, follow-up appointment, or risk assessment review.
These actions were not mere oversights. They formed a core part of the business model.
When healthcare is subordinated to a subscription model, safety becomes a secondary consideration. Done’s platform heavily relied on misleading advertising aimed at individuals seeking stimulants without a legitimate medical need. The system restricted the information available to prescribers, limited follow-up care, and imposed “hard limits” on clinical discretion. In some instances, clinicians were dissuaded from acquiring collateral data or confirming diagnostic criteria. Even with incidences of misuse, diversion, and one reported death emerging among patients linked to the platform, the model remained unaltered.
From a psychiatric perspective, the concerns were evident. ADHD is a genuine and often transformative disorder, yet diagnosing it properly necessitates time, history, context, and continuity. Stimulants can be immensely beneficial when used appropriately, but they require monitoring and follow-up, safeguards in place not to introduce bureaucracy, but to protect patients. Condensing these steps into a brief intake and an automated refill system is neither innovation nor progress. It reflects a neglect of the most fundamental components of care.
The Done case also highlights regulatory weaknesses. The DEA and FDA had recognized stimulant shortages as early as 2022, and some experts quietly questioned whether diversion and overprescribing contributed to the issue. During the COVID-19 pandemic, exemptions to the Ryan Haight Act rightly broadened access to controlled-substance prescribing via telehealth. However, those temporary provisions also opened the door for exploitation, which Done Global exploited aggressively. Oversight simply failed to keep pace.
The repercussions have been extensive. Pharmacies nationwide began rejecting prescriptions from digital-only platforms, resulting in unintended obstacles for patients who truly benefit from telepsychiatry. Some insurers and state boards intensified their requirements. Now, with this conviction, there is a genuine risk that the public will conflate reckless business practices with telemedicine itself.
That would be an error. Telehealth did not fail in this instance. A company did.
Responsible telepsychiatry remains not only feasible but crucial. Numerous clinicians offer careful, ethical, patient-focused care through digital platforms daily. Yet the Done Global verdict serves as a reminder that when a business model is crafted around speed, scale, and subscription income, it can distort clinical priorities in ways that jeopardize patients and undermine trust.
The role of licensed physicians in these operations is particularly concerning. The ethical standard of the profession (to prioritize patient welfare above all) is incompatible with systems that incentivize shortcuts or discourage thorough evaluations. When clinicians are coerced into favoring volume over judgment, the field is diminished.
The takeaway is not that telehealth is inherently unsafe. The takeaway is that telehealth must be designed with the same rigor and ethical foundation as any conventional medical practice. This means meaningful assessment durations, appropriate follow-up, safeguarding clinical autonomy, and stronger scrutiny of prescribing practices. It signifies resisting business models that claim convenience while insidiously dismantling the safeguards that ensure psychiatric care is safe.
The Done Global conviction does not mark the conclusion of this narrative. It serves as a signal and a warning. Innovation must never sacrifice integrity. And patient safety cannot be optional, regardless of whether care is delivered in an office or through a screen.