The game is played back and forth, each side jostling to score a goal where possible. The scoring can be few and far between, a lot more chances and shots at goals, than reward. Often the activity is quick, a quick run by a team toward the goal, and then the ball is going backward the other way, exchanging possession back and forth… Yet […]
As is often the case with scientific breakthroughs, Lister was not satisfied with prevailing explanations for high post-surgical mortality. Instead, he looked elsewhere, guided by observation. In hindsight, it is striking how long established—yet incorrect—explanations persisted. These were not only scientific but cognitive: reinforced by shared assumptions that made alternative interpretations difficult to see. In […]
“Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications—especially among children,” said Secretary Kennedy. “We will support patient autonomy, require informed consent and shared decision-making, and shift the standard of care toward prevention, transparency, and a more holistic approach to mental health.” In […]
That gap, between what the chart said, and what I read in the room, is where much of the work happens in primary care. Universal screening with validated tools, brief intervention, referral to treatment (e.g., SBIRT) has a robust evidence base, and at the population level, it works. A well-resourced implementation trial across 22 primary […]
A new Pediatric Collaborative Pathway has been developed to solve this problem, offering a structured, feedback-driven system that turns chaos into clarity. Here are four practical ways to implement this pathway in your practice today. 1. Make Screening Meaningful Screening shouldn’t just be a compliance task; it is the foundation of clinical decision-making. The pathway […]
Collaborative documentation is far more than a technique for writing notes. When used intentionally, it becomes a foundation for partnership‑based care and serves multiple meaningful functions that shape the clinical encounter itself. The Functions of Collaborative Documentation A Process and an Outcome Collaborative documentation turns the note into both a shared activity and a tangible […]
Marcus is a 40‑year‑old African American man whose primary care provider (PCP) recently noted significant changes in mood following his ALS diagnosis two months ago. During several follow‑up appointments, the PCP observed that Marcus appeared less engaged, showed diminished interest in life, and expressed overwhelming concern about what the progression of the disease might mean […]
During that first visit, it became clear that this new father–infant dyad had no established connection. They had met only a few times, Dad lacked basic supplies such as clothes, a crib, and a car seat, and he was anxious, overwhelmed, and unsure how to begin bonding with his baby. Over the following visits, I […]
Maria, RN By three in the afternoon, the clinic always felt a little frayed at the edges. The hum of printers, the faint ring of unanswered phone lines, the blinking of notices for new results — it all blended into the kind of background noise you stop noticing until the day feels heavy. It was […]
What’s New in the MOUD Playbook The updated Playbook offers several key enhancements: · A stronger emphasis on low-barrier, person-centered care. The Playbook underscores that using MOUD saves lives and should not be withheld due to continued substance use or resistance to counseling. It highlights the need for stigma reduction, appropriate levels of care, and […]
While many providers in primary care encounter patients at risk of suicide, they may not feel equipped to respond. A new topic brief from AHRQ’s Academy for Integrating Behavioral Health and Primary Care aims to help. Emerging Best Practices for Addressing Suicidality in Primary Care outlines strategies that can be integrated into routine care and […]
Bion’s Relevance in Modern Healthcare The psychoanalytic perspectives of Bion, especially his concepts of container-contained thinking, thinking under pressure, and emotional truth, appear conceptually distant from the practical and fast-paced demands of integrated healthcare. Yet it is precisely in this setting, where clinicians must think quickly while holding complex emotions, that Bion becomes indispensable. According […]
I’ll admit it. I’ve had Bad Bunny on repeat for weeks now. As his historic residency in Puerto Rico wraps up its final weekend, I cannot help but reflect on the unexpected lessons I felt during his concert and apply some to working in integrated care. Yes, you read that right. A reggaeton superstar’s show […]
Interestingly the word “Jenga” does not mean “angst derived from a predestinated tower of calamity.” Jenga’s roots are in Swahili from the word “kujenga” meaning “to build” (“Jenga”, 2025). Jenga got me thinking about integrated care on one of these fun Saturday nights. We take the warm handoff on the behavioral health side (or provide […]
Neuroimaging Studies Suggest a Link Between Art and Happiness In the mid-20th century, artist Margaret Naumburg came up with the concept of art as symbolic speech, and founded the field of art psychotherapy, based largely on the writings of Sigmund Freud and Carl Jung (Borowsky Junge, 2016). The American Art Therapy Association dates back to […]
While no standard framework yet exists, the brief suggests nine common components drawn from models used with children ages 0-5 in pediatric and family medicine, adapted to guide behavioral-developmental health screening and response for adolescents. Implementation of these components can be tailored to fit available resources, staff expertise, and organizational goals. The brief provides real-world […]
I lift and share my voice (well… my lyrics—because my singing, at my children’s request, is reserved for showers and car rides) with you. Together, we are a chorus singing in exam rooms, classrooms, courtrooms, boardrooms, voting booths, chat rooms, and every room we can and do squeeze into. You may not always hear this […]
Addressing vaccine hesitancy requires tailored, evidence-based strategies to address the causes. WHO grouped these determinants into contextual, individual, and group influences and vaccine/vaccination-specific issues. However, most vaccine hesitancy measurement tools have limited psychometric validation. Further studies correlating measurements with vaccination behavior and validating these tools in different populations, including pediatric populations, are warranted. Evidence-based strategies for […]
