3 minute read The recent episode on Last Week Tonight puts the failing U.S. Mental Healthcare system in the spotlight. It is a great and timely episode. You should stop reading my pedantic post and watch it now. OK, now that you’re back, let’s recap the episode and discuss what it could mean for the […]
3 minute read. Original post available here As I was talking with one of our medical assistants (MA) after a visit she helped interpret for, we both agreed, “its good to get a win.” One of my favorite parts about spring is the intentionality that graduation and orientation season brings to reflect on the past year, […]
Several changes proposed in the 2023 CMS Physician Fee Schedule and Medicare Part B policies may help to advance integrated care. The proposed changes include a new General BHI service code for use when behavioral health is the focal point of care and allowing previously excluded behavioral health professionals to provide services to Medicare patients. The […]
3 minute read The history of medicine is a massive and fascinating subject. It shows that, over time, the goals and locations of doctors have changed. From the bedside to the library and from the hospital to the laboratory, doctors have sought out the innovation and evidence that compose our healthcare system today. In the […]
In January 2021, Representative Mike Thompson introduced the Mental Health Access Improvement Act of 2021 (H.R. 432) that, among other things, would authorize Medicare payment for covered mental health and substance use services provided by licensed marriage and family therapists (LMFT) and licensed mental health counselors (LMHC. The bill was referred to the Subcommittee on […]
Two recent reports provide insight into the state of integrated care. Here we summarize their findings so you don’t have to do all the reading! The Year 4 evaluation of the CMS alternative payment model, CPC+, describes the outcomes of integrated behavioral health in the demonstration project and notes challenges to sustainability. The Graham Center report […]
3 minute read. Original post here. I want to share this story/moment/experience related to primary care behavioral health (PCBH), well, maybe more related to primary care. I once took a handoff from a provider for a patient that we would definitely say was complex. Side note: what is so awesome is how I got the […]
3 minute read The House Committee on Energy and Commerce recently advanced to the house a package of bipartisan legislation geared towards improving mental and behavioral health treatment, as well as providing substance use disorder care. If passed, this bill would have direct impact on integrated care programs throughout the U.S. I will highlight some […]
Five minute read The title of this post is a terrible pick-up line, but it reflects my musings on how we identify patients in primary care who may benefit from behavioral health services. Health screening is standard practice in primary care. We screen for physical health, mental health, substance use, health behaviors, family functioning, social […]
4 minute read. Original post available here With onboarding our new behavioral health consultant (BHC) interns and family medicine (FM) residents, we have had numerous conversations and presentations regarding the importance of integrating a contextual, compassionate approach to healthcare. Regardless of it being delivered by a BHC, by a primary care provider (PCP), by a […]
5 minutes How are helping professionals coping in the waning days of the pandemic? Signs of burnout are everywhere. One in three nurses reportedly plan to leave their jobs. Physicians, especially hospitalists, are wracked by moral injury. Behavioral health workers are being crushed by the press of people seeking help for depression, anxiety, and substance […]
4 minute read First published March, 2019. Original post here. One of the first things I noticed when starting out as a BHC in an obstetrics/gynecology clinic was that every template or model for integrated care focused on primary care as the setting for behavioral health integration. Although much of that information is adaptable to ob/gyn […]
5 minute read First published January 20, 2021. Original post here. “The key to working with behavioral health clients,” a clinical supervisor told me over 30 years ago, “is asking about the past losses they’ve suffered and exploring whether they mishandled them.” He was a loss zealot, a mourning maven. He walked clients through guided […]
10 minute read My husband, Fred Dowaliby, died of Parkinson’s Disease Dementia on Oct. 19, 2019 at the age of 77. Since his death, I have reflected on his journey of nearly a decade. Fred was an accomplished, talented man with a PhD. in educational psychology. As a researcher and statistician, he was known for […]
7 minute read Healthcare today is a team activity. The rapid accumulation of specialized knowledge in healthcare has created a substantial need for partnerships between medical and mental health practitioners. Physicians, nurses, psychologists, pharmacists, and other health professionals must work together for patient-centered care to become a reality. These partnerships are best reflected in a […]
Five minute read Most clinicians and managers are not involved in policy-making, a process often compared to sausage production. Yet, healthcare policy impacts all clinicians and other health professionals. Policy is essential for change at the highest levels in our society. Training programs, academic publications, and grant projects cannot hold a candle to the power […]
3 minute read Integrated healthcare is most important for communities with limited access to medical and/or behavioral health services. By making those services available in one place and training a care team to collaborate, vulnerable patients are more likely to get the right treatment at the right time. According to a new report, integration makes […]
3 minute read I am a little late to the game on this 2021 report from the National Academies of Sciences, Engineering, and Medicine. But my tardiness does not diminish the appeal of the ideas that jump off the 428-pages of this document. These ideas, if implemented, would terraform the primary care landscape. A reliable […]
