“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 […]
Table 1 Documentation Guidelines for Clinical Notes (Adapted from Reiter, 2023) Do Avoid Be brief and concise. Avoid using names outside of the patient’s name. Keep quotes to a minimum. Avoid terms like seems, appears. Use an active voice. Avoid value-laden language, common labels, opinionated statements. Use precise and descriptive terms. Do not use terminology […]
There was nothing particularly remarkable about that day. It wasn’t sunny. It didn’t rain. The clouds offered no movement, no promises of new shapes with hidden messages. It was just a gray day, like so many others. And yet, it became a day I would remember. It all started with a call about a patient […]
There is a copy of a Thich Nhat Hanh book in her exam room. I imagine it as an amulet, or maybe a mantra, quietly working on her behalf: “I am a continuation, like the rain is a continuation of the cloud.” She cannot be anything less, anything more. In fifteen minutes, she is expected to earn […]
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 […]
For these practices, an Integrated Psychiatry approach—directly informed by the Primary Care Behavioral Health (PCBH) model—provides a flexible, population‑focused alternative. PCBH emphasizes rapid access, same‑day consultation, brief interventions, and team‑based care embedded directly within primary care workflows. Applying these principles, Integrated Psychiatry brings psychiatric expertise into the pediatric medical home, enhancing access, reducing stigma, strengthening […]
Over time, I’ve noticed more PCBH job postings recruit only for LISW/LPCC/LMFT (or equivalent). From my experience, many psychologists would love to work in PCBH, but they never get the chance. Many job postings don’t even list psychologists as an option, and when contacted, organizations often can’t offer pay that fits the level of training […]
Our book has six parts. The first is an update on the evidence for making this huge change to the scope and delivery of primary care services. We speak directly to leaders, with a hope of preparing them for a successful launch and scale-up. In the second and third sections, we provide information on specific […]
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 […]
Disclaimer: This blog was originally published on the National Academy for State Health Policy (NASHP) website (nashp.org) on 11.18.25. It is reproduced here with the permission of the author. You can access the original blog post at this link: How States Are Modernizing Facility Licensure to Advance Integrated Care – NASHP Modernizing facility licensure is […]
Our national example has been Prospect Medical Holdings, a for-profit, 17-hospital chain serving mostly low-income patients in California, Pennsylvania, Connecticut, Rhode Island, and New Jersey. As early as 2020, ProPublica, the independent investigative journalism outfit, published a lengthy expose about how Leonard Green and Partners, a Los Angeles-based private equity firm which bought a controlling […]
How Micro-Skills Shape Patient Outcomes and Interprofessional Collaboration through fostering an integrated care model that brings together medical, behavioral, and allied health professionals to provide comprehensive, whole-person treatment. Through this post we will dive into the argument that communication functions as a core clinical and operational competency in not only integrated care, but effective care. […]
Two LMFTs explore career choice through the lens of family-of-origin and a drive towards systems change–Part II of II Reflections on an Unusual Upbringing This two-part blog was inspired by a conversation I had with Jess at the CFHA Conference in Raleigh. We shared stories about our unique upbringings and decided to collaborate on a […]
Part 1 of 2 Two LMFTs explore career choice through the lens of family-of-origin and a drive towards systems change. This series was inspired by a conversation in Raleigh at the end of Day 2 of the annual conference. Jess & Chus Is it fate? Destiny? A series of tiny nudges and moments?Is it a […]
Nearly every time we work with consulting clients working on implementing integrated care the complaint is the same. There’s a healthcare administrator breathing down their neck about how many scheduling slots are going unutilized. It’s as if the golden hammer of healthcare optimization is managing slots. It’s time we call this what it is – […]
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 […]
