If you are a clinician you know the feeling. It’s that moment in a care process with a patient where you could do more or choose to do less. You battle internally to decide what to do and ultimately you know you can’t live with yourself if you choose to do less. That’s our moment as […]
Tracing our Professional Lineage Years ago, I attended a gathering where the late family therapist Lynn Hoffman illustrated a colleague’s professional lineage by mapping out the influential figures in their career in a family tree format, like a genogram. Her friend and colleague Marcelo Pakman, a regular to these reunions, coined this exploration a “retroscope.” […]
5 minute read My first job after postdoctoral training was at a family medicine residency program in central North Carolina. It was exactly what I wanted: a combination of direct patient care, graduate medical education, and program development. I took over for Dan Marlowe, another medical family therapist who left to join the faculty at […]
5 minute read Imagine an older Latina woman we’ll call Maria who is accompanied to her primary care visit for a diabetes check-up by her two adult daughters. Because Maria speaks little English and her provider speaks little Spanish, the daughters immediately start translating for their mother. The daughters also directly answer the provider’s questions […]
3 minute read I was not ready to negotiate my first, “big boy” salary. Until that point, my pay rates were all decided by policies (e.g., minimum wage, graduate student stipends, teenager allowance). I didn’t have the moxie, or matching clothes, to negotiate. Growing up, salary talk was off the table, quite literally. My parents […]
Five minute read “She was visibly upset while she talked about the confrontation with her brother,” I said. “And then suddenly she stood up, arms wide open, asking for a hug.” “And what did you do?” my clinical supervisor asked. “What else could I do? I gave her a hug!” My supervisor smiled. “I want […]
5 minute read “You will need to screen every patient for depression using the PHQ-9,” my supervisor told me. “Focus on the first two questions and notify the internist of the scores”. Sounds simple enough. Wait, what is the PHQ-9? What’s an internist? “Don’t tell me the scores,” the internist instructed me. “Just tell me […]
7 minute read From the fifth floor window of the resident lounge, I could see the downtown Chicago skyline in the distance from Hinsdale Hospital. The Hinsdale Family Medicine Residency building was across the street from the hospital I would call home for the next 3 years, connected by an underground tunnel that came in […]
5 minute read Most of us have some intuitive sense of consciousness as a state of awakeness or awareness of internal or external mileius (APA, n.d.). Yet the ‘hard problem’ of consciousness as proposed by Australian cognitive scientist, David Chalmers, remains intractable. That question is: What makes a physical state conscious rather than unconscious, and […]
5 minute read “Welcome to day one of your integrated care practicum. The first step you’ll take is to purchase two books and begin reading them right away. OK, let’s talk about Centricity!” Fall semester of 2009. I am a new student in the Medical Family Therapy doctoral program at East Carolina University (ECU). My […]
5 minute read It is curious that so many individuals are wary of artificial intelligence, given its widespread use. Most of us wouldn’t think twice about asking Siri for advice, yet ChatGPT is an entirely different story. Why do people feel perfectly comfortable keeping company with a virtual personal assistant, but not with a natural […]
5 Minute Read. As a seasoned professional in integrated care, I’ve been part of a pioneering generation that sought to blend medical and behavioral health services to improve patient outcomes, particularly with the advent of the Primary Care Behavioral Health service delivery model (PCBH). Reflecting on this journey, it’s clear that while we’ve made significant […]
By Neftali Serrano, PsyD, 2 Minute Read In recent years, the struggle to retain and recruit behavioral health providers has intensified within primary care. A closer examination of this trend reveals a significant underlying cause: the selection bias rooted in the mental health provider training process. This bias not only shapes the career preferences of […]
5 minute read The behavioral health field is failing to fulfill one of its essential social roles. Our main function is to help people resolve behavioral health issues, but our longstanding inability to make care accessible diminishes our social value. This is an issue of equity. People should be able to access behavioral care as […]
3 minute read Having recently completed the coursework for a doctoral degree in behavioral health, I find myself reflecting on what that means, beyond any benefits to career advancement. Life is the greatest ocean of unknowns any of us will experience. We are thrust into it, unprepared except for the guidance of our parents, and […]
5 minute read Is the Healthcare System Ready? Our current integrated care models break down silos between physical and behavioral health, allowing for comprehensive screening, warm handoffs, care coordination, and streamlined referrals. Many patients, though, have unmet social, material, AND behavioral health needs. Here are some examples. • A 40-year-old man experiencing homelessness struggles to […]
5 minute read The following post will include some slight navel gazing and somewhat excessive contemplation of one particular license group. I hope the reader will indulge me. I am a licensed marriage and family therapist (LMFT). My doctoral training is in medical family therapy. I graduated from the same master’s program as my dad, […]
Original post available here. One day, while working as a clinical psychologist in a primary care practice, I was asked by the family doctor scheduled to meet that morning with Lisa, a 72-year-old woman with moderate dementia, to stop by and see her 75-year-old husband, Dennis, for counseling for possible depression. Within the hour, I […]
