5 minute read Once upon a time, I was a behavioral medicine director at a family medicine clinic in North Carolina. Part of my job was to monitor the patient waiting list. We had normal delays like confirmation of benefits and no appointment slots. My goal was to schedule new patient appointments within 1-2 weeks […]
U.S. Mental Healthcare in the Spotlight: Can John Oliver Move the Needle?
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 […]
It Feels Good to Get a Win
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, […]
Proposed 2023 CMS Medicare Payment Changes May Advance Integrated Care
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 […]
Back to the Future: How Integrated Care Fits with Hippocratic Medicine
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 […]
Medicare Mental Health Workforce: Adding LMFTs and LMHCs
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 […]
The Current State of Integrated Care
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 […]
The Power of Primary Care: A Case Example of Accessibility and Continuity
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 […]
New Bipartisan Mental Health Bill Advances to House: Implications for Integrated Care
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 […]
What Is Your Philosophy of Screening? And Other Terrible Pick-Up Lines
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 […]
Being Life Saving: A Contextual Approach to Patient Care
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 […]
Doing the Work: The Power of Relationship-Based Care
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 […]
Integrated Behavioral Health in Ob/Gyn: Is there anyone else out there?
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 […]
Filling Integrated Care Positions Challenges Health Clinics
5 Min Read. Filling that integrated care position at your clinic feel tough? You are not alone. Positions for mental health professionals of all types in primary care have grown in the last few years (see our job board and our map) and the options for mental health professionals have also expanded with telehealth uptake, […]
Counting Losses—Putting Grief at the Center of Pandemic Healthcare
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 […]
Fred’s Journey from Neurology to Palliative Care
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 […]
Choir Singing Taught Me How to Join an Integrated Care Team
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 […]
Behavioral Health Policy: Recent Congressional Meetings Signal a Focus on Healthcare Crises
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 […]