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 […]
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 […]
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 […]
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 – […]
By Neftali Serrano, PsyD Far too often, I hear the same weary refrain from healthcare professionals championing integrated care: “My leaders tell me that my integrated care program is just not making us enough money.” Let’s be clear—this isn’t a financial question. It’s a philosophical one dressed up in a spreadsheet. Because when a leadership […]
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 […]
Why We Need Dedicated Integrated Care Directors — At Every Level of the Health System If you’ve spent any time in the integrated care space, you know the pattern: A grant funds a pilot. A bold health plan tries something innovative. A state rolls out a value-based model. Then people move on, funding dries up, […]
The Firestarter Framework: Fueling Passion and Purpose Dr. Thomas opened her session delving into the Firestarter Framework to explore our personal journeys in Integrated Care leadership and inspire participants to carry the CFHA “spark” home after the conference, igniting ongoing passion for integration. This framework classifies drivers of change into three groups. These Firestarter types […]
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 […]
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 […]
The Value of a Pearls Gathering At the end of the first pandemic year, BHCs from multiple sites at the Pediatric Physicians’ Organization at Children’s (PPOC) convened to reflect on what we called the “Pearls of 2020 – Staying Integrated During the Pandemic.” The Pearls initiative identified six key elements of integration, each of which […]
