Although some improvements were found in recording trauma histories, eliciting such a history did not lead to thorough documentation of posttraumatic symptoms or to inclusion of the history in the diagnostic formulation or treatment plan.
Although mandated inquiry led to the detection of substantial abuse and trauma, this information was rarely used in assessment and treatment planning. Implementation of mandated inquiry should be accompanied by relevant education and supervision to ensure that clinicians understand the diagnostic and treatment implications of past trauma.
Previous surveys of the alumni of Columbia University's fellowship in public psychiatry suggest that a large number of alumni fill positions as program medical directors. In contrast with agency medical directors, program medical directors work within team structures and maintain a high degree of clinical involvement. The fellowship faculty surveyed the alumni to catalog the tasks performed by program medical directors, agency medical directors, and staff psychiatrists and to determine the extent to which these tasks contribute to job satisfaction. Methods: A survey form was developed using a list oftasks derived from the American Psychiatric Association's guidelines for psychiatrists working in organized mental health care delivery systems and from a recent article that surveyed job descriptions of psychiatrists in community mental health centers. The survey form was distributed to all current fellows and alumni in active practice (N 89). Results and conclusions: Seventy-two forms were returned, for a response rate of 81 percent. Respondents who were medical directors performed a greater variety of tasks and reported higher job satisfaction than those who were staff psychiatrists. Higher job satisfaction was related to a greater variety of tasks performed, especially tasks involving clinical collaboration. Most of the respondents were program medical directors rather than agency medical directors. The position of program medical director constitutes a relatively small and attainable step above that of staff psychiatrist. Agencies would do well to consider creating positions of program medical directors for their staff psychiatrists whenever feasible, and psychiatrists committed to publicsector careers should negotiate to have such positions.
Most mental health organizations are run by chief executive officers (CEOs) who are not physicians, with medical directors reporting to the CEOs. In this article the historical and organizational origins of this arrangement are reviewed. The well known disadvantages of shared management are discussed, as are the less obvious advantages. Through case vignettes the authors illustrate how bifurcated leadership can promote productive and creative administrative decisions. Guidelines are offered for strengthening collaborations between non-medical and medical mental health program directors.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.