Training the “Assertive Practitioner of Behavioral Science”: Advancing a Behavioral Medicine Track in a Family Medicine Residency

Butler, Dennis J.; Holloway, Richard L.; Fons, Dominique K.

doi:10.2190/pm.45.4.b

Cited by 4 publications

(3 citation statements)

References 12 publications

(8 reference statements)

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“…An early overview of consultation service activity is contained in an audit completed after the first four years of the service. 16 Based on a chart audit of 22 consecutive patients, the majority of referred patients presented with a diagnosable psychiatric disorder. The consultants diagnosed 85% of the patients with depression, an anxiety disorder, or an adjustment reaction.…”

Section: Description Of the Consultation Servicementioning

confidence: 99%

“…All participants are currently in practice or pursuing advanced training. The family physicians chosen included two who completed residency at the program and completed advanced training in the residency’s behavioral medicine track 17 as well as the clinic’s medical director whose clinical practice coincided with the duration of the consultation service. The three consultant psychiatrists interviewed were fourth-year residents when they provided consultations.…”

Section: Review Processmentioning

confidence: 99%

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A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting

Butler

Fons

Fisher

et al. 2018

Int J Psychiatry Med

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A significant percentage of patients with psychiatric disorders are exclusively seen for health-care services by primary care physicians. To address the mental health needs of such patients, collaborative models of care were developed including the embedded psychiatry consult model which places a consultant psychiatrist on-site to assist the primary care physician to recognize psychiatric disorders, prescribe psychiatric medication, and develop management strategies. Outcome studies have produced ambiguous and inconsistent findings regarding the impact of this model. This review examines a primary care-embedded psychiatric consultation service in place for nine years in a family medicine residency program. Psychiatric consultants, family physicians, and residents actively involved in the service participated in structured interviews designed to identify the clinical and educational value of the service. The benefits and limitations identified were then categorized into physician, consultant, patient, and systems factors. Among the challenges identified were inconsistent patient appointment-keeping, ambiguity about appropriate referrals, consultant scope-of-practice parameters, and delayed follow-up with consultation recommendations. Improved psychiatric education for primary care physicians also appeared to shift referrals toward more complex patients. The benefits identified included the availability of psychiatric services to underserved and disenfranchised patients, increased primary care physician comfort with medication management, and improved interprofessional communication and education. The integration of the service into the clinic fostered the development of a more psychologically minded practice. While highly valued by respondents, potential benefits of the service were limited by residency-specific factors including consultant availability and the high ratio of primary care physicians to consultants.

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Section: Description Of the Consultation Servicementioning

confidence: 99%

Section: Review Processmentioning

confidence: 99%

A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting

Butler

Fons

Fisher

et al. 2018

Int J Psychiatry Med

Self Cite

View full text Add to dashboard Cite

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“…The publication of the current special (double) issue marks the following milestones for the Forum–IJPM series: 7 total special issues; 645 pages; 71 peer-reviewed articles (71 first author opportunities for Forum attendees); 172 total authors (average of approximately three authors per article). 2–7 We are very pleased that this annual series continues to reinforce Forum objectives of professional networking, high-quality professional development, and advancing the integration of behavioral science into Family Medicine training. We thank Julie Rickert, PsyD, who has succeeded Dr Butler as Forum Chair as she has continued enthusiastic support for this publication partnership.…”

mentioning

confidence: 98%

Embracing and advancing the value of teams in Family Medicine

Freedy

Fields

Delbridge

2019

Int J Psychiatry Med

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Attitudes and Confidence in the Integration of Psychiatry Scale

2015

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Objective There is growing consensus in medical education regarding the importance of integrating training in behavioral health and psychiatry with other fields of medicine, given broad applicability, inter-relatedness, and clinical relevance. The authors developed a scale to measure attitudes and confidence in the integration of psychiatry into other fields of medicine. Methods The Attitudes and Confidence in Integration of Psychiatry in Medicine (ACIP) scale was developed through discussion with content experts across disciplines and pilot testing of items. This scale was administered to third- and fourth-year medical students at three United States medical schools (University of Iowa, University of Michigan, Rush University) for validation, focused on assessment of variability, internal consistency, factor structure, and test-retest reliability. Results A total of 310 medical students completed the survey (35% participation rate). The scale had a high internal consistency (Cronbach’s alpha=0.88) and was without ceiling or floor effects. Survey items loaded on the two factors of interest: attitudes and confidence. Students rated the integration of psychiatry into the practice of surgery and its subspecialties as less relevant than its integration into other specialties; however, scores were not biased by students’ interest in procedural vs. non-procedural specialties. Test-retest reliability was high (Cronbach’s alpha=0.90). Conclusions The ACIP may serve a useful role in determining the outcome of educational efforts toward integrated care.

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Training the “Assertive Practitioner of Behavioral Science”: Advancing a Behavioral Medicine Track in a Family Medicine Residency

Abstract: As developed and structured, the Behavioral Medicine track has achieved the goal of producing "assertive practitioners of behavioral science in family medicine" residents with advanced behavioral science skills and abilities who globally integrate behavioral science into primary care.

Cited by 4 publications

References 12 publications

A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting

A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting

Embracing and advancing the value of teams in Family Medicine

Attitudes and Confidence in the Integration of Psychiatry Scale

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