This week we had a guest lecturer come during lunch and speak about many aspects of mental health care.
The particular spin of the message was providing "complete" and coordinated mental health care within the current healthcare system. Some salient points were:
1. Currently medicine places a heavy emphasis on mental/emotional crisis management with less effort on crisis prevention. Logically, switching this emphasis would prevent crises, averting the disastrous and costly consequences.
2. When possible, the physician should pay careful attention to the needs of a patient's family members since they too might be experiencing some degree of trauma (psychological or otherwise) with the patient. This is especially true of family members of patients that are experiencing psychological/psychiatric difficulties.
When there are dependents involved, parental behavior can induce future problems in children.
3. The primary care physician should be the person to ensure the complete integration of all aspects of health care. This includes integrating specialty care. This ensures that all of the patient's needs are being met AND that all aspects of patient care are not causing harm to the patient.
An example of this would be 2 different specialty physicians inadvertently causing harm to a patient by prescribing non-compatible drugs without knowing of what drugs a patient is taking. It would be beneficial to all for the primary-care physician to coordinate all of these aspects of healthcare.
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2 comments:
Let me ask you this - If the primary care physician is supposed to be the collection point for all medical needs - both physical and mental - then why aren't more doctors schooled in psychology? Most doctors simply see the symptoms and prescribe drugs - which is almost useless outside of a comprehensive therapeutic plan. Why isn't mental health more prominent in the curriculum? (Not being a med student myself, I can't really say what is and isn't in the curriculum, but it has always been my impression that mental health is not covered in depth. Perhaps you could shed some light.)
This might not be the best response (or even the correct one...) but I think that it comes down to being a matter of time and then interest.
To get a master's of psychology about 2 years of graduate work are required. (My personal opinion is that 2 years would be about the minimum study/practice time to hit the "do no harm" and maybe the "do some good" milestone.) For most student physicians that much time is not available outside of core medical classes.
It also would definitely have something to do with interest. If mental health is a serious priority for a student, then he/she could take elective courses and rotations in psychiatry and/or choose a psychiatry residency. This would provide that student with breadth and depth in mental health services. But, this is interest-based and would depend on the student.
By referring to the primary care physician as the person that is responsible for integrating all aspects of health care, I was referring mostly to the primary care physician ensuring that a patient has access to and is receiving all of the care that is required in all healthcare areas.
The main goal would be that someone, somewhere within the healthcare system "keeps tabs" on the patient's entire medical history past, present, and future to make sure that all of the patient's needs are being met and that no harm is being done between multiple providers.
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