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Doody's Review ServiceReviewer: Raj Tummala, MD (Wyeth Pharmaceuticals)
Description: This is a thorough review of patient treatment in residential care facilities with a focus on patients with schizophrenia. This book is an absolute must for any clinician taking care of patients in private residential facilities.
Purpose: TThe purpose is to provide a comprehensive, easy to read, quick reference of the residential care system.
Audience: It is targeted at anyone dealing with patients in residential care settings such as psychiatrists, residents, social workers, case managers, etc.
Features: Psychopharmacological advances and economic legislations have led to the deinstitutionalization of psychiatry. As a result, chronically ill psychiatric patients now reside in residential facilities. Dr. Fleishman details his experiences in this well written review on the residential treatment system. He starts off with the history of residential care systems and outlines the facilities, the team responsible for the care of the patient with various intervention modalities. He uses case vignettes, and spreads his humor throughout. The section on space, time and techniques deserves special mention: in it, Dr. Fleishman outlines "The Ten Commandments of Residential Care Psychiatry." In view of the disparities that arise in the treatment of mentally ill patients, Dr. Fleishman outlines the various legal and economic problems and calls for a new definition of medical necessity. He does a wonderful job of explaining the Medicare audit process and the complexities associated with the Medicare system. The book has a focus on schizophrenic patients, as they comprise the majority of the patients in these settings. Special emphasis is placed on various pharmacoeconomic measures that reduce costs as a result of on-site services and new pharmacological advances. Dr. Fleishman states six goals for writing this book, including new legislation, Medicare reform, and guidelines for residential care. He has done a great job of making a case for all six of his goals.
Assessment: The book is written in a very practical, user-friendly format differentiating itself from other books in this category. It is an absolute must for anyone dealing with patients in residential care settings.