Description: This is a cased-based discussion of the use of and need for medical-psychiatric coordination physicians (MPCP).
Purpose: The purpose is to illustrate the clinical complexity of patients who require an MPCP using case vignettes. The book also details the tools needed to carry out this role.
Audience: It is written for providers trained in psychosomatic medicine or those who have been dually trained in internal medicine or family medicine and psychiatry. It provides a framework of guidance to those who manage patients with comorbid psychiatric and medical disorders or those with complex psychosocial issues in the setting of a medical illness. The authors are practitioners who have experience in the field of collaborative care.
Features: A clinically complex patient is defined as one who requires management from multiple providers for one or more conditions. This complexity can further be magnified when the patient has both a medical and a psychiatric condition. To address this problem, an MPCP can help improve communication among consultants and between consultants and the patient. Throughout the book, patient cases are used to demonstrate the difficulties of being an MPCP, as well as the importance of this role. The authors describe the role of the MPCP as providing "unification," as patients' medical conditions can be affected by their psychiatric illness. The ability to recognize psychiatric illness and its impact on a patient's medical condition is unique. The process of "truing" is described as a method of using both medical and psychosocial data to implement the best treatment plan. These concepts are repeatedly demonstrated in a variety of complex patient vignettes.
Assessment: This is a great resource for physicians who are, like me, dually trained in internal medicine and psychiatry, as it reflects the common difficulties we face. We view the patient through the lens of the psychosocial model, thus we are always seeking to integrate medical and psychiatric care. It would have been helpful if the book had spent time exploring other MPCP models in other facilities that have been successful. Overall, however, this is a well-written book that accomplishes its goal.