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Comprehensive Care for Complex Patients: The Medical-Psychiatric Coordinating Physician Model
     

Comprehensive Care for Complex Patients: The Medical-Psychiatric Coordinating Physician Model

by Steven A. Frankel
 

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'Complex patients' are a sizeable population who generally require disproportionate attention for their management and respond poorly to treatment. Their systemic medical, psychiatric and personal needs have a tendency to drain or exceed the capabilities of those who treat them whilst overutilizing health care resources. As this patient population grows, we move

Overview

'Complex patients' are a sizeable population who generally require disproportionate attention for their management and respond poorly to treatment. Their systemic medical, psychiatric and personal needs have a tendency to drain or exceed the capabilities of those who treat them whilst overutilizing health care resources. As this patient population grows, we move ever closer to a crisis in health care delivery. This volume presents an innovative team-based approach for assessing and managing diagnostically complex and management intensive patients. The physician-led 'Medical-Psychiatric Coordinating Physician (MPCP)' model not only improves patient treatment, but also provides for the containment of costs by reducing redundancy and curbing excess in the use of services. Other benefits include improved diagnostic accuracy and decision making, as well as better communication among physicians and allied health professionals. This book is essential reading for psychiatrists, primary care physicians, and physicians, directors and administrators working in multidisciplinary specialty clinics.

Editorial Reviews

Doody's Review Service
Reviewer: Alyson Myers, MD (North Shore - LIJ Hofstra School of Medicine)
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.

Product Details

ISBN-13:
9781107025158
Publisher:
Cambridge University Press
Publication date:
10/31/2012
Pages:
208
Product dimensions:
6.26(w) x 9.49(h) x 0.51(d)

Meet the Author

Steven A. Frankel, MD has practised and taught in the San Francisco Bay Area for over thirty-five years. He is certified by the American Board of Psychiatry and Neurology in general psychiatry as well as child and adolescent psychiatry, and has authored many professional articles and five books. His Collaborative Psychiatry Method of treatment for non-psychiatrists and psychiatrists alike, is elaborated in Evidence from Within: A Paradigm for Clinical Practice (2008), Making Psychotherapy Work: Collaborating Effectively with your Patient (2007), Hidden Faults: Recognizing and Resolving Therapeutic Disjunctions (2000) and Intricate Engagements: The Collaborative Basis of Therapeutic Change (1995, 2004). Comprehensive Care for Complex Patients: The Medical-Psychiatric Coordinating Physician Model, by Frankel, Bourgeois and Erdberg, dramatically expands the scope of his clinical model, placing a physician in the leadership position of treatment teams. A graduate of Yale Medical School, he was a National Institute of Mental Health research fellow in pharmacology at Stanford University Medical School. He then trained in psychiatry at the University of California Mount Zion Hospital and Medical Center in San Francisco, where he later joined the academic faculty. Dr Frankel then received psychoanalytic training at the San Francisco Psychoanalytic Institute, where he is a member of its faculty. He is an associate clinical professor at the University of California Medical School in San Francisco. He has been designated a Distinguished Fellow of the American Psychiatric Association, has attained certification by the American Psychoanalytic Association, and has been voted by his peers to Best Doctors in America® every year since 1987.

James A. Bourgeois, OD, MD is Professor and Vice Chair, Department of Psychiatry and Behavioural Neurosciences, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. He has focused his clinical and academic work on psychosomatic medicine for over 15 years.

Philip Erdberg, PhD is Assistant Clinical Professor at the University of California, San Francisco, School of Medicine, USA. He is Director of Research and Assessment at the San Francisco based Masonic Center for Youth and Families.

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