Psychologists and Primary Care Physicians: A Training Model for Creating Collaborative Relationships. Barbara A. Cubic, Ph.D. Associate Professor Eastern Virginia Medical School. Main Objective.
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Psychologists and Primary Care Physicians: A Training Model for Creating Collaborative Relationships
Barbara A. Cubic, Ph.D.Associate Professor
Eastern Virginia Medical School
Psychologists and primary care physicians are well positioned for innovative, interdisciplinary collaborations. This presentation will review models of clinical care collaboration and interdisciplinary training of physicians and psychologists which result in an egalitarian process and produce better patient outcomes.
Creating Collaborative Relationships with Primary Care Providers
The ACGME Website provides a toolbox of assessment methods and examples of use
Creativity is needed to determine specialty-specific and institutional-specific application
We’re experts in the development and validation of assessment approaches
can offer institution-wide, cross-specialty assessment
especially in domains of communication and interpersonal skills
A lack of time, educational expertise (especially regarding assessment) and funds mean meeting competencies are a challenge for program directors
ACGME often recommends nontraditional assessment methods, such as standardized patients (SPs) and our training prepares us well to objective evaluate interpersonal interactions
INTEGRATING PSYCHOLOGY INTERNSHIP TRAINING IN A PRIMARY CARE SETTING
Barbara A. Cubic, Ph.D.
Other Funded Collaborators on the Grant
Daniel Bluestein, M.D.
Kathrin Hartmann, Ph.D.
EVMS is a community based medical school founded in 1976 in Norfolk, VA
Norfolk is part of the Tidewater area of southeastern VA, consisting of 7 cities with a population exceeding 1.5 million
Ghent Family Medicine Residency is in the Department of Family and Community Medicine which has 12 full time faculty
Residency has existed since 1975 and it is an accredited three-year program which meets all the training requirements of the American Board of Family Medicine
Accepts approximately 5 residents per PGY year
Speaking a New Language:“When in Rome do as the Romans Do”
As a psychologist you are like a foreigner in a new country. It is your job to learn the language, not their job to adapt to you.
Real World Knowledge of Primary Care
or Informal Training Experiences in Primary Care Should be a Prerequisite
PCP Office (with brief notes
to document interactions with the
patients or discussions with providers)
Forget What You Learned About Report Writing In School!!!
PCPs are not Impressed with Theories, Lengthy Details or Specific Test Scores. Focus on Final Conclusions and Recommendations!!!
(Brief Interactions or Therapy Sessions)
Diversity of Skills
80-85% of Presenting
Problems should be Managed in the Office
Diversity of Skills
Carry a Tool Box
(e.g. PRIME-MD Patient Health Questionnaire;
Beck Depression, Anxiety, Hopelessness Scales;
Geriatric Depression Scale; Cognistat; Conner’s;
(e.g. Coping with Depression, Relaxation Scripts, AA Meeting Directories, Pointers for Parents with Children with ADHD, Sleep Hygiene)
(e.g. Keep an index of services, support groups, and internet resources for issues of bereavement, cancer, cardiovascular disease, diabetes, domestic violence, fibromyalgia, parenting, pregnancy, senior citizens, social services, substance abuse, STDs, transportation)
“I think Sarah has anorexia nervosa, let’s set up a family meeting”
“In the last 3 months Sarah’s weight has dropped 18 lbs. She hasn’t had a menstrual cycle and she is starving herself intentionally. My findings on the Eating Disorder Inventory-II suggest that she has a high degree of dietary restraint and poor interoceptive awareness. Her body image issues place her at risk for a negative prognosis if we don’t involve her family immediately in her care. Are you comfortable with me setting up a meeting between you, me, the dietician, Sarah and her family?”
Coordination of Care
Patient Contact Reports
# of patients seen, # of patients identified with mental health issue, other relevant tracking data
Pre and Post Physician’s Belief Scales
Trainee Satisfaction Ratings
Patient Satisfaction Ratings
Pre and Post Tests on Knowledge of Primary Care Medicine, Attitudes about the Elderly and Issues in Treating Children
Pre-Grant Scores on the Physician’s Belief Scalefor the DFCM Residents(Higher Scores Reflect More Negative Beliefs about Identifying and Treating Psychosocial Issues)
In Summary, the Training Expands the number of Psychology Interns and Family Medicine Residents that are prepared to work within an Integrated Interdisciplinary Model and Prepares both set of Trainees for a Number of Other Settings