Restraint rules for young people are filled with troublesome provisions. The Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration) want to change some of the restraint use rules that apply to Medicaid residential facilities for patients under the age of 21.
My Office Door - Poetry of the Times
What is abandonment? Who is responsible? Where is the line drawn between no liability to treat and abandonment? Read how psychiatrists can protect themselves from the legal ramifications of abandonment.
The doctor/patient relationship has become more complicated and less effective with the introduction of third-party managers into the payment process. The authors propose a middle path solution to this problem that emphasizes clear, up-front communication in order to ensure fairness, privacy and informed consent.
Were you unable to attend the annual meeting of the American Psychiatric Association in May? Read the first part in a series of summaries of important new research presented there.
In the current climate of psychiatric medicine, changes that greatly impact a psychiatrist's time, income potential and career enjoyment are constantly occurring. Is a career in psychiatric administration and academics a rewarding combination?
When treating alcohol-dependent patients, clinicians may be well advised to integrate disulfiram into the treatment plan. Who are good candidates, and who are not? How can you enlist the aid of family members and friends to ensure compliance?
With an increasing number of drugs in the pipeline, the efficacy and safety of drug trials become even more important. Who are the various entities sponsoring these trials, and what are their goals?
In this narrative of his patient, the author illustrates how the involvement of managed care in mental health treatment can thwart the therapeutic process and demean both doctors and patients.
In 1995, the American Board of Family Practice and the American Board of Psychiatry and Neurology issued a white paper describing board requirements for residency training programs that combine the specialties of family practice and psychiatry. The first few students of these programs have graduated and are on their career paths. Might this be an opportunity for you?
The ranks of the elderly are swelling, yet fewer and fewer physicians are choosing to practice geriatric psychiatry. What will be the impact on older patients who receive their mental health care from primary care physicians?
The issue for us is whether positive thinking is relevant in certain situations. Would it help, or would it create more problems than it would solve?
On May 3, U.S. Surgeon General David Satcher, M.D., launched a national plan to reduce the suicide rate in the United States. A collaborative effort by the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Health Resources and Services Administration, the National Strategy for Suicide Prevention maps out 11 goals and provides a blueprint for action on those goals.
The great debate over whether to allow psychologists to have prescribing privileges continues. What is ultimately the best for the patient's well-being? Ali Hashmi, M.D., a practicing psychiatrist from Arkansas, tells both sides to this story, and offers his opinion on the matter.
What Makes a Psychiatrist Cry - Poetry of the Times
The threat of a bioterrorist attack is very real and should be of real concern to those in the health care field. While federal government budgets have been requested to address the mental health aftermath of such attacks, they have been repeatedly denied. Psychiatrists will be needed to help treat panic and hysteria among populationsthose who are affected, those who are not but believe they are and those who are left to pick up the pieces.
There are three types of integration practiced by psychotherapists: Common Factors, Assimilative Integration and Theoretical Integration. How do they differ from each other, and how does psychotherapy integration differ from an eclectic approach to therapy?
In addition to improving patients' emotional well-being, aggressive treatment of psychiatric illnesses such as depression can substantially increase patients' cognitive functioning and even decrease mortality. A growing number of psychiatrists and other medical doctors are joining forces to create integrated care settings where the diagnosis and treatment of mental disorders occurs alongside that of physical illness.
Can brain scans show a difference between drug therapy and psychotherapy? A researcher at University of California at Los Angeles uses positron emission tomography to observe the difference in brain changes between these two types of treatment for major depression.
Since adolescent patients often retreat into fantasy worlds of their own making, they can be difficult to treat. Psychotherapists can create a common fantasy world for successful group therapy with the use of popular fiction books, television series and movies.
After the recent decade of the brain and in the present era of evidence-based practice, psychoanalytic treatment of personality disorder is being challenged.
Is consent necessary for medical records to be utilized for treatment, payment and health care operations? The medical records privacy rule demands it. Will prepayment and postpayment audits by insurance companies be cut back? The Medicare Education and Regulatory Fairness Act of 2001 is an attempt to solve this and other issues.
With so many Americans lacking appropriate health care insurance and so much of the large insurance companies' premiums going to overhead and profit, it makes sense to move forward with a single payer system. The author discusses some of the basic features of a proposed system.
Poetic License - Poetry of the Times
Carveout programs for behavioral health care are becoming more common. Who do they benefit3/4the patient, the doctor or the insurance company?
Stephen R. Shuchter, M.D., professor of clinical psychiatry and associate director of residency training at University of California, San Diego, spends his "down" time performing as Elvis and other rock 'n' roll legends. In these efforts, he expresses his creativity and brings delight to those he entertains. Lessons from each "career" have helped his success in the other.
Stemming from evolutionary man and his simple, primitive act of help in exchange for help and Darwinian theory, Paul Genova, M.D., discusses the role reciprocal altruism plays in the "helping profession" of psychiatry.
Is there a difference between bifrontal, bitemporal and right unilateral? In addition to talking about other research into optimal strength and electrode placement, Max Fink, M.D., outlines some of his own ongoing research.
This is the second part of an article series discussing the high risk of suicide attempts in patients with schizophrenia. Herbert Y. Meltzer, M.D., continues the discussion with treatment options and efficacy.