Russell Phillips, MD, head of the Center for Primary Care at Harvard Medical School, makes the case for integrating behavioral healthcare into health clinics, as described in Deborah Olsen’s recent article in Medical Economics.
In discussing his practice at Harvard clinics alongside clinical social workers, he relates that, “When I see a patient who might have depression, I can introduce him or her to a (clinical) social worker and initiate treatment.” This helps to create a relationship—otherwise unlikely to happen—as the clinical social worker engages the patient on-site and removes the need for the patient “to go somewhere else for psychiatric care.”
Phillips alludes to studies showing that most primary care doctors are not successful at referring patients to outside behavioral health providers. They need to get better fast, for the Affordable Care Act requires that most health plans cover preventive services such as depression screening for adults and behavioral assessments for children.
Olsen writes that Phillips recommends a treatment-team approach, as implemented at six Harvard-affiliated practices. There, the teams typically include a “population manager” (often a nurse); a clinical social worker, who provides psychotherapy; and a clinical pharmacist adjusting the medications. A medical assistant screens patients for behavioral health disorders using tools such as the depression-focused Patient Health Questionnaire (PHQ-9).
The clinics affiliated with Harvard’s Center for Primary Care find that patients like a “one-stop shop” within their primary care physician’s office. And clinical social workers appreciate being on a treatment team, rather than simply filing reports with the physician.
How does this form of clinical practice—touted as the wave of the future—sound to you?