Comprehensive Care for Complex Patients

by Frankel, Steven A., M.D.; Bourgeois, James A., M.D.; Erdberg, Philip

• ISBN13: 9781107025158
• ISBN10: 110702515X
• Edition: 1st
• Format: Hardcover
• Copyright: 2012-11-30
• Publisher: Cambridge Univ Pr

Summary

'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.

Table of Contents

Preface

Foreword

Introduction

Clinical complexity: the evolving place for a medical-psychiatric coordinating physician

Beyond the physician-patient model: the value of a treatment team for dealing with clinical complexity

Guidance for Negotiating Clinical Complexity

Sorting out clinical complexity: medical and psychometric testing

The limitations of algorithms: details of two clinically complex treatments

Negotiating the subjectivity and inter-subjectivity of the clinical field: the complexity inherent in clinical work

Clinical Decisions and their Execution: Accuracy Within Complexity

The intersection of data and clinical judgment: the place of subjectivity in treatment decisions

Clinical strategy: grappling with treatment complexity

Working consensus: the importance of physician-patient collaboration

Linking truing measures: technical and interpersonal precision in work with complex cases

The Application of the Model: The Medical-Psychiatric Coordinating Physician

Managing complex treatments: the medical-psychiatric coordinating physician

The medical-psychiatric coordinating physician model: its components, costs, and future

Bibliography

Index

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