Mental health care in DPC

(Robin Dickinson) #1

I’m curious if anyone has an on-site mental health provider? It’s the one thing I really love about the PCMH model/payment is that most of the ones I know have on-site mental healthcare of some sort. It seems harder to manage in a DPC model. At the same time, all the patients are less work if their emotional/social needs are met so I keep thinking how lovely either a social worker (case management plus therapy) or therapist would be.

(cjs56) #2

FQHCs use much social workers mostly because they are cheaper than psychologists. They work hard. But, I think a DPC family medicine physician is quite capable enough to do the mental health without need for an ancillary provider…unless dealing with severe schizophrenics/borderline who may be suicidal…like many adult and adolescent patients in CA.
With the hour appointment, I believe it would be quite relaxing to do mental health in a DPC practice. Look at all the time you have. Further, think about how John D. Rockefeller would run a business. He would watch every penny. And, then donate some of his time/money to another needy cause.

(Robin Dickinson) #3

Yes, I spend the majority of my time essentially functioning as a therapist. I teach CBT, mindfulness, self care, etc. That said, I do not think that takes the place of weekly therapy. And I can’t do EMDR for trauma, which a majority of my patients need.

(cjs56) #4

There may be psychologists or social workers who have completed school and may be looking to do a so-called “externship” whereby they may do volunteer work (even part time) at an office in order to gain experience to be used at a later job.
So, those professionals may be productive in a D.P.C. practice that needs a bit of mental health counseling for its patients and at no cost for the D.P.C. practice.
Check with the University of Colorado or other residency programs who may know of such people.
The same is true in California where many of the medical assistants have no experience at all.
A F.Q.H.C. is their first job. Many tell me that they had to work at other sites first to get experience (even a refugee clinic).
Hope that helps.
I am posing a question on the “New Topic” section regarding Single Payor that I hope to get feedback from and learn.