dpc
Why is it such a challenge to get my patients seen by a psychiatrist?
The unfortunate reality is that there is a shortage of psychiatrists throughout New England. Often times, this lack of access results in less-than-optimal treatment or no treatment at all for patients in need of care.
Traditionally, patients have been referred to psychiatry by their primary care physicians for formal consultation when questions have arisen about a mental illness. However, given the limited numbers of psychiatrists in our region, patients simply often linger on wait lists for months to years.
There are other potential difficulties as well. The time and cost associated with regularly meeting with a psychiatrist is not insignificant and can serve as further impediments to treatment access.
What are informal curbside consultations and how can they help me and the patients in my care?
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Informal curbside consultations focused on general medical advice, which take place between primary care physicians and psychiatrists, are one proposed solution for addressing gaps in accessibility and the affordability of psychiatric treatment.
These informal curbside consultations are a well-established practice in medicine and have the ability to increase the quality of patient care, accelerate the transfer of knowledge between specialists and generalists, and provide mutual support amongst physicians.
Collegial discussions are a crucial component of professional development and continuing education. Additionally, we believe that by conferring informally with colleagues, patients get better care and physicians feel better about the care they deliver.
What can psychiatrie.me offer my practice?
We have a fond appreciation and immense respect for direct primary care practices and the dedicated physicians supporting their patients through this innovative care model.
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Given that it is the family physician or internist who is often the first point of contact for patients presenting with a mental health need, psychiatrie.me is looking to partner with DPC practices to ensure those physicians are well supported.
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The program focuses on connecting direct primary care physicians with a board-certified psychiatrist who can provide informal curbside consultations on an as needed basis.
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An important component of the partnerships is the development of an ongoing longitudinal relationship between the DPC physician and psychiatrist. Over time and through experience, the psychiatry consultant and primary care consultee develop a working relationship and an appreciation for each other’s way of approaching problems and devising solutions.
How does this service work?
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The way the program is structured is that a primary care physician would contact psychiatrie.me when there is a question they need help around. This is accomplished by sending an email with a small amount of background and without any patient identifying information.
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Dr. Abreu will review the information contained in the message and will then set up a Zoom meeting to discuss the question(s) and to provide the general medical principles for the primary care physician may wish to take under consideration.
Our goal is it have a turnaround time, from start to finish, of 72 hours. This ensures that you are getting questions answered quickly and efficiently.
How much does this service cost?
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We know that the cost of a formal psychiatry consultation can range from a few hundred dollars to nearly a thousand dollars. We also know that most patients cannot simply absorb these high out-of-pocket costs.
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Our goal is to maintain a low-cost, low-barrier consultative service that meets the needs of caring and thoughtful DPC physicians. The price of an informal curbside consultation is $100. This price covers the time associated with reviewing and responding to the initial curbside request. It also ensures that you can circle back around with Dr. Abreu if other follow up questions emerge over the next two months.
What else should I know about informal curbside consultations?
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It is important to keep these general considerations in mind when requesting an informal curbside consultation:
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- the psychiatrist cannot make or confirm a diagnosis
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- the psychiatrist cannot prescribe medication
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- the psychiatrist cannot provide complex advice
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- the psychiatrist cannot review patient records or history
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- the psychiatrist cannot have access to patient identifying information
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- the psychiatrist does not document in the patient’s medical record
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- the primary care physician cannot refer to the psychiatrist by name either in the medical record or with their patient
These are important considerations as you are deciding whether your patient needs a referral for a formal psychiatry consultation or whether you can address a question through an informal curbside consultation.
Who do I contact if I want to get started?
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The easiest way to get started is to send us a message. Also, please be sure to review our Curbside Consultation Agreement that outlines the same information as above:
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Direct Primary Care - Curbside Consultation
We look forward to hearing from you!