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Primarycareshrink.com
Добавлен 20 окт 2006
A series of podcasts for viewers interested in primary care behavioral health, in particular the behavioral health consultant model. This podcast is hosted by the CEO of the Collaborative Family Healthcare Association.
You Can Work With Kids!
Empowering Behavioral Health Professionals: Effective Strategies for Working with Children
Dr. Neftali Serrano, CEO of the Collaborative Family Healthcare Association (CFHA), shares insights on integrating physical and behavioral health, specifically within primary care. He provides valuable tips on working with children and families in exam rooms, emphasizing curiosity, room management, and focusing on parental involvement. Dr. Serrano also highlights CFHA's upcoming fall conference and physician leadership training. The episode aims to build confidence among healthcare professionals in handling pediatric cases, offering structured approaches and practical advice for effective interventio...
Dr. Neftali Serrano, CEO of the Collaborative Family Healthcare Association (CFHA), shares insights on integrating physical and behavioral health, specifically within primary care. He provides valuable tips on working with children and families in exam rooms, emphasizing curiosity, room management, and focusing on parental involvement. Dr. Serrano also highlights CFHA's upcoming fall conference and physician leadership training. The episode aims to build confidence among healthcare professionals in handling pediatric cases, offering structured approaches and practical advice for effective interventio...
Просмотров: 25
Видео
I Can Do Mental Health In Primary Care As A Career?
Просмотров 455 месяцев назад
If you are thinking of a career in mental health this video encourages you to think about primary care as an exciting, fast growing option. Behavioral Health Consultants play a key role in providing behavioral health support to patients of all ages in a convenient, one-stop approach that combines medical and mental health support.
Grief In Primary Care
Просмотров 908 месяцев назад
1. Introduction and Sponsorship: Dr. Neftali Serrano introduces himself and his affiliation with the Collaborative Family Healthcare Association (CFHA), which sponsors the podcast. 2. Importance of Grief in Primary Care: Dr. Serrano emphasizes that grief is a common topic in primary care, especially during the holidays. He highlights the need to address this important aspect of patient care. 3....
CoCM & PCBH
Просмотров 16011 месяцев назад
Dr. Serrano discusses how CoCM and PCBH work well together and poses the notion that models are necessary but not sufficient for the aspirations of integrated care. Join us for our annual conference: integratedcareconference.com.
BHC Self-Management
Просмотров 14211 месяцев назад
How do you manage your time and routines on a day-to-day basis as a BHC? Dr. Serrano addresses how to go about setting good routines that keep you on your game in primary care as a Behavioral Health Consultant. What are your key routines?
5 Minute Clinical Hot Tip: Matching Stage of Change To Dosing & Care Plan
Просмотров 56Год назад
Dr. Serrano addresses how to use the stages of change to dose and plan care with a patient in an integrated primary care setting. For more on the CFHA conference: integratedcareconference.com.
This Conference Is A Must For Your Career
Просмотров 49Год назад
Dr. Serrano gives you a quick primer on the breadth of opportunities at the upcoming CFHA conference. Even if you are not attending this can be a great way to think about your career development.
Reaction Video! Beachy & Bauman, When You Don't Feel The Warm and Fuzzies For PCBH Consults
Просмотров 83Год назад
Dr. Serrano reacts to a PCBH Corner video. Check the original out yourself: ruclips.net/video/Lj0apTMhVFU/видео.html. The video covers struggles with a PCBH/ primary care identity.
Sleep & The BHC Consult
Просмотров 170Год назад
How do you intervene with patients struggling with insomnia? Dr. Serrano covers the basics of CBT-I.
Air Traffic Control: Handling Multiple Consults In PCBH
Просмотров 69Год назад
Air Traffic Control: Handling Multiple Consults In PCBH
To Refer or Not Refer, That Is The Question!
Просмотров 145Год назад
To Refer or Not Refer, That Is The Question!
Dosing & Titrating Care For Integrated Care
Просмотров 135Год назад
Dosing & Titrating Care For Integrated Care
The Contextual Interview: Love, Work, Play, Health, Spirituality
Просмотров 321Год назад
The Contextual Interview: Love, Work, Play, Health, Spirituality
What does the PCP do in integrated care?
Просмотров 100Год назад
What does the PCP do in integrated care?
3 Tips For A Successful Career In Integrated Care
Просмотров 159Год назад
3 Tips For A Successful Career In Integrated Care
How To Get Connected To The World Of Integrated Care
Просмотров 602 года назад
How To Get Connected To The World Of Integrated Care
The Best Way To Get Continuing Education Credits For Integrated Care
Просмотров 3313 года назад
The Best Way To Get Continuing Education Credits For Integrated Care
#1 Hot Tip For Mental Health Professionals Transitioning To Primary Care
Просмотров 7733 года назад
#1 Hot Tip For Mental Health Professionals Transitioning To Primary Care
Trying to get things done at your clinic
Просмотров 4388 лет назад
Trying to get things done at your clinic
Maintaining The Boundaries of the BHC Role
Просмотров 1,5 тыс.9 лет назад
Maintaining The Boundaries of the BHC Role
Currently researching this for my thesis! Thank you for a clear picture of the role 🙏🏽
Instead of the BHC trying to read all of your nonverbal cues, how about the providers clearly state verbally what their preference is? that would eliminate all the confusion of BHC trying to guess what you might be asking for or not.
'Promo SM' 🙃
great explanation and the easiest way put it together to be understood thanks doctor
I had to Google what a BHC stands for. :) Thank you for the video!
Fantastic! Thank you!
Thank you, Dr. Serrano! Your explanation of SOAP note is precise and direct. My professor, JP, at CSUEB referred me to watch your video.
I needed this today! I often feel like I'm battling to make my setting more PCBH, but I am the only BHC in my system and I serve two clinics. This means there are days in each clinic where they do not have a BHC on site, and it's been difficult to work on buy-in. Thank you for validating my PCBH-ish framework, while hopefully we will be able to increase our workforce and move to a more PCBH model soon.
Spot on. Most of the time IMO...folks are struggling with the 1st scenario you went through...where the health system doesn't have what the person needs...the clinician panics and erroneously concludes they need specialty care! Thank you for taking on this topic!!!!
🙏 "promo sm"
As far as text goes, I'm copying it in here as best as I can from a formatting perspective. Hope this helps - it is built for EPIC. ASSESSMENT: PT with (1***), related to (2***), in the context of (3***). Patient would benefit from (4***). Stage of change: {Stage of change: 5 xxxxx} Intervention Type: {BHCintervention: 6} Diagnosis: {Current visit dx: 7 xxxxxx} PLAN: 1. F/U with behavioral health consultant {Time Interval: 8}. 2. Medications: {Medication: 9}. 3. Behavioral recommendation(s): A. 10 *** B. *** SUBJECTIVE: Pt here for {11 INITIAL CONSULTATION/ REFERRAL/ FOLLOW-UP/ OTHER:} regarding 12 ***. {13 Gender/Parent:} reported the following symptoms/concerns: 14 *** Progress towards prior plan: {15 BHCprogress:} Duration of problem: {16 BLANK:19884::"1-2 Weeks","2-4 Weeks","1-3 Months","3-6 Months","6-12 Months","Several Years","Lifelong Course","Lifelong Course With Waxing & Waning","Lifelong Course With Recent Exacerbation"} Severity: {17 BHCSeverity:} OBJECTIVE: Referred by: {18 BHCpcp:}. Orientation & Cognition: Oriented x3. Associations logical, no gross signs of thought disorder. Mood, Affect: {19 bhcmood:}. Appearance: Appropriately dressed and groomed. Harm to self or others: {20 BHCHarm:} Substance use: {21 BHCSubstanceuse:} Psychiatric medication use: {22 BHCmeds:} Health risk behaviors: {23 BHChealthriskfactors:} Completion of screening measures: 24 Yes/ No; {25 Screening Measures:} -------------------------------------------- Time spent face-to-face with patient: 25 *** minutes -------------------------------------------- @ME@ {BLANK:19884::"The patient was informed of the following characteristics of their care within the primary care medical home at XXX Community Health Centers: a. Behavorial health providers operate as consultants to the medical team and not as stand-alone providers of care, b. All information discussed with team members as applicable/appropriate will be documented in the shared electronic health record and visible by all care team members, c. The Behavioral Health Team works as a group providing care to all Access patients and as such a patient is likely to work with multiple Behavioral Health providers. Patient consented to meet with BHC."} ------------------------ *Note that the elements in {brackets} would be drop down or list elements in EPIC that are unique to your build. In other words, you can't copy this into EPIC and have the lists work, but you can easily replace the lists with similar lists in your iteration of EPIC
thank you for this! Is your progress note template available for universal use?
Love your videos, I am working as a BHC ,the concept is not new to me but I had to have a better understanding of how to proceed and your video have been helpful.
Thank you for this breakdown
#PAIN contracts are not #contracts at all! They are 3 pages of 37 itemized reasons for so-called PAIN doctors to DISCHARGE patients in agony!
638
Thanks. I learned a lot from this video!
SOWK 638
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This role wears a hat of crisis intervention specialist The hat of a broker. The hat of an advocate. The hat of a motivational interviewer. The hat of problem solver.
If a patient knows they will be in a lot of pain if their doctor discontinues their pain med for not improving in function, they are likely to lie about their activities.
Agreed
@@morganrose6974 When people are getting enough pain medication and feeling better, they tend to increase their function naturally. But nowadays, function assessment has become another hoop to jump. Another threat to your ability to receive pain meds and stay out of agony. They expect you to perform at higher levels with less opioid relief. Some doctors call their patients' relatives to see if they are functioning well enough. No privacy rights for a pain patient? Even with close family, a doctor shouldn't be discussing his patients' issues without their written permission. As more hoops and assessments are added to the pain system, sadly people feel themselves trapped in corners and find themselves (and their families) lying and covering up in order to continue receiving opioid pain relief.
Is there a template of this available
This was excellent! Thank you.
For just Three months, my very own daily attack of sleeping disorders has finally gone. The sleeping remedy , Sυnodoz Plan , Go ogle it , that I followed had ended up saving me costs from purchasing medica tions. Prior to all these, I can simply acquire 3 or 4 hours of good rest. When I started out making use of the plan, I had been able to achieve 7 straight hours of rest..
😍😍😍😍😍😍
Dr. Serrano, your videos are incredibly helpful! Thank you. Is it possible for you to provide a transcript of each of your videos? Some You Tube creators enable that option below their videos. I found your introduction to IBH to be useful and would love to read along as I listen to it again. Thank you for your time, knowledge and dedication to providing quality information and service.
Hmmm... I'll have to look into that!
Thank you this was very helpful, however i think that you should also physically write out a few SOAP notes to give to the viewer an idea of what it looks like
Thank you.
no volume
@NEFTALI SERRANO, PSYD. Why don’t you just say in the video you’re title )? “DR”may be technically correct, but it’s misleading and silly
I
Thanks a lot very helpful
This is so helpful! Thank you! I am new to the role and in orientation period trying to figure out scheduling etc.
Jayden
Thank you, that was helpful!
HI. Do you have an email where I can reach you? I am a LCSW with Veterans Affairs and would like to ask a few questions. Also, to get your approval to share your videos. Thanks!
Excellent overview of the three models
This was very helpful to me. Thank you so much. I also have to say that the Leg Lamp in the background was the perfect addition. LOL!
Do you have any recommendations for using ACT in BHCs?
thank you! very helpful in understanding the vocab associated with integrated care models
hi dr. serrano! i just wanted to say thank you so much for your videos. i am a counseling student that is interested in working in an integrated care model in the future and have been watching your videos to get more information!! a question i have for you is, for me who is just a student in mental health counseling (going to graduate with an m.a), what steps should i take and what should i study in order to hopefully end up in a clinic and prepare myself as best possible. thank you!
Dr Serrano, your podcast have been helpful. I appreciate your willingness to share your knowledge and experience.
Basically decentralized V. centralized management, inclusive V. exclusive care team and improving quality of life V. improving level of care appearance.
How much time, if any, do you spend on the phone with patients, doing case management-like activity? (i.e. referring a patient to a community-based mental health specialty practice when their treatment needs are greater than what a BHC could provide in a 20-30 minute encounters.) And, if you do spend time on the phone, how is that time recognized by your agency? Our productivity is measured by # of face-to-face encounters, %of encounters that fill out the PHQ-9. Our PCP's will often request that we contact one of their patients to help them get connected with a psychiatrist and/or therapist in the community, so I contact the patient and help them negotiate the complicated system of getting connected with a provider who can address their treatment needs. And, do you get directly involved in filling out patient's FMLA forms and short term disability forms. If we have seen patient a few times, and the patient is out of work due to a mental health condition, our PCP's will ask us to fill out these forms.
Good question.A good BHC uses a phone effectively as a tool, often for phone check ins in between visits with patients and sometimes well-developed phone consults where you are actually performing interventions over the phone with a patient. Of course, unfortunately, none of this is reimbursable at this point. what a good BHC avoids doing however is doing an extensive amount of social work case management. That role is distinct and requires its own personnel (for example referrals to housing or assistance with filling out paperwork etc.). In general I depend as much as possible on patients to initiate their own contact with specialty mental health agencies as facilitating these contacts can be very time-consuming. Of course in select circumstances I may go the extra mile for a patient if I know certain barriers will exist to keep the patient from accessing those services. In general the rule is you shouldn't be referring out more than about one out of every 10 patients you see, if that.
O.K. that seems to be generally in line with what I am doing. In general, when referring patients out to specialty practices, I give phone #s and websites to practices that I know is geographically in reach and taking their insurance. On some occasions, when I assess that the patient has much difficulty negotiating the system, I will make a speaker phone call together with the patient in the exam room to connect them with a provider. To me it seems to gave great impact to have that 'warm hand off' from me to that provider (even if it's the provider's admin assistant)...it's helping the patient make that connection. I'm curious about the 1/10 referring out ratio. I would like to have that conversation with my BHC peers and maybe you on how we make that decision. I'm thinking about the number of patients I see who present with PTSD, or those who are encountering behavioral health for the first time; and they present with unprocessed significant family of origin experiences (usually some form of trauma) that bubble up and interfere with their ability to engage in current daily health behaviors.
Hi Dr. Serrano: I just want to let you know that I enjoy and value your podcast entries. I have been embedded in a large primary care practice for 2 years. At the time that I started, there was not a clear definition of what my role would look like there. So I have utilized your guidance to help me find my way in the practice. And, now I have 12 fellow BHC's in other primary care satellite offices doing what I do. So, I emailed them links to your youtube podcasts, and we recently had discussions about our work, utilizing your work as a springboard. So, thank you!
Great description of how Behavioral Health Consultants can assist PCP in saving time and providing a broader spectrum of care.
Thank you, doctor. I'll be using this in my work.
Excellent!
Thanks for sharing. Documentation and Epic are continued struggles for our providers. Do you do any diagnostics assessments or health and behavior assessments in primary care? (In Minnesota we are required to even though it's primary care. ) If so, what does that look like? Any tips or tricks for making that more efficient for your PCBH providers?
We do not have such requirements. Are these requirements state based or policies of your organizations or payers? In many states I have found that providers are actually told something, either by payers or by their organizations but the requirements are nowhere to be found in state law. As for efficiency, EPIC is a very click heavy software unfortunately, but certainly creating smart phrases helps.
Primarycareshrink.com Thanks for your response. I actually met with the Minnesota Department of Human Services and they reiterated that we needed to conduct diagnostic assessments in primary care prior to initiating any course of treatment. We advocated for change of this requirement in primary care but so far have been unsuccessful. I was hoping you had some magic tricks for documenting. We have some smartphrase and work closely with our EHR department, which has resulted in improved smartphrases. I welcome more video podcasts on use of technology in PCBH. Thanks again.