As we mature in our efforts to improve healthcare in America, one of the lessons we have learned is that we need to focus more on people and less on diseases. Our patients want and need us to be present with them in ways that make for meaningful, therapeutic connections. We have also learned that we cannot do this alone. We must coordinate our efforts and strengthen relationships with our staff and other colleagues.
All of us need to be on board—physicians, RNs, MAs, and behavioralists—for this to work well.
One way we have achieved this at Confluence Health is through the integration of behavioral-health professionals within our practices. We started with a focus on primary care. Some studies show that up to 70 percent of patients seen in primary care bring some issue related to behavioral health to their visit.
Each behavioralist (primarily a psychologist) is assigned to a team of four to eight physicians and advanced practice providers, and is asked to keep their schedule mostly open for same-day appointments. There is regular dialogue with the teams on “how to use each other best.” Patients with a behavioral-health need are then invited to see our behavioral-health colleague in real time.
So far, the results have been very positive. Patients and care teams feel better supported. We are doing depression screening with reflex-suicide prevention screening for nearly every patient seen; we are also able to act quickly on those cases with positive screening tests. Most importantly, instead of ignoring these challenging conversations due to a lack of time or expertise, or referring patients to a specialty department elsewhere, we have been able through this process to enhance relationships with our patients and clearly improve the quality of our care.
We continue to learn from this model and are expanding to other specialties. We think this is a good example of “whole-person care, drawing on the whole team.”