The Psychiatric Consultant supports the PCP and Behavioral Health Care Manager (BHCM) in treating patients with behavioral health problems. This role can be performed by any psychiatric expert who can assist the primary care team diagnosis, treatment planning and recommendations about changes in treatment when the patient is not at least 50% improved after 10-12 weeks on any given treatment plan.
The Psychiatric Consultant may suggest treatment modifications for the PCP to consider, recommend the PCP see the patient for an in-person consultation, or consult on patients who are clinically challenging or who need specialty mental health services. The consultant does not see the patient, except in rare circumstances, and does not prescribe medications. The psychiatric consultant is available to the BHCM and the PCP during business hours for ad hoc consultation as needed.
· Provide regularly scheduled (usually weekly) caseload consultation to behavioral health care managers. Case review consultations focus primarily on patients who are new to the caseload or who are not improving as expected under their current treatment plan. Case reviews may be conducted by telephone, video, or in person.
· Work with behavioral health care managers to oversee the status and population health of their assigned patient caseload. The psychiatric consultant uses a registry to track all assigned patients and prioritize patients for case review and treatment adjustment. Registry functions can be accomplished through an EHR build, on a spreadsheet used in conjunction with an EHR, or can be built into a stand-alone clinical management tracking system that may or may not be linked to an EHR.
· Recommend any treatment adjustments through the case review process or in ad hoc consultations, including medication recommendations and other interventions, within 24 hours of consulting with a behavioral health care manager or other team members.
· Advise on treatment for patients who may need more intensive or more specialized mental health care, supporting treatment in the medical setting until patients can be engaged in specialized care as appropriate.
· Clearly communicate the limitations of the case review consultation and treatment recommendations if the patient is not evaluated in person. The following disclaimer statement is an example of how to acknowledge these limitations in consultation notes in an EHR:
“The above treatment considerations and suggestions are based on consultation with the patient's behavioral health care manager and a review of information available in registry. I have not personally examined the patient. All recommendations should be implemented with consideration of the patient's relevant prior history and current clinical status. Please feel free to call me with any questions about the care of this patient.” 6. Be available to provide occasional ad hoc telephone consultation to primary care providers for very complex patients or challenging patient situations. Respond to telephone calls from primary care providers and behavioral health care managers within one business day. Respond to urgent telephone calls within one hour, if available. Coordinate with other psychiatric consultants for vacation coverage.
· Board certified or board eligible in child and adolescent psychiatry
· Demonstrated ability to work in collaborative care virtual clinic with psychology, social work, pediatricians, other child psychiatrist, and case managers
· Strong knowledge in childhood disorders-ADHD, depression, anxiety, mood disorders, autism spectrum disorders
· Work with children from ages 3-4 through early childhood
· Comfortable prescribing medication for children
· Able to provide consultation along with feedback and guidance to other team members in the clinic regarding difficult patients
· Positive, flexible, and solution-focused attitude
· Ability to quickly synthesize medical and psychiatric data and formulate effective and evidence based clinical recommendations
· Board-eligible in psychiatry.
· Experience with primary care psychiatry or consultation-liaison psychiatry.