Frankel (psychiatry, U. of California at San Francisco), Bourgeois, and Erdberg outline a team-based approach psychiatrists, primary care physicians, and physicians, directors, and administrators in multidisciplinary specialty clinics can use to assess and manage complex patients who have systemic medical, psychiatric, and psychosocial comorbidity and demand a lot from the healthcare system. They detail a medical-psychiatric coordinating physician model for working with these patients, discussing the value of having a treatment team to deal with clinical complexity and focusing on how to arrive at the best possible outcomes, know they are optimal, and be sure that they last, and who should oversee the process. They address aspects like complexity in medical and psychometric testing, the limitations of algorithms, negotiating subjectivity and inter-subjectivity in clinical work, intuition, clinical judgment, strategic thinking, and collaboration with the patient, other physicians, and other healthcare professionals, as well as using the model to organize and optimize care, the role and skills of the coordinating physician, training, costs, and implementation. Example cases are provided. Annotation ©2013 Book News, Inc., Portland, OR (booknews.com)
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An innovative guide for all physicians, especially psychiatrists, who are challenged to work with complex, resource demanding patients.
| Forewords |
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vii | |
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| Preface |
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xi | |
| Endorsements |
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xiii | |
| Acknowledgments |
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xviii | |
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1 Complex treatments: the evolving place for a medical--psychiatric coordinating physician |
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1 | (24) |
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Section 2 Guidance for negotiating clinical complexity |
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2 Beyond the physician-patient model: the value of a treatment team for dealing with clinical complexity |
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25 | (11) |
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3 Sorting out clinical complexity: medical and psychometric testing |
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36 | (12) |
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4 The limitations of algorithms: details of two "clinically complex" treatments |
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48 | (17) |
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5 Negotiating the subjectivity and inter-subjectivity of the clinical field: the complexity inherent in clinical work |
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65 | (16) |
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Section 3 Clinical decisions and their execution: accuracy within complexity |
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6 The intersection of data and clinical judgment: the place of subjectivity in treatment decisions |
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81 | (10) |
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7 Clinical strategy: grappling with treatment complexity |
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91 | (14) |
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8 Working consensus: the importance of physician--patient collaboration |
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105 | (14) |
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9 Linking truing measures: technical and interpersonal precision in work with complex cases |
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119 | (14) |
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Section 4 The application of the model: the medical--psychiatric coordinating physician |
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10 Managing complex treatments: the medical--psychiatric coordinating physician |
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133 | (15) |
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11 The medical--psychiatric coordinating physician: clinical role, training models, costs, and future directions |
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148 | (21) |
| References |
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169 | (9) |
| Index |
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178 | |
Steven A. Frankel, MD has practised and taught in the San Francisco Bay Area for over thirty-five years. He is certified by the American Board of Psychiatry and Neurology in general psychiatry as well as child and adolescent psychiatry, and has authored many professional articles and five books. His Collaborative Psychiatry Method of treatment for non-psychiatrists and psychiatrists alike, is elaborated in Evidence from Within: A Paradigm for Clinical Practice (2008), Making Psychotherapy Work: Collaborating Effectively with your Patient (2007), Hidden Faults: Recognizing and Resolving Therapeutic Disjunctions (2000) and Intricate Engagements: The Collaborative Basis of Therapeutic Change (1995, 2004). Comprehensive Care for Complex Patients: The Medical-Psychiatric Coordinating Physician Model, by Frankel, Bourgeois and Erdberg, dramatically expands the scope of his clinical model, placing a physician in the leadership position of treatment teams. A graduate of Yale Medical School, he was a National Institute of Mental Health research fellow in pharmacology at Stanford University Medical School. He then trained in psychiatry at the University of California Mount Zion Hospital and Medical Center in San Francisco, where he later joined the academic faculty. Dr Frankel then received psychoanalytic training at the San Francisco Psychoanalytic Institute, where he is a member of its faculty. He is an associate clinical professor at the University of California Medical School in San Francisco. He has been designated a Distinguished Fellow of the American Psychiatric Association, has attained certification by the American Psychoanalytic Association, and has been voted by his peers to Best Doctors in America® every year since 1987. James A. Bourgeois, OD, MD is Professor and Vice Chair, Department of Psychiatry and Behavioural Neurosciences, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. He has focused his clinical and academic work on psychosomatic medicine for over 15 years. Philip Erdberg, PhD is Assistant Clinical Professor at the University of California, San Francisco, School of Medicine, USA. He is Director of Research and Assessment at the San Francisco based Masonic Center for Youth and Families.
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