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Learn more about our new psychiatry model for collaborative care
Frequently asked questions
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What do we mean by Collaborative Care Psychiatry?
Collaborative Care Psychiatry is when our psychiatrist cares for you in coordination and partnership with your primary care provider. Another term for this is Integrated Care.
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Why do we recommend collaborative psychiatry?
Because doing so provides you with the highest quality care and most improves your overall health. Other important reasons to receive psychiatric care this way are safety, wellness, and efficiency.
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Why is collaborative psychiatry safer for me?
In this model, there is more responsible oversight of controlled substance prescriptions, which is important due to their potential for addiction and the risks of combining controlled substances with other medications. Controlled substances being prescribed by more than one provider is a common occurrence, but can easily be avoided by us collaborating with your primary care provider. When appropriate, we will provide our recommendations to them and request that they prescribe you these types of medications in order to help avoid duplication of prescriptions, excessive use of the medications, and medication conflicts.
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Why will I get more fully well with collaborative psychiatry?
Studies repeatedly show that your overall health can be most improved by coordinating your mental and physical health care. Also, we realize that sometimes controlled substances are necessary to treat your condition, and we want you to receive the optimal treatment rather than offering you an alternative or second choice medication. As part of our collaborative approach, we may also recommend nutrition and/or talk therapy services to help you achieve optimal wellness.
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Why is collaborative psychiatry more efficient?
Health care costs and inconveniences are rising due largely to redundancy of services caused by poor communication between providers. To manage your conditions responsibly, laboratory and diagnostic testing and specialist referrals are occasionally needed either for accurate diagnosis or ongoing monitoring. As with controlled substances, these recommendations will be made and carried out through your primary care provider, again avoiding duplication of tests and providing the best coordination of your care.
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What is the role of the psychiatrist in the collaborative care?
The psychiatrist will perform the initial psychiatric evaluation and all follow up visits with you, make a diagnosis and revise it as necessary over time, and prescribe you the psychiatric medications needed to get you well. With your permission, after each visit he will send a copy of the visit note to your primary care provider so they know what medications have been prescribed for you. The only medications the psychiatrist will not prescribe to you directly are any controlled substances, but he can recommend in his note that your primary care provider prescribe those for you. Other things the psychiatrist may recommend to your primary care provider are to order any lab tests, diagnostic studies, or specialist referrals that the psychiatrist may feel are important in managing your condition.
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What are controlled substance medications?
Certain medication that are potentially addictive are considered “controlled”, and can only be prescribed by a provider who has met you in person first, as per the federal regulation, The Ryan Haight Act of 2008. Examples of controlled medications are:
- Benzodiazepines - used for anxiety, panic, sleep disorders, tremors, and seizures - include medications such as Xanax, Ativan, Restoril, Valium, Klonopin, and Librium
- Hypnotics - used for insomnia - include medications such as Ambien, Ambien CR, Lunesta, and Sonata
- Stimulants - used for ADD/ADHD, fatigue, depression, cognitive issues, and narcolepsy - include medications such as Dextroamphetamine, Adderall, Vyvanse, Dexedrine, Methylphendiate, Ritalin, Concerta, Focalin, Provigil, and Nuvigil
- Opioids, used for pain, and will not generally be recommended by psychiatrists
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How might I get controlled medications from my primary care provider?
Once your primary care provider has received the visit note from your psychiatrist recommending these medications be prescribed for you, you can call your primary care provider’s office and see if they will call those medications into your pharmacy for you to pick up. Your primary care provider may want you to schedule and come in for a visit with them first before they will prescribe these medications in some cases. In other cases, you may find that your primary care provider does not want to work collaboratively and does not agree to help you in this way. Should this be the case, one option is to consider finding a primary care provider who believes in collaborative care, wants to see that you get the help you need, and is willing to be part of this safe and thoughtful process.
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What is my primary care provider’s role in this collaboration?
The primary care provider’s role in collaborating with the psychiatrist is to receive and review the visit noted sent by your psychiatrist, and consider following the recommendations that have been made. These recommendations may include prescribing a controlled medication, ordering laboratory or diagnostic tests, and making a referral to a specialist for evaluation of other possible relevant conditions. The primary care doctor will see that copies of all such tests and evaluations are sent back to the psychiatrist for his record. Finally, if the primary care provider has any concerns over how the psychiatric medications may be affecting your physical health or other medical medications, he will communicate this to your psychiatrist for his consideration.
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How do my psychiatrist and primary care provider communicate with each other?
Besides regularly sharing notes and test results back and forth, there will be a secure voicemail line for your psychiatrist that your primary care provider will have access to allowing them to either speak on the phone or leave each other messages. It is very important that you do not use this voicemail to communicate with your psychiatrist, as it is for primary care providers only and using it may prevent other doctors from being able to communicate with our psychiatrists. Please be aware that your psychiatrist will not respond to messages left on this line by patients.
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How do I receive this collaborative psychiatric care?
Call your primary care provider’s office and obtain their office fax number. You will need to enter your doctor’s fax number on our platform to enable us to coordinate your care. When you call your primary care provider’s office, inform the office that you will be getting your psychiatric care online and that they will be getting a note from your psychiatric visit outlining your diagnosis and treatment plan which may contain specific requests for your primary care provider. Advocate for yourself by explaining that you would like for them to work together with your psychiatric provider, who will be available to discuss your care with them anytime.
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What if I don’t currently have a primary care provider or I find that the one I have doesn’t want to work with me in this way?
You can still receive psychiatric care with us even if you don’t have a family doctor. However, without this collaboration, we won’t be able to prescribe you any controlled medications should you need them.
If you do have a primary care provider but find that they do not support a collaborative approach, your best option may be to find one that does. You deserve a provider that cares about your overall health and wellness, wants to see that you get the help you need, and is interested in being an active part of a safe and thoughtful process that has proven to achieve the best outcomes.
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Is there any additional cost for getting collaborative psychiatric care?
There is no additional cost to get all of the many benefits of our collaborative care psychiatry.