by Judy E. Hall, PhD
Health Service Providers in Psychology (HSPP) may practice in independent practice settings, however, a larger percent practice in institutional settings. Many follow the traditional and often cumbersome specialty referral model, simply working beside other health care professionals, referring to each other as necessary. A more exciting model is practiced by a small but growing number of HSPPs: the integrated healthcare model (IHC). This model requires psychologists to physically practice in an integrated health or primary care setting. Psychologists in these setting have demonstrated that they are effective team players, add incredible expertise to the understanding of the mind-body relationship, and are actively engaged in the design and evaluation of evidence-based treatment programs.
In this issue, we provide five different examples of the IHC practice setting (also frequently referred to as primary care). Three examples profiled have pursued the IHC model for many years and have periodically published the results of those efforts; two others are newer and offer fresh insight on the training model that leads to effective HSPP inclusion.
This is your opportunity to learn from your colleagues and perhaps influence or expand the way you practice. We all recognize our healthcare system needs restructuring. One of those fixes involves moving healthcare to an integrated model, as our authors argue.
There are many reasons for recommending an IHC model to psychologists. IHC presents an excellent opportunity for HSPP to demonstrate their competence as doctoral level health care professionals and eventually increase their scope of practice and level of involvement in primary care. Secondly, it has been repeatedly demonstrated that the IHC model is effective and reduces healthcare costs especially in terms of unnecessary or inappropriate medication. As experts in behavior, properly educated psychologists can play an important role in assisting in proper medication management. Third, we know that the specialty referral model for health care provision suffers from lackluster patient follow up (and thus failure to achieve results needed) and sufficient funding. As a result of these inefficiencies, funds are wasted on services or products that could be applied to funding more health care practitioners. Fourth, opportunities already exist to train psychologists at the practica, internship and postdoctoral level. Finally, the integrated health care setting provides a perfect opportunity for psychologists who have obtained a postdoctoral masters degree in psychopharmacology to collaborate with physicians and thus obtain the supervised training needed to supplement the education contained in the master’s degree. (For more information on the program designation criteria approved by the ASPPB/National Register, go to http://www.nationalregister.org/designate_psychopharmacology.html.)
There are also many reasons to recommend the IHC model to consumers. The patient is treated by a team of healthcare professionals who address both physical and behavioral issues, with screening for or anticipation of other incipient problems. This leads to efficient one-stop service provision for the consumer. The members of the family or the community are typically involved in supportive treatment. Unnecessary or inappropriate medication is reduced. Patient satisfaction increases. Who can argue with those results?
While sufficient literature exists in various journals to educate those who are not familiar with the details of this model, we have pulled together in this issue five examples of integrated practice where psychologists work together with other healthcare professionals to identify, treat, and prevent healthcare impairment.