Physicians with medicine/psych training can help complex cases

(HealthDay)—Physicians boarded in both medicine and psychiatry can offer a way to address some of the challenges associated with caring for medical patients with psychiatric comorbidities, according to an article published in Psychiatric Times.

Noting that patients with psychiatric issues frequently receive substandard medical care in the hospital setting, the article discusses combined training for physicians in medicine and psychiatry as a potential solution to these problems. The combined training is five years in duration, and the number of programs is increasing slowly, although interest seems to be outpacing growth.

In a case vignette describing a patient in his 30s with type 1 diabetes, bipolar disorder, and relatively new-onset congestive heart failure who was notorious for becoming agitated and signing out against medical advice, the article describes how med/psych residents were able to deal with the situation. Providing effective care for the patient did not require much additional time or effort but did require extra training. Psychiatry residents are taught to deal with agitated patients and de-escalate situations. By approaching the patient with kindness and empathy, the residents were able to form a therapeutic relationship with him.

"While there are not currently many of us, the med/psych physician is perfectly poised to work with these complicated patients, as well as to provide education to our peers on both the medicine and psychiatry sides of the issue," according to the article.

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