behavioral health

October Physician Focus: Telemedicine

Posted in behavioral health, Health, Health IT, Physician Focus, Primary Care on September 30th, 2016 by MMS Communications – Comments Off on October Physician Focus: Telemedicine

Technology has been rapidly changing the practice of medicine, and one of the fastest growing areas is telemedicine, using such means as video platforms, text messaging, patient portals, and health “apps” that permit communication between physician and patient.

From left: Dr. Dale Magee, Dr. Adam Licurse, Dr. Steven Locke

From left: Dr. Dale Magee, Dr. Adam Licurse, Dr. Steven Locke.

The October edition of Physician Focus takes a look at this emerging area of medicine with Adam Licurse, M.D., a primary care physician and Associate Medical Director of Brigham and Women’s Physicians Organization and Partners Population Health Management, and psychiatrist Steven Locke, M.D., Chief Medical Officer and Co-Founder of iHope Network and member of the MMS Committee on Information Technology.  Hosting this edition is Dale Magee, M.D., a past president of MMS.

The discussion examines the impact of telemedicine on physicians and patients, its advantages and shortcomings, how the field of mental health has acted as a pioneer in the field, how it can help to ease the stigma that prevent patients from getting care, and the concerns clinicians still have with the application of telemedicine in patient care.

Physician Focus is distributed to public access television stations throughout Massachusetts, reaching residents in more than 275 cities and towns. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus and on YouTube.

January Physician Focus: Mindfulness

Posted in behavioral health, Health, mental health, Physician Focus on January 15th, 2016 by MMS Communications – Comments Off on January Physician Focus: Mindfulness

The stresses of daily life – financial pressures, family demands, professional or occupational stress – can Mindfulness1produce fatigue, sleeplessness, and other physical conditions that can harm our mental and physical health.

Mindfulness is an emerging approach that can help patients deal with these concerns by helping them participate in their own health care. Proponents of mindfulness say the practice can reduce stress, improve health, help to manage chronic illnesses such as heart disease or diabetes, and even be useful in treating addiction, substance abuse, and even pain. An approach that came into practice more than 30 years ago, mindfulness is now reaching mainstream medicine, considered to be a way to complement and enhance individual health for people of any age.

The January edition of Physician Focus provides an introduction to mindfulness — how it is practiced, whom it can help, and how it can improve our mental and physical health and overall well-being. Guests are Michael Guidi, D.O. and Jefferson Prince, M.D.

Dr. Guidi (right, photo), is a family physician in Haverhill and Chair of the MMS Committee on Student Health and Sports Medicine. He is engaged in efforts to reduce youth substance abuse by introducing mindfulness to students, parents, and teachers. Dr. Prince (center, photo) is Director of Child Psychiatry and Vice Chair of the Department of Psychiatry at MassGeneral for Children at North Shore Medical Center in Salem, Mass. and is an instructor in the Medical Center’s Mindfulness-Based Stress Reduction Program. Hosting this edition is primary care physician Bruce Karlin, M.D. (photo, left).

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on YouTube.

June Physician Focus: The Other Side of Alzheimer’s: Caregivers and Families

Posted in alzheimer's disease, behavioral health, Caring for the Caregivers, Physician Focus on May 29th, 2015 by MMS Communications – Comments Off on June Physician Focus: The Other Side of Alzheimer’s: Caregivers and Families

Alzheimer’s disease currently affects some 5.3 million Americans, with most of those over 65 years of age, and as our population ages, its incidence is likely to increase: estimates are that by 2025 another two million  Alzheimer'sseniors will be afflicted.

The toll of Alzheimer’s on patients is cruel and tragic, but the effects of the disease go far beyond the patient, to family members and friends who act as caregivers. And that group is large indeed: More than 15 million Americans provide unpaid care for people with Alzheimer’s and other dementias, according to the Alzheimer’s Association.

To provide some perspective of the impact on caregivers, the June episode of Physician Focus features two health care professionals from Summit ElderCare in Worcester, one of six PACE programs (Programs of All-Inclusive Care for the Elderly) in Massachusetts.

Guests are Susan Hardy, M.D., (photo, center) a board-certified internist with a subspecialty in geriatric medicine and Summit’s Associate Medical Director, and Brenda King, Psy.D., (right) a clinical psychologist with specialties in health psychology and gerontology and Summit’s Behavioral Health Specialist. Hosting this edition is Bruce Karlin, M.D.

The conversation explores such areas as the many demands required of caregivers and families, the difficulties they face, the emotional and physical toll that caregiving takes, the importance of early recognition and planning, the resources available for help, and how a team approach can enhance care.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on YouTube.

January Physician Focus: Smoking, Tobacco, and Health

Posted in behavioral health, Physician Focus, Public Health on December 31st, 2013 by MMS Communications – Comments Off on January Physician Focus: Smoking, Tobacco, and Health

Fifty years ago this January, then-U.S. Surgeon General Rear Admiral Luther Terry, M.D.  issued the nation’s first comprehensive report on the dangers of tobacco. The landmark document  marked the start of the nation’s public health campaign against tobacco and smoking.

Since that first effort in 1964, 36 additional reports on tobacco from the Surgeon General have followed, testifying to the topic’s critical importance and the intensity of the campaign.

Although the last five decades have seen much progress in reducing tobacco use among all ages, tobacco is still the leading cause of preventable disease and premature death in the U.S., contributing to more than 440,000 deaths annually. Nearly 44 million Americans still smoke, and tobacco use claims a huge portion of the nation’s health care costs – at $96 billion a year.

The January edition of Physician Focus, Smoking, Tobacco, and Health, examines the impact of tobacco on personal and public health on the 50th anniversary of the Surgeon General’s report.

It looks at how far we’ve come in reducing tobacco use since that first report, tobacco’s particular link to young people, what can be done to further reduce the use of cigarettes and other tobacco products, the challenges posed by new products such as e-cigarettes, and ways for people to quit smoking.

Guests are Alan Woodward, M.D. (photo, right), Chair of Tobacco Free Mass, a member of the Massachusetts Public Health Council, and a past president of the Massachusetts Medical Society; and Douglas Ziedonis, M.D., M.P.H. (center), Professor and Chair of the Department of Psychiatry at the University of Massachusetts Medical School and UMass Memorial Health Care, and a Distinguished Fellow of the American Psychiatric Association. Hosting this edition is James Kenealy, M.D. (left), a physician with ENT Associates in Framingham.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and online at www.massmed.org/physicianfocus and www.physicianfocus.org.

December Physician Focus: Violence and Mental Illness

Posted in behavioral health, Health, mental health, Physician Focus, Public Health, violence on December 2nd, 2013 by MMS Communications – Comments Off on December Physician Focus: Violence and Mental Illness

Mass killings such as those at the Washington Navy Yard earlier this year and in Aurora, Colorado and Newtown, Connecticut last year continue to raise alarms about the link between violence and mental illness. A recent Gallup poll found that nearly half of Americans – 48 percent – blame the mental health system “a great deal” for mass shootings and for failing to identify individuals who are a danger to others.

The December episode of Physician Focus offers a perspective on the topics of violence and mental illness and explores the link between them.

Guests are John Bradley, M.D. (center, photo), Chief of Psychiatry and Deputy Director of Mental Health for the Veterans Administration Boston Healthcare System and former Chief of Psychiatry at Walter Reed National Military Medical Center, and Michael Tang, D.O., M.P.H. (right), psychiatry resident at Harvard South Shore Psychiatry, a program of Harvard Medical School. Hosting this program is John Fromson, M.D. (left), Vice Chairman for Clinical Affairs of the Department of Psychiatry at Brigham and Women’s Hospital and Chief of Psychiatry at Brigham and Women’s Faulkner Hospital.

Among the topics of conversation are the definitions of violence and mental illness, predictors and risk factors for violent behavior, the pervasiveness of violence in daily life, the role and impact of the media in covering violent acts, the relationship of violence to firearm access, and whether, as public opinion polls suggest, the mental health system has failed in identifying individuals who may commit violent acts.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and online at www.massmed.org/physicianfocus and www.physicianfocus.org.

August Physician Focus: Complicated Grief

Posted in behavioral health, mental health, Physician Focus, Uncategorized on August 2nd, 2013 by MMS Communications – Comments Off on August Physician Focus: Complicated Grief

Grief is a universal phenomenon, reaching all of us at one time or another following the loss of a loved one. Most people, after a period of mourning, adapt successfully to the loss and begin to move forward. Some, however, find it much harder to accept the loss and develop what is called complicated grief.

Complicated grief, which can affect a person’s physical and mental health, has just been recognized as a new diagnosis (called “persistent complex bereavement disorder”) in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5. It is the subject of discussion in the August edition of Physician Focus.

Naomi Simon, M.D., (photo, right) Director of the Complicated Grief Program and Director of the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital in Boston, joins colleague and program host John Fromson, M.D., (photo, left) Associate Director of the Center, to discuss complicated grief, how it affects individuals, and how it is treated.

The conversation includes such areas as the prevalence of the condition; its characteristics; the differences among complicated grief, depression, and post-traumatic stress disorder; the roles of “avoidance” and “isolation” in extending complicated grief; the influence of religious and cultural traditions in dealing with grief; how the diagnosis of complicated grief came to be recognized; and how it is treated.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and also available online at www.massmed.org/physicianfocus , www.physicianfocus.org  and on iTunes at www.massmed.org/itunes.

 

Physicians Take Notice: Suicide Rates are Increasing Dramatically

Posted in behavioral health, Medicine, mental health, Steve Adelman on May 23rd, 2013 by MMS – Comments Off on Physicians Take Notice: Suicide Rates are Increasing Dramatically

By Steve Adelman, MD

Earlier this month, the CDC’s Morbidity and Mortality Weekly Report (MMWR) presented alarming data comparing age-adjusted suicide rates between 1999 and 2010.

Historically, the two major causes of death of younger people have been motor vehicle accidents and suicide. As motor vehicle accident deaths have gone down, suicides have gone up: 2009 was the first year in which the number of people who put an end to their lives themselves was greater than the number who lost their lives in car accidents.

Overall, the suicide rate jumped by 28.4% among persons aged 35-64. The rate of increase was even greater for whites, American Indian/Alaska Natives, older women (60-64), and people living in the West. As usual, in most successful suicides the cause of death is firearms.

To put the numbers in perspective, let’s think about a busy, multispecialty ambulatory adult primary care practice that employs a group of 4 internists, 2 nurse practitioners and a physician assistant. In the course of a year, perhaps 12,000 unique patients are seen in the office. A practice of this sort in Massachusetts, New York or New Jersey is likely to see one patient die by suicide per year. In Midwestern practices of this size, a second patient suicide would be predicted.

Suicide, not murder, is the most prevalent form of firearm death in this country. What is the role of primary care physicians in addressing this worrisome, growing public health problem?

Provide an opening: Give patients in the office enough time and space to talk about the things that worry them and weigh on them. A question like, “Is there anything else going on that you’d like to share with me? “ may give permission for a suicidal person to open up. A comment like, “Sometimes the most important stuff is the hardest to talk about….I’m all ears,” followed by enough time for the patient to think and open up, can make a difference.

Know your patient’s psychiatric history: Many elements in a patient’s history elevate the risk of suicide: a history of previous suicide attempts, a known mood disorder, a history of a substance use disorder, recent losses, and family history of suicide. Take the time to know your patients, and get help from mental professionals, as appropriate.

Clarify access to firearms: As firearms are the commonest proximate cause of violent deaths, physicians should understand whether or not their patients have access to firearms. It is appropriate to be worrying about high-risk patients with access to firearms, and to address this risk factor with the help of the patient’s family, mental health professionals, and, in some cases, the police.

Let patients know that the channels of communication are always open: People who know that they can always call and reach a health care professional have a place to turn when all else fails. Make sure that your practice has accessible 24/7 coverage, and that those covering know what to do when somebody suicidal calls for help.

In my next  post, I plan to discuss an important related topic: physician suicide. We have always been a high risk group, and this is especially worrisome in view of the recent overall increase in suicide.

Dr. Adelman is director of Physician Health Services, Inc., a corporation of the Massachusetts Medical Society. For more information, visit www.physicianhealth.org. Opinions expressed here are his own, and do not necessarily reflect those of the Massachusetts Medical Society or Physician Health Services.