Comprehensive care for complex patients: the medical-psychiatric coordinating physician model

Preface; Forewords James Rundell, Roger Kathol, and Wolfgang Soellner; Part I. Introduction: 1. Clinical complexity: the evolving place for a medical-psychiatric coordinating physician; 2. Beyond the physician-patient model: the value of a treatment team for dealing with clinical complexity; Part II. Guidance for Negotiating Clinical Complexity: 3. Sorting out clinical complexity: medical and psychometric testing; 4. The limitations of algorithms: details of two clinically complex treatments; 5. Negotiating the subjectivity and inter-subjectivity of the clinical field: the complexity inherent in clinical work; Part III. Clinical Decisions and their Execution: Accuracy Within Complexity: 6. The intersection of data and clinical judgment: the place of subjectivity in treatment decisions; 7. Clinical strategy: grappling with treatment complexity; 8. Working consensus: the importance of physician-patient collaboration; 9. Linking truing measures: technical and interpersonal precision in work with complex cases; Part IV. The Application of the Model: The Medical-Psychiatric Coordinating Physician: 10. Managing complex treatments: the medical-psychiatric coordinating physician; 11. The medical-psychiatric coordinating physician model: its components, costs, and future; Bibliography; Index.

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'Complex patients' are a sizeable population who generally require disproportionate attention for their management and respond poorly to treatment. Their systemic medical, psychiatric and personal needs have a tendency to drain or exceed the capabilities of those who treat them whilst overutilizing health care resources. As this patient population grows, we move ever closer to a crisis in health care delivery. This volume presents an innovative team-based approach for assessing and managing diagnostically complex and management intensive patients. The physician-led 'Medical-Psychiatric Coordinating Physician (MPCP)' model not only improves patient treatment, but also provides for the containment of costs by reducing redundancy and curbing excess in the use of services. Other benefits include improved diagnostic accuracy and decision making, as well as better communication among physicians and allied health professionals. This book is essential reading for psychiatrists, primary care physicians, and physicians, directors and administrators working in multidisciplinary specialty clinics.