June 2002 • Volume 8 • Number 6 |
To the editor:
I'm responding to "FPs Should Be Paid for Mental Health Care" in the March FP Report. As a fourth-year combined FP/psych resident, I find it difficult to have enough time to appropriately manage patients with psychiatric issues in a busy family practice setting. I insist that they see me in the psychiatric clinic and/or with other auxiliary mental health care providers.
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Regarding one comment in the article -- "We control costs by providing the care we're trained to offer instead of referring the patient to a subspecialist" -- just because you get four weeks of orthopedic surgery training as a resident does not mean you can go out and practice this on your patients any more than two weeks of psychiatric training allows one to practice psychiatry.
When antidepressants are started by FPs, many do not even inquire about suicidal ideation, psychosis or a history of bipolar disorder. There is often no follow-through after starting medications. If FPs want the responsibility of prescribing and managing mental health care for their patients with psychiatric illnesses, they must also realize they're opening themselves up to the major reason psychiatrists get sued: not routinely asking about suicidal and homicidal ideation.
Laurie McCormick, M.D.
Tulsa, Okla.
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