Top 10: Ways for Primary Care Providers to Know It May Be Time to Refer to Rogers

Introduction

Behavioral health issues are part of the fabric of our human existence, but few people understand them and even less people understand how they can be treated. People who suddenly find themselves in the middle of a crisis having to do with mental health issues don’t know where to turn. They end up visiting a primary care physician or a psych ward at a local hospital. Sometimes this is all that is needed, other times, the patient and/or family need more specialized or depth of care than a primary care provider can give.

In these situations, primary care providers may ask themselves two questions. How do I know when it is time to refer my patient? Or why are providers consistently choosing Rogers Memorial Hospital? The main reasons based on feedback Rogers receives are:

• Excellent communication with the primary care provider
• Overall consistency and rich history of being leaders in behavioral health
• Experts in the field who not only understand behavioral health, but lead the way in helping treatment evolve into something that works better and better over time.
• Structured programs using proven methods of care like: Cognitive-Behavioral Therapy (CBT) for anxiety and OCD and Dialectical Behavioral Therapy (DBT) informed care for eating disorders.

Effective referral begins with a good consulted-consultant relationship that includes familiarity with each other’s needs and idiosyncrasies. The process will, in part, hinge on expectations and knowledge each has of the other.

10. Substance use has reached an unhealthy level. Treating the symptoms of addiction is not typically something a primary care provider would refer for. However, when addiction becomes more prominent in a patients ill-health, specific substance-use disorder treatment may be needed.
9. Medication administration. There are times when a primary care provider or general practitioner may not feel comfortable or be qualified to administer certain types of medications, such as Suboxone(buprenorphine).
8. Drain of resources. Psychiatric care often has different billing, insurance, patient satisfaction and other requirements that can be time consuming in a small primary care practice. Because this is our focus, Rogers is prepared for nuances and understands the approaches specific to behavioral medicine.
7. Changes in weight or sleeping patterns. When major depression sets in or an eating disorder takes over a thought process, changes in normal living can happen with little or no medical explanation. Providers have learned that this “red flag” may be time to get a specialized behavioral health provider in the loop.
6. Physical symptoms manifested from mental illness. When a healthy patients show symptoms such as ulcers and/or high blood pressure, that cannot be otherwise medically explained, a general practitioner may refer to Rogers.
5. Family dysfunction. A physician may refer to a psychiatry specialist when family problems may interfere with diagnosis and/or treatment.
4. Confirmation of a mental health diagnosis. The primary care provider understands their patients well and symptoms of mental illness are clear. The provider strongly believes in the diagnosis, however, depending on the severity of the condition they may seek a specialist for a second opinion.
3. Proper assessment. There are situations where care providers must be board certified and licensed in order to render a diagnosis or rule out certain types of mental illness.
2. Continuum of care. There are situations where a stepped down continuum is needed for proper treatment of a mental illness. Treatment may start off very intensive and as the patient recovers less intense treatment is needed.

The number one reason why Primary Care Providers refer to Rogers?

1. Concern for a patient’s well-being and safety. Today there are many specialists providers can refer to in situations that may be beyond their particular expertise. We work closely to facilitate relationships with other health care professionals to support them and their patients in these sometimes difficult situations.

Rogers Memorial Hospital has an outreach staff communicating with primary care providers the depth and breadth of the services available to patients and families.