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Biomedical subjects

B Reifler

Publications and source records attributed to B Reifler.

8 recordsLinked to original sources
PubMed2000

A managed behavioral health organization operated by an academic psychiatry department.

As a means of adapting to managed care, the psychiatry department at Wake Forest University developed a managed behavioral health organization (MBHO) to manage the care of enrollees in QualChoice, the health maintenance organization of the Wake Forest University Baptist Medical Center. Before the academic MBHO was created, care was managed by a for-profit MBHO. In this case study, financial and utilization data were obtained from both MBHOs and from QualChoice. The data confirm that the academic MBHO was able to offer competitive rates for its services. It also was able to increase enrollees' use of the medical center's own providers and facilities by making more referrals than were made by the for-profit MBHO. Developing a managed behavioral health organization can allow academic psychiatry departments, either individually or as consortia, to preserve the patient base they require for teaching, research, and financial stability.

Academic Medical Centers↗
PubMed1982

Psychiatric diagnoses among geriatric patients seen in an outreach program.

Over 2300 patients referred to a geriatric outreach program were evaluated for the relationships between diagnosis and (1) referral reason, (2) referral source, and (3) age. Referral reason was only a clue to the eventual diagnosis. Patients referred for depression received a diagnosis of depression in only 46 per cent of such referrals, and patients referred for forgetfulness or confusion received a diagnosis of dementia in only 37 per cent of these referrals. Families were most likely to refer demented patients, and health agencies to refer depressed patients. Apartment managers and housing authority representatives were least likely to refer depressed patients and most likely to refer paranoid patients. The rate for diagnosis of dementia increased with age, whereas the rates for diagnoses of depression and alcohol/drug abuse decreased with age.

Aged↗
PubMedDate not supplied

Social anxiety disorder. A guide for primary care physicians.

Social anxiety disorder is prevalent, potentially disabling, but quite treatable. A thorough and directed history can distinguish social phobia from depression, panic disorder, and OCD. It can also screen for and identify possible substance abuse. Once the diagnosis is made, a combination of pharmacologic and psychotherapy is indicated. The SSRIs, MAOIs, benzodiazepines, and beta-blockers--as well as CBT--can effectively treat social anxiety symptoms. Primary care physicians may well want to begin by prescribing an SSRI like paroxetine, along with a high potency benzodiazepine to be taken on a regular or an as-needed basis, and a beta-blocker to take as needed in anticipation of stressful social situations. A referral for CBT should be considered. If the patient has marked side effects from drug treatment or a lack of adequate response to medication, psychiatric referral is definitely indicated.

Adult↗