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Biomedical subjects

J P Shemo

Publications and source records attributed to J P Shemo.

10 recordsLinked to original sources
PubMed1988

Medical psychotherapy. Clinical application in an inpatient setting.

Under the prevailing Current Procedural Terminology (CPT) billing codes, the function of the inpatient psychiatrist is defined in terms of providing "psychotherapy." Various third-party auditors have raised the implication of fraud when this has not been provided in a standardized fashion. In response, revisions in the CPT codes have been proposed aimed at legitimizing the true responsibilities of the attending psychiatrist. As an alternative solution, I have attempted to briefly summarize the concept of "medical psychotherapy," clarify how this approach would apply in an acute inpatient setting, and outline how it differs from the more classically defined outpatient psychotherapy models.

Humans↗
PubMed1986

Medical psychotherapy: an evolving concept.

The term "medical psychotherapy" is gaining ascendancy in its use to describe the approach to therapeutic intervention used by psychiatrists who conceptualize their function as being at the more medical end of the spectrum of psychiatric practice styles. The following definition represents an attempt to crystallize a model that is in an active stage of evolution. I hope to stimulate continued debate and refinement of the concept.

Humans↗
PubMed1984

Primary care management of mental illness: medication as a tool.

The central position of the primary care physician in providing mental health services in the United States is emphasized by two amply supported research conclusions: (1) more patients with diagnosable mental disorders are treated by primary care physicians than by all of the classically defined mental health disciplines combined; and (2) the majority of persons seeking care from the primary care system not only have no evidence of organic pathology, but have positive evidence that psychologic factors underlie their complaints. These patients frequently present particularly problematic treatment dilemmas in primary care because they so often have ill-defined but tenaciously defended somatic complaints and resist accepting the psychologic implications of their illnesses. Thus their treatment is often conceptualized in terms of "stress management" and psychopharmacologic interventions are frequently used. Adherence to proposed guidelines may help the primary care physician better integrate this aspect of the treatment of these often difficult patients.

Child↗
PubMed1982

A conjoint psychiatry-internal medicine program: development of a teaching and clinical model.

At a time when psychiatry's repertoire of successful treatment strategies is burgeoning and the public is seeking primary medical care with greater emphasis on humanistic issues, psychiatry has been paradoxically losing status and trainees, partly because it has failed to make its expertise integratable by nonpsychiatric physicians. In response to the educational and patient care deficiencies that result, two universities developed a teaching and clinical program that leads to partial integration of their departments of psychiatry and internal medicine. This collaborative approach includes a conjoint internal medicine-behavioral medicine inpatient unit and a residency program leading to Board eligibility in both specialties.

Education, Medical, Undergraduate↗
PubMed1980

Psychiatry as an internal medicine subspecialty: an educational model.

Psychiatry has been integrated into the Department of Internal Medicine at the West Virginia University School of Medicine as a means of ameliorating the educational and patient care deficiencies engendered by the traditional mind-body dichotomy in medical education. A major project derived from this merger of clinical and teaching activities has been the transformation of the university hospital psychiatric ward in to the Conjoint Medicine Service. This service, to which patients with a variety of emotional and medical problems are admitted, is staffed by medical house officers and a general internist in a close collaborative relationship with the Department of Psychiatry. The nursing care is oriented toward patient education, exemplified by group sessions. House staff and students are trained to recognize and evaluate the underlying emotional and interrelational factors which affect each patient's health status and prognosis as a routine part of a comprehensive medical work-up. Student and patient acceptance of this integrated approach has been enthusiastic.

Curriculum↗
PubMed1980

Evaluating a conjoint psychiatric-medical inpatient unit--a one year follow-up study of depressed patients.

In an effort to evaluate a new Conjoint Psychiatric-Medical Unit, depressed patients treated on the service are compared with depressed patients treated on the same unit when it was a psychiatric service. Recidivism, return to responsibilities, and patient satisfaction are the parameters that are compared, and no significant differences are noted. These findings would suggest that the new Inpatient Service appears to be an effective treatment modality for depressed patients.

Adult↗
PubMedDate not supplied

Cost-effectiveness of providing mental health services: the offset effect.

An offset effect occurs when the provision of one type of service leads to a reduction in the use of other related services. This article examines the offset which occurs in medical utilization when mental health services are appropriately provided, especially within prepaid group health care settings. While no study in this area is free of methodologic flaws, the weight of the evidence strongly suggests that, within such settings, the provision of psychiatric input not only provides a service which is indispensible to the concept of comprehensive health care, but also is affordable, in part because of the realization of offset effects.

Cost-Benefit Analysis↗