For one, we need to make technology our friend. Doctors and patients may be averse to the introduction of technology, but that is generally when it distances providers from their patients or seems to produce more work. Examples of advances that have been met with concern include burdensome electronic medical records and other online paperwork that require typing instead of talking during visits. In addition, privacy concerns are ever-present, with too many instances of security breaches, often from human error, not hacking. But these are solvable problems that must be overcome since the alternative is delayed or no care.
A well-known technology solution to improving safety and quality of care is telemedicine, or telepsychiatry for mental health. A psychiatrist, say in Minneapolis, Washington or New York City connects via a secure channel to a remote clinic, hospital or prison and, in live-time, consults on or actually delivers care to a patient (sometimes family as well), thereby assisting local clinicians. While this bridges misdistribution gaps, it does not increase the actual total supply of doctors. It is invaluable, nevertheless, in helping to remedy geographic disparities.
In addition, many patients can be served by brief email, text or Skype interactions. This communication is not only convenient but also a way for patients to receive immediate and interactive medical attention and avoid treatment, rather than wait weeks to spend half a day in the waiting room of a doctor’s office for an eight-minute visit. Financial support for these forms of care has yet to catch up with its needed provision, which calls for prompt policy changes. Today this kind of change is happening in long distance Psychologist & Psychiatrist Services
What is emerging, and it can’t come soon enough, are a set of capabilities delivered by smart phones and wearable devices. Of course, these are no substitute for the human touch. But once a treatment plan is in place these can provide prompts to follow medical and wellness care as well as monitor a variety of information, including vital signs, sleep and physical activity patterns and phone and purchasing behaviors – all of which can signal the risk of relapse and alert clients and caregivers if an intervention is needed. The predictive analytic precision that is being developed is remarkable and beyond any form of monitoring we have had to date. Medical visits may thus be driven by data, not just rote scheduling, thereby also maximizing limited resources.
Psychiatrists, as well, will need to be redistributed from their high concentrations in large urban to more rural and underserved areas. Some actual, literal movement away from cities may happen with more training programs located in cities centered in rural areas as well as by financial incentives (described above) that are tied to where doctors work, not where they reside.
Complex, enduring problems such as these outlined here call for innovative solutions, and often more than one employed at a time to have impact. Tinkering doesn’t cut it. More of the same old meets (what I prefer to consider) Einstein’s definition of foolhardiness. The variety of very plausible solutions offered here will require significant policy and practice changes as well as investment of capital and people. If solving the psychiatrist workforce shortage was easy or inexpensive. we would have fixed the problem long ago.
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