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2022-08-22

Common Q's: Psychiatry consults

Primary care providers (PCPs) play an increasingly large role in the diagnosis and management of mental and behavioral health conditions. Often times, a quick and collaborative discussion between the PCP and a local psychiatrist is enough to optimize a patient's care plan within the primary care setting.

We often get queries about which types of questions make good psychiatry consult requests. We asked a Virtual Hallway psychiatrist for their most commonly received, yet effective, consult questions.

Making a diagnosis

Patient’s symptoms don’t always point to an obvious diagnosis. Often, it takes a historical review, physical examination and investigation to figure out what might be going on. Consulting with a psychiatrist during this process can help narrow the diagnostic possibilities and aid in formulating a plan for the next steps in a patient’s care. 

Managing complex patients 

Often times, PCPs manage notably complex patient cases with little, or no, psychiatry support. Virtual Hallway consults with a psychiatrist can aid in educating a patient on their condition, as well as understanding how to approach care and select the best models of delivery.

Psychotropic medication 

Psychotropic medications are one of most complex sets of medications to prescribe. Phone consults with a psychiatrist are a great way to clarify and confirm dosages, combination strategies and discuss second/third line options.

Waiting for an in-person referral

When a patient is referred for an in-person psychiatric assessment, they will most likely face a long wait (a year or more in some cases). Managing a patient's condition as they wait is critical to their care - Virtual Hallway consults enable access to specialist input on emerging or ongoing challenges. In some cases, specialist advice is enough to optimize the care plan and their in-person appointment may no longer be required.

Confirmation of existing plan 

Many Virtual Hallway consults are simply to review, discuss and provide confirmation by a psychiatrist that the existing care plan is reasonable given the patient’s presentation. A second opinion only takes 10 minutes, instilling confidence and confirmation on the best path forward.

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