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Brian Costello, MD, Clinical Program Development Associate, Quartet
November 17, 2016 - 12:00pm

Targeting behavioral health to lighten the load on physicians

Nearly half of the US population suffers from at least one chronic health condition, and as anyone working in healthcare can tell you, managing a chronic health condition is no easy task. On top of dealing with difficult symptoms, patients with chronic health conditions are asked to follow challenging treatment plans and to quickly learn new behaviors to manage their health effectively. This is inherently stressful and can make engaging in treatment even more difficult. 

Early behavioral health interventions are the solution for patients with chronic health conditions. These interventions reduce stress, decrease symptoms, increase adherence to treatment plans, promote self-management, and lead to better patient outcomes. Yet, these interventions are not included as standard of care for chronic health conditions. This needs to change. For all chronic health conditions, behavioral health interventions should be considered first-line adjunctive treatment.

There is ample evidence demonstrating that behavioral health interventions can improve patient outcomes. For example, a stress management-focused cognitive behavioral therapy program was shown to reduce recurrent stroke and mental illness by over 40% for those with coronary disease (Archives of Internal Medicine). 

And, more generally, patients in general behavioral health focused self-management programs for chronic physical health conditions saw a reduction in common symptoms; improved medication adherence, communication with physicians and quality of life; and fewer ER visits and hospitalizations (Medical Care). 

Why is this important? 

Stress management and disease self-management are not quick fixes, and there simply isn’t enough time in a primary care provider's schedule to deliver all the care patients need. In fact, to provide all of the recommended preventive services and provide best practice care for patients with chronic conditions, the average PCP would have to work 18 hours per day. Adding in the time needed to provide care for acute health conditions brings the total hours per day to 22.6 hours (Institute for Healthcare Improvement). Let behavioral health specialists lighten the load.

Screening all patients for depression and anxiety with validated instruments like the PHQ-9 and GAD-7 is a starting point. Quartet provides this service. In addition, when a patient is newly diagnosed with a chronic health condition, struggling to manage their current condition, or has a decline in their health, physicians can refer their patients to behavioral health providers who can support in the management of their condition. 

 

Brian Costello MD is a Clinical Program Development Associate with Quartet. Prior to joining the Quartet team, he developed Aging Well, a wellness program for seniors, and worked as a healthcare consultant.