NHMH NO HEALTH WITHOUT MENTAL HEALTH A 501(c)(3) non profit   San Francisco - Washington DC

Q1: Do you use a PHQ-9 on all your patients?

Why: A Patient Health Questionnaire is a list of 9 questions on your general mental health, how you are feeling, etc. It is what’s called a rating scale that helps doctors identify any common mental disorders (e.g. depression, anxiety, substance abuse, etc), and if more serious mental disorder, arrange for a referral to a specialist in mental health. This form, to be completed by the patient, should be part of a routine office visit.

Here is some reference information to gauge the PHQ [in PDF format]

Q2: Is your practice following a PCMH or ACO care delivery model, or plan to?

Why: PCMH (patient-centered medical homes) and ACO (accountable care organizations) are new ways to provide patients with high quality, efficient, evidence-based health care that is cost-effective and importantly leads to better health results. Typical features include use of digitalized electronic records and communications, integration of medical and behavioral health care, collaborative care teams, including patient, patients registries and care managers who help patients handle referral to specialists, keep appointments, stick with medications, etc

Q3: Does this practice integrate mental health and substance use care?

Why: High-quality, high-value medical practices today now means treating BOTH physical conditions and behavioral health (mental health + substance use). Behavioral health problems like depression or anxiety, alcohol or drug (including prescription drug) abuse are among the most common and disabling conditions. They often co-occur with medical conditions like diabetes, heart disease, asthma, cancer etc). If BH problems are not treated, they can worsen or prevent recovery from the medical conditions. Most patients prefer an integrated approach in which primary care and mental health doctors work together to address medical and behavioral health needs. Some medical practices have a psychiatrist or psychologist right in their offices, others refer their medical patients to such BH specialists. But a key feature is that both the medical doctor and mental health professional work closely together sharing appropriate patient information and discussing both medical and mental health care.

Q4: Do you have a care manager on your staff?

Why: A care manager is a health care professional – usually a nurse practitioner – who is a member of the doctor’s staff and the patient’s health care team, who works under the supervision of the primary care doctor. The care manager performs vital functions beneficial to patients, such as facilitating patient’s visits to outside referrals (doctors, clinics, hospitals, rehab, nursing homes etc), monitoring patient’s adherence and tolerance of medications, answering questions, helping keep appointments, etc.

Q5: Do you offer e-consultations and appointments beyond 9-5?

Why: Medical practices are now modernizing to become more “patient-centered” – that means the patient – YOU! – is part of, and at the center of, a the health care team, all coordinated by your care doctor. A key feature of this new type of medical practice is listening to the patient and hearing what he/she wants to see in their health care, and considering how care can be delivered more efficiently and conveniently to the patient, utilizing modern technologies such as email, websites, twitter, etc. These changes lead to a much more efficient practice.

Q6: Does your practice use electronic health records?

Why: Bringing medical offices into the modern age includes using digitalized electronic health records which gives all the doctors in your health care team better, faster information and helps you and them in making key health decisions. Electronic health records will also allow practices to collect and analyze medical information (with personal identifiers left out) on a population-wide basis, giving all of us better knowledge and data about health, disease, treatments, recoveries, etc. Data collection, using latest technology, is essential for a high-quality, high-value medical practice. And it helps give all of us more information on which to base our health care decisions.

Q7: Do you practice evidence-based care and utilize comparative effectiveness research?

Why: A high-quality medical care practice uses, and is based on, the latest findings of science and medicine. Right now, doctors own professional organizations confirm that just 50% of health care has an actual scientific basis. This has to change to ensure doctors, while utilizing their own knowledge, experience and judgment, ALSO pay attention to and incorporate evidence-based knowledge. Comparative effectiveness research refers to research that compares various treatment options for their results. Research that provides hard data on effectiveness, risks, harms, benefits etc of an array of treatment options.

Q8: Do you offer and share patient satisfaction surveys?

Why: This speaks for itself! A vital part of patient-centeredness in a high-quality medical practice is listening to the patient. Patient satisfaction surveys give doctors the feedback they need from their patients on a broader basis, and actually saves the doctors time in learning what their patients are thinking and how they are reacting to changes in the practice.

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