Tips When Reviewing Labs

Topics: Laboratory Testing in Psychiatry | Practice Tools and Tips

Dhwani Shah, MD Associate Clinical Professor of Psychiatry, University of Pennsylvania School of Medicine Lisa Rosenthal, MD Assistant Professor of Clinical Psychiatry, University of Pennsylvania School of Medicine Dr. Shah and Dr. Rosenthal report no financial relationships with any commercial companies related to this article. It’s easy to

The Role of Etiquette-Based Medicine

Topics: Practice Tools and Tips

Using Treatment Guidelines

Topics: Practice Tools and Tips

One way to enhance the quality of our care of patients is to learn and implement expert practice guidelines. But there are some problems. First of all, there are so many guidelines out there that it is hard to know which ones to learn. A related issue is that some guidelines are funded by drug companies standing to benefit financially from the recommend

Outcome Scales in Psychiatry

Topics: Practice Tools and Tips

Should we use outcome scales in psychiatric practice? If so, which ones? Which are actually feasible in terms of time and utility? Relatively few psychiatrists use outcome scales on a routine basis. In one study of 314 psychiatrists, for example, only 6.5% said they “almost always” used scales, and 61% said they never or rarely used such scales (

Using the PHQ-9 in Psychiatric Practice

Topics: Practice Tools and Tips

DEA changes rules to allow post-dating of schedule II substances

Topics: Practice Tools and Tips

Practice Tips: Four Questions to Evaluate Insomnia

Topics: Practice Tools and Tips

Stephen C. Ellen, a psychiatrist and sleep medicine expert who is the medical director of The Counseling Center of Nashua, New Hampshire, recommends the following four questions for a quick initial evaluation of insomnia. How long does it usually take you to fall asleep? (Normal sleep latency is about 10 minutes; while we focus on long latencies fo

Practical Sleep Hygiene Tips

Topics: Hypnotics | Practice Tools and Tips

Is Cognitive Behavior Therapy more Effective than Medication? According to a review in the New England Journal of Medicine, cognitive behavioral therapy (CBT) is at least as effective as hypnotics for chronic insomnia, and probably provides more sustained benefit (Silber MH, NEJM 2005;353:803-810). For example, in one study, young and middle-aged pat

Good Forensic Habits for your Practice

Topics: Practice Tools and Tips

When it comes to legal issues, prevention is by far the best medicine. In this article, we will talk about good forensic habits that will protect you from certified letters signed by attorneys. Much of this advice is gleaned from that classic textbook, Clinical Handbook of Psychiatry and the Law (Gutheil and Appelbaum, Lippincott Williams and Wilkins, 3

Topics in Confidentiality and Duty to Warn

Topics: Practice Tools and Tips

How to Read a Journal Article

Topics: Practice Tools and Tips | Understanding Psychiatric Research

By Jeffrey S. Barkin, M.D. Dr. Barkin has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity. If you are like most busy psychiatrists, reading journal articles is about as entertaining as filling out treatment authorization forms. The good news is that

Handheld Drug Information: Which Software Works Best?

Topics: Practice Tools and Tips

It's another hectic day in the office. You are evaluating a complicated new patient, who presents with multiple medical and psychiatric problems. Over the next 50 minutes, you're going to have to make a number of medication decisions, and you don't have the time to dig around in your bookcase, nor have you spent enough time in the gym to be able to heav

E-prescribing: The Time is Now!

Topics: Practice Tools and Tips

Electronic prescribing allows you to write prescriptions from your computer, and either print them or, in some areas, transmit them directly to a pharmacy. There are many advantages to the practitioner and the patient: most programs provide automatic drug-interaction checks for all the medications a patient is taking, you don’t have to deal with pharm

Internet Resources for Psychiatrists

Topics: Practice Tools and Tips

You’ve probably heard that looking for something on the internet is like taking a drink from a fire hydrant…. We’ve made it a bit easier by describing a few of our favorite websites. www.pdr.net Provides the complete and official PDR information, but searching and entering drug regimens is more awkward than it should be. www.epocrates.com Dr

Computer Technology and Psychiatry

Topics: Practice Tools and Tips

E-mail Communication with Patients

Topics: Practice Tools and Tips

Dr. Grohol, you frequently speak on the use of e-mail in clinical practice. Can you give us some guidelines for how we should most appropriately use e-mail with our patients? The first thing I recommend is that physicians and therapists give a good amount of thought to their own boundaries around e-mail communication with patients. One of the crucial q

How to Bring STAR*D Techniques into Your Practice

Topics: Antidepressants | Practice Tools and Tips

Because the first results from STAR*D make antidepressants look less powerful than we might have hoped, researchers have emphasized another aspect of the study – namely, that it represents a system that allows us to bring research techniques into our practices. And while some statements made in support of the STAR*D methodology come across as pretty g

VNS: Some Practical Information

Topics: Antidepressants | Brain Devices | Practice Tools and Tips

If, after reviewing our admittedly lukewarm evaluation of the VNS data, you decide that you want to offer it to your patients, here’s some useful information. The procedure is being done primarily at major tertiary medical centers now, but this will change over time. Currently, insurance plans pay for the procedure for depression only on a case-by-