Dr. Hernandez has 30 years of experience as a psychologist working with physicians in a major hospital and in the community.  Now in private practice, she continues to endorse and provide such service to providers and their patients, and networks with other providers.  She writes:

“Over fifty percent of patients who present in a primary care setting come for other than the medical problem they report; sometimes there are underlying psychosocial problems causing stress-related disease or exacerbating pain, but more often a physical symptom or pain is an excuse to seek help from a health provider.  In fact, the psychosocial issues in people’s lives that impact upon their well-being are significant enough that on any day a psychologist could walk into a busy hospital clinic and find a full day’s work.  Up to 40% of patients coming to primary care physicians (PCPs) need some form of mental health treatment, but less than 10% of them actually get to a mental health provider for reasons stemming from the stigma associated with seeking such treatment to the difficulty of making a separate appointment and getting to the mental health offices.  More than two-thirds of PCPs report finding mental health care for their patients quite difficult.  Even when they do identify a mental health provider, patients often do not follow through.  The research showed that when there was a mental health provider available at the primary care office, some 90% of those patients enter treatment.

Integration in healthcare is brought into the forefront again by the American Psychological Association (APA) and the American Medical Association (AMA).  The APA Monitor regularly describes integration of psychologists into various disciplines of medicine, including primary care and palliative care.  The APA and the AMA have recently worked together to offer diagnostic codes for psychologists who treat medical patients so that they can bill appropriately for their time.  Their intention was to move integrative health care forward; even in the era of increased specialization in both the AMA and the APA, or possibly because of it, this has helped.

Two areas where interdisciplinary care is essential are palliative care and chronic pain management.  Here, the psychologist may actually take the lead in care provision, addressing the psychological and spiritual aspects of the patients’ changing position in society.  Again, coordination of care with physicians is very important, and it requires a unique and practiced set of skills.”