Transcript Survey of Combined-Trained Physicians 2010

Why Do Combined Training?
2010 Survey of Combined-Trained Physicians
Jane P. Gagliardi MD
Rationale for This Survey
• Medical students need honest information
about combined training!
Rationale for This Survey
• Students in institutions without combinedtrained physicians hear the following:
– Billing is too complex; better to do one
specialty rather than two (or more)
– Most people end up doing one or the other
specialty in their post-training lives
– Condensed education would lead to deficient
training in both fields
Participants
• Past and current members of the
Association of Medicine and Psychiatry
• Solicited anonymously through email
• Email sent 7/6/2010
• As of 7/16/2010: N=33 respondents
Results
27/33 (84.4%) Internal Medicine/Psychiatry
5/33 (15.6%) Family Practice/Psychiatry
Board Certification
100% of Respondents are Board-Certified:
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ABIM
Internal Medicine, Psychiatry,
Psychosomatic Medicine
Internal Medicine
IM and Psych
med and psych
ABIM & ABPN
Family medicine, psychiatry, hospice and
palliative medicine
IM & Psych
Internal Medicine and Psychiatry
Internal Medicine, General Psychiatry,
Psychosomatic Psychiatry
Int Med, General Psych, Psychosomatic
Med, Geriatric Psych
ABIM, ABPN
medicine and psychiatry
ABPN, psychosomatic medicine
ABFM, ABPN
ABIM and ABPN
Family Medicine, Psychiatry, Psychosomatic
Medicine
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Internal Medicine and Psychiatry and
Endocrinology and Metabolism
Internal Medicine and Psychiatry
IM, Adult psych, Psychosomatic Medicine,
Geriatric Psychiatry
Medicine, Psychiatry, Psychosomatic
Medicine
Psychiatry & Neurology
IM and Psychiatry
IM and psych
Internal Medicine and Psychiatry
Psychiatry, Psychosomatic medicine,
emergency medicine (never took IM boards)
Family Medicine and Psychiatry
internal medicine, psychiatry in process (part
II pending)
ABPN ABFM
ABPN
Internal Medicine, Psychiatry, Geriatric
Medicine, Geriatric Psychiatry
9/33 (27.3%) Yes
24/33 (72.7%) No
Fellowships
(n=9 of 33; 27.3%)
• Consultation-Liaison Psychiatry
(Psychosomatic Medicine) (3)
• Endocrinology and Metabolism (2)
• Academic Fellowship in Primary Care
Research
• Internal Medicine
• Clinical Research Training Fellowship
(NIMH)
• Geriatric Medicine
Work Settings
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Academic inpatient psychiatry unit
Academic combined medical-psychiatric
inpatient unit
Academic general medicine service
Academic C/L
Academic medical or primary care clinic
Academic Psychiatric Consultation Clinic
Medical school
Federal Public Health agency
Previously worked as private practice
medicine-psychiatry hospitalist (medicine
service)
Private practice psychiatric clinic
Academic medical or primary care clinic
Academic inpatient psychiatry consults
Private practice combined clinic
Academic medical or primary care clinic
Academic psychiatric clinic
Academic medical or primary care clinic
Academic psychiatric clinic
Hospice medical director
Private practice psychiatric clinic
Private hospital inpatient psychiatry unit
Private substance abuse inpatient unit
Consult-liason psychiatry
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Academic combined clinic
Academic medical or primary care clinic
Private hospital consult
Academic medical or primary care clinic
Academic psychiatric clinic
Academic hospitalist in medicine
Inpatient Psychiatry Consults
Academic inpatient psychiatry unit
Academic medical or primary care clinic
Academic combined clinic
Academic inpatient psychiatry unit
Academic combined medical-psychiatric
inpatient unit
Skilled Nursing Facility
Academic medical or primary care clinic
Academic hospitalist in medicine
Private practice med or primary care clinic
Private practice specialty medical clinic
Private practice psychiatric clinic
Private practice inpatient medical specialty
Consultation-Liaison
Private practice psychiatric clinic
Academic medical or primary care clinic
Academic psychiatric clinic
Academic hospitalist in medicine
Work Settings
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Service Chief at an Academic VA Hospital
Academic specialty medical clinic
Academic substance abuse clinic
Academic combined clinic
Academic inpatient psychiatry unit
Academic combined medical-psychiatric
inpatient unit
Private practice psychiatric clinic
Private hospital inpatient psychiatry unit
Geriatric Psychiatry Unit
Academic combined medical-psychiatric
inpatient unit
Medical management consulting
Cover for consult psychiatrists at county
hospital occasionally
Private practice combined clinic
Private practice psychiatric clinic
Academic combined clinic
Academic inpatient psychiatry unit
Psychiatry Research
Academic medical or primary care clinic
Academic specialty medical clinic
Academic psychiatric clinic
Academic combined clinic
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Private practice psychiatric clinic
Academic medical or primary care clinic
Academic inpatient psychiatry unit
Private practice psychiatric clinic
Private practice combined clinic
Academic medical or primary care clinic
Academic combined clinic
Academic inpatient psychiatry unit
Academic combined medical-psychiatric
inpatient unit
Academic inpatient psychiatry unit
Academic hospitalist in medicine
Academic combined medical-psychiatric
inpatient unit
Psych CL
I consider myself a MedPsych hospitalist :)
Academic medical or primary care clinic
Academic psychiatric clinic
Academic psychiatric clinic
Academic medical or primary care clinic
Academic combined clinic
Academic inpatient psychiatry unit
Academic hospitalist in medicine
Academic consultation-liaison
28 of 33 (84.8%) respondents report inpatient work in the last 12 months
25 of 33 (75.8%) respondents report outpatient work in the last 12 months
Table: Clinical Activities over the Last 12 Months
N=33 respondents as of 7/16/2010
NHP = nursing home psychiatry
Periop = perioperative medicine
30/33 (90.9%) Yes
3/33 (9.1%)
No
Administrative Roles
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Educational
Associate Dean
Assoc Dean of Hospital Affairs
Director of Medical Education
Director of Undergraduate Medical Education – medicine
Medical director of consult service, residency training program
Med-Psych Program Director
FMP training director
Program director
Program Director
Residency Director
Residency Director
Residency Director
Residency program director
Fellowship Director
IM Program Director
IM Program Director
Associate Program Director of psychiatry residency programs
Associate Program Director for residency in medicine/psychiatry
Medicine subinternship director
Medicine clerkship director
Course Director for second year medical student class
Organizational
President of national consulting company
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Departmental / Clinical
Service Chief at VA Hospital
Chair Care of Pts with Life Threatening illness
VP of Medical Affairs
Chief Psychiatry
Vice chair
Assistant Chair
Director of Department of Psychiatry
Department Director
Vice Chair of Clinical Operations in a Department of
Psychiatry
Clinical Program Director
Medical Director
Medical Director for inpatient psychiatry services at the local
hospital
Medical Director med/psych combined service
Director of Medicine/Psychiatric Combined Inpatient Service,
Private Hospital
Medical Director C/L service
Medical Director for IM training clinic
Medical Director of clinic
Hospice medical director
Assistant Medical Director inpatient psychiatry unit
Assistant Medical Director med/psych combined service
Assistant Medical Director C/L service
President of national organizations
Member national specialty committees
Chairman local, regional, national committees
Board member and officer of state medical and psychiatric
organizations
Responses include multiple administrative roles (past and current) listed by 28 of 33 respondents
20/33 (60.6%) Yes
13/33 (39.4%) No
Types of Research
(specified by 19 of 33 respondents; some common research interests)
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Clinical research
Delirium
Medical education
Epidemiology of sexually transmitted diseases
Metabolic syndrome and antipsychotics
Depression and heart disease
CL topics
Panic disorder
Delay in Acutely Ill Patients
Health services research on the interaction of medical and mental
health conditions (formerly psychoneuroendocrinology)
• psychopharmacology, brain imaging
30/33 (93.8%) Yes
2/33 (6.3%) No
1/33 No response
N=32
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N=31
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N=33