Invisible Work for New Patient Consultations

Peter Forster About GPS, Best Practices, Costs of Treatment Leave a Comment

New patient consultations at Gateway are expensive, in large part because of the hidden or invisible work that takes place as part of the consultation process. The table below contrasts the visible work, which is contained in the two sessions with clinicians, to the hidden work done by clinical and nonclinical staff in order to make those two in person …

Insurance Assistance

Insurance Assistance with Better – Kelsey

Peter Forster Costs of Treatment, GPS Update Leave a Comment

Better – insurance assistance that works to get you paid what you are owed.  I recently had a phone call with Rachael Norman, Better Founder and CEO, to learn more about how Better might be of service to Gateway patients.  I am thrilled to pass along this resource, which takes the work and time out of getting reimbursed by your …

Maintenance TMS

Maintenance TMS

Peter Forster Major Depression, Treatments of Depression Leave a Comment

A patient with treatment resistant depression and an excellent initial response to TMS asked me about the value of maintenance TMS. The question is a reasonable one given what we know generally about the treatment of chronic and/or treatment resistant depression. Almost all of the effective treatments (psychotherapy, medications, ECT, etcetera) have acute and maintenance treatment components. And for all …

Bipolar 101

Bipolar Group – Bipolar 101 Update – Gina

Peter Forster About GPS, Bipolar Treatment, GPS Update Leave a Comment

I recently hosted another Bipolar 101 Group and received overwhelmingly positive feedback from those who attended the group. I regularly hear of the value that support plays in the lives of people I work with who are managing bipolar disorder;they frequently speak about their communities, friends, and families and the impact they have in their lives. Our first Bipolar 101 …

Adult Onset ADHD

Adult Onset ADHD Symptoms – What Do They Mean?

Peter Forster Diagnosis, Other Psychiatric Disorders Leave a Comment

Adult onset ADHD symptoms – symptoms of inattentiveness or hyperactivity that are present in adulthood but did not exist to a clinically significant degree in childhood – have been the subject of much controversy in the research literature in the last three years. Until recently,  it was understood that ADHD had to have its onset in childhood. In other words …

Predicting Lithium Response with Functional Brain Imaging

Predicting Lithium Response with Brain Imaging

Peter Forster Bipolar Treatment, Testing Leave a Comment

Predicting lithium response with brain imaging may be an option in the future if the preliminary results of a study published in 2017 are confirmed. Researchers from the University of Cincinnati used three tools to create a program that was remarkably successful at predicting which bipolar patients would respond to lithium. 20 first onset bipolar patients who received adequate trials …

State and Trait Brain Function in Depression

State and Trait Brain Function in Depression

Peter Forster Basic Science, Major Depression, Psychobiology Leave a Comment

Understanding the neurobiology of depression involves more than just knowing about serotonin, we need to know how state and trait brain function in depression is different from brain functioning in those who have never had a major depression. State and trait are key concepts in understanding psychiatric conditions: state refers to those alterations in functioning that occur when someone is …

Ketamine Reduces Suicidal Thoughts

Peter Forster Treatments of Depression Leave a Comment

A single infusion of ketamine reduces suicidal thoughts in depressed patients in one day, with benefits lasting for up to one week, according to a meta-analysis reported in the American Journal of Psychiatry. Further, ketamine did not seem to be just treating depression, it seemed to have an effect on suicidal thinking that was greater than its effect on depression “This suggests that …