specialty care for bipolar matters according to bob post

Specialty Care for Bipolar Matters

Peter Forster Best Practices, Bipolar Treatment Leave a Comment

Bob Post (one of the most eminent psychiatrists of our time) published a passionate article in the March 2018 edition of the Journal of the American Medical Association in support of the importance of specialty care for bipolar disorder. Of course, we couldn’t agree more. That is one of the reasons we founded the clinic. We saw that specialty care …

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 …

Integrated Care

Peter Forster About GPS, Best Practices

We have a passion for providing the most effective treatment at Gateway and that passion is illustrated by the efforts that we make to ensure that we deliver integrated care. Integrated care is a very simple idea. In fact it is probably something that you expect your treatment providers are already delivering. It means that the different providers who are …

Measurement Based Care Controversies

Peter Forster Best Practices

Measurement based care often evokes controversies. A brilliant colleague, Carol Heckler, who is something of a local expert in psychopharmacology, interrupted a conversation I was having with another psychiatrist to say that she thought that standardized rating scales were useless. Echoing comments that I’ve heard from many of my patients, she said “how can you reduce human experience to a number?” This …

Insomnia Relief

Peter Forster Best Practices, Insomnia, Insomnia Treatment

How to find insomnia relief is a question that many people we work with struggle with. A recent editorial in JAMA Psychiatry and the accompanying research article suggests that the online program that we’ve been recommending to our patients for years (SHUTi) is the treatment of choice for insomnia. We have been extremely pleased with the results from this program which can …

Measurement Based Care Improves Outcomes

Peter Forster About GPS, Best Practices

Patients at Gateway Psychiatric are sometimes perplexed by the amount of time and energy we devote to tracking how they are doing. It can seem annoying to answer questions repeatedly or to fill out forms. An article in the journal Psychiatric Services summarizes the data that shows that this process (known as “measurement based care” or MBC) is associated with significantly …

Genetic Tests for Depression Reviewed

Peter Forster Best Practices, Major Depression, Psychobiology, Testing

Are genetic tests for depression treatment worthwhile? Or is this an expensive technology that is not ready for routine use? Peter Roy-Byrne, writing in NEJM Journal Watch seems to say no. Although some clinicians may argue that such testing “can’t hurt and might help,” current psychopharmacological practice is complex, usually including combinations of multiple medications, and patients can have multiple …

Image of a mature woman, holding her head with both hands, while alarm clock is lying in bed

Chronic Insomnia Best Treatments

Peter Forster Insomnia, Insomnia Treatment

Chronic Insomnia – What are the Best Treatments? The American College of Physicians just published guidelines on the treatment of chronic insomnia. These guidelines were based on a comprehensive review of the literature. They note that chronic insomnia is very common, but the literature on treatment is relatively poor. Many treatments that are used do not have good evidence supporting …