Home Forums Discussions General Discussion SBIRT

And now we have SBIRT. It is only because of these damned acronyms they force us to do that there is a September 10, 2023 Physician Suicide Awareness Day. (PSAD)

Screening
Brief Intervention
Referral to Treatment

Good luck with that.
No treatment available

And how many times do you need to screen the same preson and provide useless brief interventions?

I know. Well, we have chosen 11 years old and up on Medicaid. If they say no to all four questions, you get $29.00 from the state, which is going to be most kids 14 and under especially with their parents in the room.

15 and up may get you some cigarettes and some drinking. Then you have to spend 10 to 15 minutes or so counseling them. Like what can I tell someone who drinks more than 5 drinks a day in the past year to get them down to 4 drinks a day.

Or counsel on cigarette smoking.

And others. But, it is $29.00. I guess I would spend 7 to 8 minutes as that would seem like 15 minutes to the kid.

The silver lining of CoVid pandemic was the explosion of telemed for mental health professionals. In Knoxville, most therapists are still primarily using telemed. One patient of mine said she went through 7 local therapists to find her 8th who would see her in her office. Some have given up offices completely. There are national and regional therapists online. BetterHelp.com seems to be one of the better. I thought Talkiatry might be a good idea until I read the reviews of what seemed to be muliple instances of surprise billing. Biggest difficulty is turnover in therapists and psychiatrists. One of my former psych NP's went to work for FastPace Urgent Care with offices in multiple states where they do both psychotropic meds and psychotherapy. Studies show teletherapy is non-inferior to office-based. I still do about 10% of my practice virtually, especially to people in Sevierville and Gatlinburg because they don't want to fight Dollywood and Pigeon Forge traffic AND Knoxville traffic. The other issue is trying to get records from these places is just about impossible. As long as you are licensed in that particular state, it doesn't matter where the mental health professional lives. The NP's I know say it's pretty easy to get licensed in many other states.

Telemed in general. It saved our practice. I mean what can I do at a med check for ADHD in office that I can't do over the phone except check blood pressures and have a chance to do pill counts and urine tests but those are generally random.