Addressing the workforce crisis in integrated primary care. 2009

F Alexander Blount, and Benjamin F Miller
University of Massachusetts Medical School, Worcester, MA, USA. blounta@ummhc.org

Training and education in integrated primary care is limited. We see a need for addressing the looming workforce shortage as behavioral health services in primary care become more widely implemented. Bringing mental health clinicians straight from specialty mental health settings into primary care often results in program failure due to poor skills fit, assumptions about services needed, and routines of practice these clinicians bring from their specialty settings. Health psychology graduate programs tend to prepare graduates for specialty research and practice in medical settings rather than preparing them for the pace, culture and broad spectrum of needs in primary care. Family medicine residency programs provide an underutilized resource for training primary care psychologists and family physicians together. Even if comprehensive graduate training programs in integrated primary care were developed, they could not begin to meet the need for behavioral health clinicians in primary care that the present expansion will require. In response to the demand for mental health providers in primary care, new initiatives have emerged which attempt to provide training for the preexisting mental health workforce to enable their successful integration into primary care settings.

UI MeSH Term Description Entries
D007400 Interprofessional Relations The reciprocal interaction of two or more professional individuals. Etiquette, Medical,Medical Etiquette,Relations, Interprofessional
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D003299 Cooperative Behavior The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed) Compliant Behavior,Behavior, Compliant,Behavior, Cooperative,Compliant Behaviors,Cooperative Behaviors
D004493 Education Acquisition of knowledge as a result of instruction in a formal course of study. Literacy Programs,Training Programs,Activities, Educational,Educational Activities,Workshops,Activity, Educational,Educational Activity,Literacy Program,Program, Literacy,Program, Training,Programs, Literacy,Programs, Training,Training Program,Workshop
D004651 Employment The state of being engaged in an activity or service for wages or salary. Employment Termination,Employment Status,Labor Force,Occupational Status,Status, Occupational,Underemployment,Labor Forces,Status, Employment,Termination, Employment
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000078329 Workforce The number of people working or available for work or service. Human Resources,Labor Supply,Manpower,Staffing,Womanpower,Human Resource,Labor Supplies,Manpowers,Staffings,Supply, Labor,Womanpowers,Workforces
D001524 Behavioral Medicine The interdisciplinary field concerned with the development and integration of behavioral and biomedical science, knowledge, and techniques relevant to health and illness and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation. Health Psychology,Psychology, Health,Medicine, Behavioral,Health Psychologies,Psychologies, Health
D015279 Organizational Culture Beliefs and values shared by all members of the organization. These shared values, which are subject to change, are reflected in the day to day management of the organization. Corporate Culture,Corporate Cultures,Culture, Corporate,Culture, Organizational,Cultures, Corporate,Cultures, Organizational,Organizational Cultures
D019033 Delivery of Health Care, Integrated A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7) Integrated Delivery Systems,Integrated Health Care Systems,Delivery System, Integrated,Delivery Systems, Integrated,Integrated Delivery System,System, Integrated Delivery,Systems, Integrated Delivery

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