Monday, January 28th, 2013
What is psychiatric coverage?
Because of the newness of the industry, psychiatric coverage is a phrase that is not yet well known in the mental health community. “Psychiatric Coverage” is on-call coverage for psychiatrists. Similar to an on-call nurse, available after-hours during times of patient need, psychiatric coverage is what private practice psychiatrists use when they want or need to take a break from the 24/7 availability requirement. Because the law does not dictate that the treating psychiatrist must be the one to answer when a patient calls outside of office hours (likewise, a psychiatric patient can seek help and treatment from any psychiatrist or nurse at will), psychiatric coverage fulfills a need to both patients and psychiatrists. We also have an introduction to PsychCoverage and founder Jack Coughlin.
What Psychiatric Coverage means to patients
Patients understand that their psychiatrist operates a practice with normal business hours, just like a doctor’s office – limited evening and weekend appointments (if any) and, despite the legal and ethical obligation, no guarantee that phone calls after-hours will be answered. Unfortunately, patients with anxiety and depression can learn to dread the evenings and weekends when they know the office is closed and don’t have the ability to call in and have a live person answer. Most patients also feel guilty calling their psychiatrist after hours, recognizing they’re real people with lives and families and will try to wait until office hours or their next appointment, which can exacerbate their illness. When a psychiatrist goes on vacation it can trigger symptoms in patients, just because they know their doctor is out of touch.
Psychiatric coverage eases these thoughts for the patient. When a patient knows he can call in any time and talk with a trained professional, he automatically feels more relaxed. We make a point to tell every patient that their call is not an inconvenience, that it’s what we’re there for. We reassure patients that we’re here whenever they need us, whatever time of day; if their doctor is unavailable and they need someone to talk to, we answer that call. And that alone tends to have a great effect on patients. 90% of the patients who call in were diagnosed with depression or anxiety and often just want someone to talk to who understands and can provide advice or encouragement. Many of the calls PsychCoverage gets are about medication: last minute refills, questions about side effects, and questions about discontinuing the medication are highly common. These are questions the treating psychiatrist doesn’t need to be the one to answer, but the patient still needs an answer to.
What Psychiatric Coverage means to psychiatrists
For the first time in California (and soon in other states), psychiatrists can turn off their phones on evening, weekends, and vacations and not feel one ounce of guilt and not have to play catch up later. Psychiatric coverage means psychiatrists have an alternative to being “at work” 24 hours a day, 7 days a week. While there’s no guarantee that every night or every weekend will involve a patient call, there’s also no guarantee that there will be no calls – which means psychiatrists have to always have their phone on, with them, and be available to take an emergency call (it doesn’t matter if a patient is calling for a medication refill, calling with a quick question about their new medication, or calling with an emergency situation, the call has to be answered). Just knowing the phone might ring, whether for a trivial reason or crisis, a psychiatrist can feel as if he is just waiting for a call when he should be resting or spending time with family.
Being able to turn the phone off and know patients will be taken care of if they need it can be immensely relaxing and comforting. We know this is a successful, if brand new, industry because our existing clients have had nothing but good things to say about our services and the relief it gives them on weekends. We remove the burden of asking colleagues for help (and returning the favor), and provide peace of mind, if nothing else. But that peace of mind can be a career saver. Very rarely, and only when the psychiatrist asks for it, do we need to contact the psychiatrist during a coverage period. During set up we gather all of the information we would need (notes on particular patients, standing refill orders, etc.) so that we can function as a seamless extension of their office.
Thursday, January 17th, 2013
In the second part of our series to introduce PsychCoverage and the novel services we provide, we’ll meet founder Jack Coughlin, RN, and discover how he decided to begin his unique business.
Hi, I’m Jack.
I’m a Registered Nurse. I became a Psychiatric Nurse in 1985 after completing my education at Hahnemann University and Temple in Philadelphia, and started my career in California in 1992. Since the early 2000s I have been working for a company called Status One, a cutting-edge management operation helping to pioneer disease management. Now it’s a trend in healthcare, but back then it was a novel idea. Part of my job was giving leadership training and care management training, focusing on mental health and teaching non-psychiatric nurses how to assess patients for risk, especially those who may be depressed or suicidal.
But on the side, my wife and I were covering for a local psychiatric practice part-time, taking on weekend calls. When their offices closed Friday evening, they forwarded any phone calls to us. After a while I realized we were really doing disease management for depression. Then we started to get phone calls from other psychiatrists who were interested in us covering for their practices, too. Now we’re covering for psychiatrists across California, and hopefully next year we’ll be providing these services to practices in Texas, Arizona and Nevada.
There currently is no other service that psychiatrists can rely on when they want a little break, or at least some separation between practice and home life. It’s well documented that the inability to get away from their practice has been a significant contributor to burnout, which is prevalent throughout the profession. Giving psychiatrists this break helps them with face-to-face patient care.
The number one service we provide is to psychiatrists, and that’s peace of mind. Patients may never call over the weekend but a psychiatrist has to always be available no matter what. Obviously this is mentally draining. We exist so the doctor never has to worry on the weekends about what he or she might miss because of a call. The other service we provide is to the patients, and that’s experienced, professional phone triage. The vast majority of our calls are from patients who are worried about their medication or who just need someone to talk to. We’ll give them more education on their medication and side effects and help them understand the recovery process a little better. We’re an extension of their doctor’s office that just happens to be available any time their doctor isn’t.
I’m able to do this because, and this may sound cliche, it really doesn’t feel like work to me. Whenever I get a call I just sit down and never feel like I have to cut it short or give a patient less than my full attention or a full response, even when the call comes at an inconvenient time. I just really love what I do. I do have other psychiatric nurses working for me now, but even if I didn’t I don’t see myself ever not doing this. And that is what keeps me going and keeps me excited about introducing this new field to other psychiatrists and really helping everyone to do what they do best.
You can read more about my practice, PsychCoverage, Inc., here, or visit our website to learn more about our psychiatric coverage services.
Thursday, January 10th, 2013
PsychCoverage, Inc is a company that fills a very unique, very specific need in the medical community, and because this niche is so specialized there are not yet other companies that offer these types of services. Thanks to this unique position, many practitioners have questions about what PsychCoverage is and what it means to them. Here, we’ll explain in depth all about our company, how it came to be, and what it’s meant to do.
Meet PsychCoverage
Psychiatrists have the legal and ethical obligation to be available to their patients 24 hours a day, 7 days a week, 365 days a year. This means that any time that pager or cell phone rings it must be answered. To patients this sounds like a wonderful requirement because it’s comforting to know that your psychiatrist isn’t restricted to 9-5, just like mental illness is not bound by time or place. But for psychiatrists, who spend all day with their patients and working on paperwork and other requirements of a practice, the last thing they may feel like doing late at night is sitting on the phone with a patient in crisis. That, however, is the call of the trade and something the vast majority of psychiatrists accept in the beginning.
Fast forward ten years and the psychiatrist has a young family and a growing practice. After an 8-10 hour day and another 2-4 hours with the kids and dealing with home life, the exhausted psychiatrist gets a phone call. He has a choice to make: answer it and spend an hour talking through symptoms of a new medication or ignore it and go to bed worried about the patient (and deal with the aftermath in the morning). Some psychiatrists will ask their colleagues to cover their phone on an important night or while on vacation, but because of the amount of stress this requires, not to mention the fact that they’d have to return the favor in the future, many psychiatrists do not choose that option. PsychCoverage provides a reliable third choice for the tired, burned out practitioner: hire a trained psychiatric nurse to answer your calls at night, on the weekends, and while on vacation. This practice fulfills the obligation to be available for patients at all times while giving psychiatrists their own lives back.
How psychiatric coverage works
One of the most common after-hours calls a psychiatrist receives is related to medication and symptoms. Patients starting a new medication will have worries and concerns if things aren’t going the way they think it should or if they’re not better immediately. Rather than forcing a psychiatrist to spend his evenings re-explaining the benefits of the medication and the importance of sticking to the regimen, or risk the patient deciding on his own to stop taking the medication, an experienced RN at PsychCoverage can reassure and educate the patient. Most of the time that’s all that’s necessary, and the calm, soothing voice of a trained RN can be enough to get the patient to relax until their next appointment. One reason this is especially helpful is because a burned out psychiatrist, who has already explained everything to a patient, may not be in the best of spirits to go through it all again. A fresh perspective (but one that agrees with the psychiatrist) is a wonderful resource for a concerned patient.
PsychCoverage offers more peace of mind than anything else. The anxiety and uncertainty that surrounds a private psychiatric practice is too often overwhelming for practitioners and their families, and PsychCoverage removes that stress. Imagine: your phone doesn’t ring all weekend or all vacation but when you return you have a full report of any patient interaction and there’s no playing catch up.
How to get PsychCoverage services
If all of this has enticed you and made you realize just how much you could benefit, you’ll be happy to know the process is easy. You can sign up here or call 800-544-6444 and founder Jack Coughlin, RN will discuss your needs and your level of coverage. Once an agreement is made, you’re able to specify if you want to be contacted by PsychCoverage in certain situations, such as if a specific patient calls or in a specific circumstance. You also authorize medication refills for specific patients (PsychCoverage will not authorize any new medication or any medication refills that isn’t pre-authorized by you). This makes for an easy transition for your patients and ensures they’re taken care of in your absence. From then on, you can relax knowing your phone won’t ring, your patients will be cared for, and you can get back to living your own life and enjoying a little bit more separation from work.
Learn about the founder of PsychCoverage, Jack Coughlin, RN here.
