Letters to the Editor
To the Editor:
As directors of a psychiatry residency, we welcome the perspective offered by Rubin and Zorumski1 regarding the future of psychiatry education.
We heartily agree that one promising future for psychiatrists lies in collaborating with primary care physicians in providing integrated, quality care to patients.1,2 We have found that although residents are initially challenged as they adapt to a model of brief and focused consultations with primary care providers, they ultimately recognize the public health benefits of assisting those providers in caring for a wide variety of patients.
Rubin and Zorumski also mentioned the value of quality-of-care measurements. We concur. Widespread application of quality improvement (QI) principles would ensure use of evidence-based diagnosis and therapies.3 Thus, it is critical that psychiatry residents be taught how to conduct QI projects. Toward that goal, we have developed a model curriculum at the University of Wisconsin.4
Finally, we agree with Rubin and Zorumski that there are serious problems with the mental health system. Practicing evidence-based psychiatry is necessary but insufficient for fixing the system. Advocacy education has recently been vigorously discussed in Academic Medicine. 5 What physicians do in clinical venues affects no more than 10% to 50% of health outcomes.6 We suggest that training residents in advocacy is necessary to translate evidence-based practice into changes that will improve the mental health system.
Art Walaszek, MD
Associate professor, vice chair for education, and residency training director, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; firstname.lastname@example.org.
Claudia Reardon, MD
Assistant professor of psychiatry and associate residency training director, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
1. Rubin EH, Zorumski CF. Perspective: Upcoming paradigm shifts for psychiatry in clinical care, research, and education. Acad Med. 2012;87:261–265
2. Serrano N, Monden K. The effect of behavioral health consultation on the care of depression by primary care clinicians. WMJ. 2011;110:113–118
3. Harding KJ, Rush AJ, Arbuckle M, Trivedi MH, Pincus HA. Measurement-based care in psychiatric practice: A policy framework for implementation. J Clin Psychiatry. 2011;72:1136–1143
4. Reardon CL, Ogrinc G, Walaszek A. A didactic and experiential quality improvement curriculum for psychiatry residents. J Grad Med Educ. 2011;3:562–565
5. Dharamsi S, Ho A, Spadafora SM, Woollard R. The physician as health advocate: Translating the quest for social responsibility into medical education and practice. Acad Med. 2011;86:1108–1113
6. . Do medical professionalism and medical education involve commitments to political advocacy? [Eight letters to the editor and one reply]. Acad Med. 2011;86:1061–1065