Integrated Care for Complicated Patients: A Role for Combined Training and Practice

Patients with chronic medical disease frequently have comorbid psychiatric ill-ness, yet mental and physical healthcare is frequently siloed in the United States. Integrated behavioral healthcare models, such as medicine-psychiatry services, are feasible, improve patient outcomes, and reduce costs. The Duke University Hospital medicine-psychiatry service provides holistic patient care and serves as a model for those interested in developing combined services or training programs elsewhere. Combined residency training in psychiatry is a way to provide a workforce of physician-scientist educators adept at providing coordinated, integrated care for complex patients with comorbid illness. (Am J Geriatr Psychiatry 2023; 31:222-231)

Automated summary

Patients with chronic medical disease often have comorbid psychiatric illness, but healthcare in the US is often divided between mental and physical care. Integrated behavioral healthcare models, such as medicine-psychiatry services, are feasible, improve patient outcomes, and reduce costs. The Duke University Hospital medicine-psychiatry service provides comprehensive patient care and serves as a model for other institutions interested in developing combined services or training programs. Combined residency training in psychiatry is a way to provide a workforce of physician-scientist educators skilled in providing coordinated, integrated care for complex patients with comorbid illness.