Often, legal entities will engage in Psychiatric expert services. These services vary by venue and are usually time-limited. They often involve solving a particular concern or question. I have many years’ experience in providing these services.

A good way to look at a truly integrative efficient model that utilizes limited expert services and distributes them effectively is the “hub and spoke”. This model efficiently uses limited expert services by distributing them effectively. This approach can be effective if implemented properly. The “hub” represents the locus of expert resources in a rural area and the “spokes” are the satellites sites or points of entry where clients are screened and treated at some level of service. The integration of sites has supported research and grant applications by addressing specific needs, particularly in under-served areas where specialists are scarce and primary care is heavily utilized. As an addiction psychiatrist in such a rural area I was able to consult very effectively in multiple facilities even within the same week/day. These included : forensic (jails) for emergent issues or medication management, hospitals for complex psychiatric cases when there was not a psychiatrist on staff, ER settings for emergent needs in detoxes or medication questions, group homes for medications and guidance, MAT clinics for protocols and quality of care issues, therapist groups and PCP groups for guidance and cases, neurological centers for cases with mixed presentations, APN’s consultations , and policy protocols groups, as well as lecture/discussions to specified target audiences that would facilitate the increase in quality care in PCP or mid-level providers and perhaps decrease the need for psychiatric referrals This was an experience that truly illustrates how consulting can increase efficiency, and the quality of integrative care. It is a “team effort” that can pay off in improved client care despite less resources!

To read more about this topic please see “Comorbidities in Psychiatry: Prescribing Pearls” blog article