Dr. Migalski and his colleagues at Andersonville Behavioral Health regularly accept referrals from primary care physicians and consult to assist physicians manage their caseloads, which can fill with patients who struggle with co-occurring medical and psychiatric disorders. Often, these patients present with non-adherence or inconsistent compliance to medical and behavioral regimens, which is both frustrating and difficult for physicians who find themselves back-to-back with patients and hectic schedules. Moreover, when patients with primary psychiatric disorders find themselves on the caseloads of primary care physicians, it can be onerous and extremely burdensome for the physician whose principal expertise is not behavioral or mental health. Examples of primary-care patients referred to us have included:
• The hypertensive patient whose psychosocial stress and poor lifestyle habits create an increased risk for a more serious medical condition.
• The patient ridden with somatic anxiety, whose physical examination and labs show no significant findings.
• The diabetic patient whose nutritional compliance and insulin adherence are complicated by a behavior disorder.
• The gastric bypass patient who is not adjusting well post-surgically to the dramatic shift in food intake now required for healthy weight loss.
• The elderly patient whose memory loss may be normatively linked to a depressive illness rather than the onset of dementia.
• The inattentive patient presenting with subclinical attention deficits and wavering concentration that seeks psychostimulant medication but has never had an ADHD evaluation.