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J S McIntyre

Publications and source records attributed to J S McIntyre.

15 recordsLinked to original sources
PubMed1998

Characterizing psychiatry with findings from the 1996 National Survey of Psychiatric Practice.

OBJECTIVE: The authors' goal was to characterize psychiatric practice by reporting findings from the 1996 National Survey of Psychiatric Practice. METHODS: A random sample of 1,481 APA members was selected to participate in the study; 1,375 APA members were determined to be eligible for study participation. The authors report data from 970 respondents (70.5% response rate) and compare them with data from previous surveys of psychiatrists. RESULTS: Twenty-five percent of the participating psychiatrists were women, compared with 19% in a 1988-1989 survey. Since 1988-1989, the proportion of psychiatrists 39 years old or younger has decreased and the proportion of those 55 years old or older has increased. In 1996, psychiatrists saw, on average, 35.4 unduplicated patients and worked an average of 46.4 hours in a typical week. Patients with mood disorders as their primary diagnoses accounted for the greatest proportion of psychiatrists' caseloads, followed by patients with anxiety disorders, then those with schizophrenia and other psychotic disorders. Public sources of payment and uncompensated care were the main sources of payment for psychiatrists services for 41.7% of patients. The primary payment mechanism for psychiatrists' patient care services was fee-for-service, accounting for 52.5% of psychiatrists' income from direct patient care. Twenty-nine percent of psychiatric patients received care through some form of managed care system, and 41.6% received treatment through a nonmanaged public or private health plan. CONCLUSIONS: As psychiatry moves into the next century, findings from the National Survey of Psychiatric Practice will form a baseline for monitoring changes and trends in the delivery and financing of mental health services.

Adolescent↗
PubMed1997

Practice-based research in psychiatry.

OBJECTIVE: The authors describe the APA Practice Research Network (PRN), a national research initiative that ultimately will engage 1,000 practicing psychiatrists in collaborative clinical and services research. The PRN is designed to generate practice-relevant information and to inform future service delivery, policy, and financing decisions pertinent to psychiatry. METHOD: The authors review the relative strengths and limitations of practice-based research compared with other widely used research methods. They also describe the structure of the PRN and its procedures for recruiting network members and for identifying and developing specific network studies. The three primary sources of data for the PRN are 1) the biannual National Survey of Psychiatric Practice, which provides not only a mechanism for randomly recruiting the two-thirds of network participants who are not volunteers but also a baseline for assessing the generalizability of PRN findings; 2) separate biannual studies of psychiatric patients and treatments to characterize the network patient/treatment denominator, which is used to monitor trends in psychiatric practice and plan network studies; and 3) specific studies. RESULTS: Pilot data from the PRN have yielded detailed information on the diagnostic and clinical characteristics of 725 patients and on the treatments provided by network psychiatrists. CONCLUSIONS: The APA PRN offers a powerful complement to traditional clinical and health services research approaches. The PRN will help psychiatry improve its ability to meet patients needs in a context of rapidly evolving scientific and clinical progress and legislative and economic forces affecting health care delivery.

Confidentiality↗
PubMed1996

A model for psychiatric services in primary care settings.

The integration of mental health care and primary medical care enhances the quality of patient care and may improve the overall cost-effectiveness of a health care system. The authors describe implementation of a program that provides mental health care at 12 locations in a network of primary care sites associated with a university-affiliated community hospital in Rochester, New York. A project of the hospital's department of psychiatry, the program has as its goals improved recognition, diagnosis, and treatment of mental health problems and education of primary care providers in these areas. Each of the program's three primary therapists provide short-term, symptom-focused individual, marital, family, and group therapies and case consultation at several primary care sites. The program director, a psychiatrist, makes diagnostic assessments and provides medication consultation to both the primary therapists and the primary care physicians. The authors discuss the advantages and disadvantages of the program model and plans for its future development.

Combined Modality Therapy↗
PubMed1979

Mania: the common symptom of several illnesses.

A clinical picture of mania can have many causes, including amphetamine or cocaine use, acute schizophrenia, manic-depressive illness, and viral encephalitis. Accurate and complete history--of both the present episode and past experiences--is most valuable in the differentiation, along with mental status examination, physical examination, and selected laboratory tests. It is advisable to withhold drug therapy, if possible, until the initial evaluation is completed, for it may obscure the diagnosis.

Adult↗
PubMed1977

Is there a stethoscope in the house (and is it used)?

A survey was conducted in Rochester, NY, of the attitudes and practices of psychiatrists (both in private practice and fulltime academic settings), psychiatric residents, internists, and fourth-year medical students concerning physical examinations of psychiatric patients. Thirteen percent of the psychiatrists frequently perform an initial physical examination on their inpatients and 8% frequently do an initial physical examination on their outpatients. These percentages are much larger for the resident groups. A very high percentage of all respondents report that they feel a physical examination of psychiatric patients is important especially when the patient is receiving medication. The largest number of psychiatrists report that they omit the physical examination because the patient has been referred to them after a physical examination by another physician or they refer the patient for such an examination. A notable percentage of psychiatrists in this sample report that they do not feel competent performing a physical examination.

Attitude to Health↗