There was a time when Julie Radico, PsyD, didn’t know the difference between Type 1 and 2 diabetes and had no idea how to interpret A1C level measures. No longer: As an assistant professor of family and community medicine at Penn State’s Milton S. Hershey Medical Center, Radico now teaches resident physicians, nursing students, pharmacist trainees and others how to better serve patients with diabetes and other medical problems. “I joke I’m getting an honorary medical degree,” laughs Radico.
But being the only psychologist on an interdisciplinary team means working differently than traditional practitioners. Radico and others offer advice for being an effective team member:
- Educate the team about your role. At first, says Radico, the resident physicians and others she trains often referred patients to her simply because they were difficult or time-consuming. “The term often used for that is 'punting',” she says. She has since taught trainees to come up with specific clinical questions for her to answer instead of, “I don’t want to talk to them for 20 minutes; you do it.” But don’t get pigeonholed as a mental health provider, says Radico, explaining that her role is primarily to address behaviors impeding good health. “And just because I’m a psychologist doesn’t mean I do everything related to psychology,” she says. Completing comprehensive patient assessments for dementia or attention-deficit/hyperactivity disorder isn’t her job, for example.
- Be brief. Medical settings are fast-paced, so communication needs to be super-concise. “Physicians are just go, go, go,” says Radico, who tries to limit her reports to just 30 seconds. Instead of providing extensive background, she boils things down to what she found plus treatment strategies, then sends a detailed note. (Avoiding jargon is also key, she says, remembering one physician’s blank look when she mentioned “emotional regulation.”) Interventions are brief, too — just three sessions.
Be flexible. In private practices, psychologists usually know who’s coming in when, says Sarah Beckmann, PsyD, a behavioral health consultant at Yakima Valley Farm Workers Clinic in Washington. That’s not the case for her. “Typically, when I walk in the door, I only have three people on my schedule,” says Beckmann. “But I end up seeing 10 to 15 patients per day while also consulting with doctors and nurses.”
Get training. Although a base of knowledge in health psychology is important, “a lot of learning also happens on the job,” says Emily Selby-Nelson, PsyD, director of behavioral health at Cabin Creek Health Systems in Kanawha County, West Virginia. But if your graduate training didn’t include health psychology, she says, take advantage of the training in integrated care offered by APA’s Div. 38 (Society for Health Psychology) or the University of Massachusetts Medical School. Supervision can also help boost skills, says Selby-Nelson, adding that consultation can prevent the isolation and burnout that may go along with being the only psychologist on your team.- Watch your scope of practice. When you’re working alongside various medical providers, says Radico, scope-of-practice issues may crop up. A patient might complain to Radico about the side effects of an antidepressant, for example. It's perfectly acceptable to ask the patient about medication adherence, look up and share information about common side effects and send a note alerting the patient's physician of concerns, says Radico. What's not OK is telling the patient to stop the medication. And if a patient asks Radico a medical question, Radico says, “That’s a great question, but it’s a question for a physician and I’m not a physician.” She then sends a message to the patient's physician or makes a plan for the patient to follow up with the physician on their own.