TAILIEUCHUNG - Primary care clinic in office practice 34 (2007)

Primary care clinicians often provide continuity of care, emphasize prevention, and address chronic illness with their patients. All these endeavors require the active involvement of the patient in treatment planning and adherence. An active and healthy therapeutic alliance that recognizes that patients are the chief consumers of health care is essential in this regard. This critical role in directing one’s health care can be either facilitated or complicated by a patient’s emotional, cognitive, and behavioral strengths or weaknesses (ie, mental health). It is widely recognized that patients who have mental health concerns often present first to their primary care physician, and most continue to receive treatment of their mental. | PRIMARY CARE CLINICS IN OFFICE PRACTICE ELSEVIER SAUNDERS Prim Care Clin Office Pract 34 2007 xi-xii PRIMARY CARE CLINICS IN OFFICE PRACTICE Preface Ralph A. Gillies PhD J. Sloan Manning MD Guest Editors Primary care clinicians often provide continuity of care emphasize prevention and address chronic illness with their patients. All these endeavors require the active involvement of the patient in treatment planning and adherence. An active and healthy therapeutic alliance that recognizes that patients are the chief consumers of health care is essential in this regard. This critical role in directing one s health care can be either facilitated or complicated by a patient s emotional cognitive and behavioral strengths or weaknesses ie mental health . It is widely recognized that patients who have mental health concerns often present first to their primary care physician and most continue to receive treatment of their mental concerns eg depression anxiety in primary care. This reality is compounded because many health conditions that affect a patient s level of functioning eg chronic pain diabetes headaches often have mental health comorbidities that influence the course of illness and treatment. Primary care clinicians are well positioned to identify and assist patients who have mental health concerns. This central or de facto role in mental health care however is complicated by factors that hinder the delivery of evidenced-based care that is optimally integrated into the clinical process as a whole. Among the obstacles to such a rational approach to health care are an undue focus on acute rather than chronic health issues lack of specific training in the recognition assessment and management of mental distress or illness and financial obstacles mental health carve-outs and other obstacles that prevent the effective collaboration among diverse health professionals necessary to implement and manage effective treatment. 0095-4543 07 - see front matter .

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