Tips for Working with Physicians

Non-medical clinicians train and practice in a world that is considerably different from that of physicians. With the employment of the medical model and the liberal use of psychotropic medications to correct the biochemistry of certain mental health syndromes on the rise, knowledge and appreciation of medical culture is more important than ever before in strengthening collaborative relations with physicians.

Therapists are at times reluctant to pursue collaboration with physicians who are intimidating, boorish, insulting, controlling or egotistical. Physicians also carry their own stereotypes of therapists as being too ‘theory oriented,” “touchy-feely” or not “symptom focused.”

These contradicting viewpoints demand that professionals sharing client care become familiar with each other’s role and respect the value of each other’s views and opinions. For the non-medical clinician though,

With this in mind, here are some tips for working with physicians:

  • Approach physicians in an assertive, confident manner. This will endear you to doctors faster than anything else. If you find yourself apprehensive or anxious, jot down your points or questions on an index card or notepad. Be succinct and make eye contact.
  • If you work in an on-site system, find the “main traffic area” and place yourself in the middle of it. Greet physicians as they walk by with a smile and where appropriate, a handshake. This builds goodwill – an ally you’re going to need.
  • Establish your expertise as a competent worker, and respond timely to physicians that reach out to you. This speaks for itself. Do your job, do it well, and be available. Once you establish your competence, you’ll become the “go-to” person, particularly for difficult cases.
  • Speak their language. This means focusing on symptoms and eschewing any theory jargon. For example, if after placing Ms. Jones on Cymbalta for a few days she has become more restless or agitated, report this only. This is not the time to discuss her repressed memories from childhood.
  • Never recommend a specific medication treatment. This is an egregious boundary violation, unless the doctor asks for your suggestion(s). Medication decisions are made by the physician in concert with input from the client system.
  • Understand and appreciate cultural differences. Physicians are under severe time constraints, which should be respected. Physicians take a tremendous amount of responsibility for their patients’ well-being and in facilitating change in their patients’ condition. Non-medical clinicians on the other hand, often place the responsibility for change on the backs of their patients. This difference can create conflict which in turn fuels skewed expectations of one another. So recognizing and appreciating role differentiation between the non-medically trained practitioner and the physician can be a productive step toward working collaboratively.
Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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