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The Doctor Is In
Getting ADHD Help
from a Pediatrician By Katherine Bontrager
from a Pediatrician
"Historically, primary care physicians haven't been adequately trained to practice behavioral health," Dr. Lichtenstein says. "There's always been a dichotomy in medical training a split between those who study physical disease systems and those who study mental or psychiatric disorders. The dichotomization has been so firmly drawn that medical trainees didn't get well grounded in mental health issues. Even in the pediatric and internal medicine residencies, physicians were learning to take care of classic physical conditions. Any training that had to do with diseases of the mind, such as ADHD or depression, was cordoned off to be mastered by another group of trainees in psychiatry."
This division didn't go unnoticed by residency directors, specialty boards and state and national legislatures and became an increasing area of concern, Dr. Lichtenstein says. Essentially, there was a shortage of help equipped to handle both the physical and the mental side of medicine. But, according to Dr. Lichtenstein, there has been a renewed focus on including training mental health issues in primary care physicians' training.
"There's been a tremendous effort nationally to refocus training and to put more emphasis in mental and behavioral health issues, with the long-term prospect of making primary care physicians collaborators in and equal participants in the triaging of patients with mental health care problems," Dr. Lichtenstein says.
Dr. Lichtenstein's role in Cincinnati is to work with physicians who are already out in the field. "We focus on familiarizing doctors with the diagnostic guidelines, the tools available for making the ADHD diagnosis and how to use those treatments optimally," he says. "The format for doing this is a direct adaptation of the methodologies introduced in Dr. Gephart's national collaborative project five years ago."
And Cincinnati is only one of many cities looking to help. Among the hospitals that have gotten on board and started offering similar training are Children's Mercy Hospitals and Clinics in Kansas City, Mo. The entire idea originated from area physicians in a focus group, says Kevin W. Turner, the AHD education coordinator in the Health Management Department.
