VIDEO: Novel imaging technique helps hunt for pulmonary lesions

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PHOENIX – Each year more than 250,000 patients present with ground-glass opacities and other solitary pulmonary nodules, and they are difficult to locate.

“There’s been a need for our field to develop new technologies to find these nodules in the OR,” Dr. Sunil Singhal said in a video interview at the annual meeting of the Society of Thoracic Surgeons. “The fallback plan has always been that we can make a thoracotomy. Some studies have shown that in about one out of every two cases you end up opening a patient just to find a tiny little nodule.”

Dr. Singhal of the division of cardiothoracic surgery at the University of Pennsylvania School of Medicine, Philadelphia, discussed preoperative and intraoperative localization methods, including an investigational technology in which patients receive an intravascular dye that localizes the pulmonary tumor. “When we put our video-assisted thoracoscopic surgery camera in, the tumors are glowing,” he said. “We can then do a localized wedge excision and confirm margins of the staple line. We’ve done this [in] about 80 patients, and it’s been non-toxic, very safe, and very effective. Our biggest limitation has been our depth of penetration.”

Dr. Singhal reported having no financial disclosures.

 

 

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PHOENIX – Each year more than 250,000 patients present with ground-glass opacities and other solitary pulmonary nodules, and they are difficult to locate.

“There’s been a need for our field to develop new technologies to find these nodules in the OR,” Dr. Sunil Singhal said in a video interview at the annual meeting of the Society of Thoracic Surgeons. “The fallback plan has always been that we can make a thoracotomy. Some studies have shown that in about one out of every two cases you end up opening a patient just to find a tiny little nodule.”

Dr. Singhal of the division of cardiothoracic surgery at the University of Pennsylvania School of Medicine, Philadelphia, discussed preoperative and intraoperative localization methods, including an investigational technology in which patients receive an intravascular dye that localizes the pulmonary tumor. “When we put our video-assisted thoracoscopic surgery camera in, the tumors are glowing,” he said. “We can then do a localized wedge excision and confirm margins of the staple line. We’ve done this [in] about 80 patients, and it’s been non-toxic, very safe, and very effective. Our biggest limitation has been our depth of penetration.”

Dr. Singhal reported having no financial disclosures.

 

 

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

 

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PHOENIX – Each year more than 250,000 patients present with ground-glass opacities and other solitary pulmonary nodules, and they are difficult to locate.

“There’s been a need for our field to develop new technologies to find these nodules in the OR,” Dr. Sunil Singhal said in a video interview at the annual meeting of the Society of Thoracic Surgeons. “The fallback plan has always been that we can make a thoracotomy. Some studies have shown that in about one out of every two cases you end up opening a patient just to find a tiny little nodule.”

Dr. Singhal of the division of cardiothoracic surgery at the University of Pennsylvania School of Medicine, Philadelphia, discussed preoperative and intraoperative localization methods, including an investigational technology in which patients receive an intravascular dye that localizes the pulmonary tumor. “When we put our video-assisted thoracoscopic surgery camera in, the tumors are glowing,” he said. “We can then do a localized wedge excision and confirm margins of the staple line. We’ve done this [in] about 80 patients, and it’s been non-toxic, very safe, and very effective. Our biggest limitation has been our depth of penetration.”

Dr. Singhal reported having no financial disclosures.

 

 

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EXPERT ANALYSIS FROM THE STS ANNUAL MEETING

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VIDEO: One in five hospital patients get health care–acquired infection

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PHOENIX – If you happen to believe that the impact of health care–acquired infections is insignificant, think again. According to Dr. Kevin W. Lobdell, health care–acquired infections (HAIs) cause more deaths each year in the United States than breast cancer, lung cancer, and AIDS combined.

“If you look at hospitalized patients, one in five will acquire a health care–acquired infection,” Dr. Lobdell of the Sanger Heart and Vascular Institute at Carolinas Health System, Charlotte, N.C., said in a video interview at the annual meeting of the Society of Thoracic Surgeons. “With respect to length of stay, that goes from 5 days on average for a normal, uninfected patient, to 22 days if they’ve had an infection. The mortality rate can be as high as 6% in those people that have developed infections, so that in itself is an enormous burden.”

He went on to discuss the most common HAIs in the hospital setting and noted that combating them involves strategies that consider people, the environment, and technology. He predicted that in coming years clinicians will have a better “analytic capability to understand what we’ve done in the past and what correlates with success in the future, and then be able to implement and learn from that.”

Dr. Lobdell reported having no financial disclosures.

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PHOENIX – If you happen to believe that the impact of health care–acquired infections is insignificant, think again. According to Dr. Kevin W. Lobdell, health care–acquired infections (HAIs) cause more deaths each year in the United States than breast cancer, lung cancer, and AIDS combined.

“If you look at hospitalized patients, one in five will acquire a health care–acquired infection,” Dr. Lobdell of the Sanger Heart and Vascular Institute at Carolinas Health System, Charlotte, N.C., said in a video interview at the annual meeting of the Society of Thoracic Surgeons. “With respect to length of stay, that goes from 5 days on average for a normal, uninfected patient, to 22 days if they’ve had an infection. The mortality rate can be as high as 6% in those people that have developed infections, so that in itself is an enormous burden.”

He went on to discuss the most common HAIs in the hospital setting and noted that combating them involves strategies that consider people, the environment, and technology. He predicted that in coming years clinicians will have a better “analytic capability to understand what we’ve done in the past and what correlates with success in the future, and then be able to implement and learn from that.”

Dr. Lobdell reported having no financial disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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PHOENIX – If you happen to believe that the impact of health care–acquired infections is insignificant, think again. According to Dr. Kevin W. Lobdell, health care–acquired infections (HAIs) cause more deaths each year in the United States than breast cancer, lung cancer, and AIDS combined.

“If you look at hospitalized patients, one in five will acquire a health care–acquired infection,” Dr. Lobdell of the Sanger Heart and Vascular Institute at Carolinas Health System, Charlotte, N.C., said in a video interview at the annual meeting of the Society of Thoracic Surgeons. “With respect to length of stay, that goes from 5 days on average for a normal, uninfected patient, to 22 days if they’ve had an infection. The mortality rate can be as high as 6% in those people that have developed infections, so that in itself is an enormous burden.”

He went on to discuss the most common HAIs in the hospital setting and noted that combating them involves strategies that consider people, the environment, and technology. He predicted that in coming years clinicians will have a better “analytic capability to understand what we’ve done in the past and what correlates with success in the future, and then be able to implement and learn from that.”

Dr. Lobdell reported having no financial disclosures.

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VIDEO: Preventing healthcare acquired infections after CT surgery

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PHOENIX – More and more attention is being paid to preventing healthcare acquired infections (HAIs) in the hospital setting, and the role of HAIs in cardiothoracic surgery is a particlularly important area of focus.

“The good news is that cardiothoracic surgeons are really good at preventing infections. There’s been a lot of pressure over the past many years to report infections after cardiothoracic surgery, and so they’ve gotten a lot of things right,” Dr. Emily Landon said in a video interview at the annual meeting of the Society of Thoracic Surgeons.

“However, patients that undergo cardiothoracic surgery are still at risk of the infections that plague everyone in hospitals ... all of these are a problem based on whatever the hospital’s current situation is.”

Dr. Landon, who is the medical director of antimicrobial stewardship and infection control at University of Chicago Medicine, Chicago, discussed how cardiothroacic surgeons can maintain their own good outcomes and how they can have a postive impact outside the OR on protecting their patients after surgery.

Dr. Landon reported having no financial disclosures.

 

 

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PHOENIX – More and more attention is being paid to preventing healthcare acquired infections (HAIs) in the hospital setting, and the role of HAIs in cardiothoracic surgery is a particlularly important area of focus.

“The good news is that cardiothoracic surgeons are really good at preventing infections. There’s been a lot of pressure over the past many years to report infections after cardiothoracic surgery, and so they’ve gotten a lot of things right,” Dr. Emily Landon said in a video interview at the annual meeting of the Society of Thoracic Surgeons.

“However, patients that undergo cardiothoracic surgery are still at risk of the infections that plague everyone in hospitals ... all of these are a problem based on whatever the hospital’s current situation is.”

Dr. Landon, who is the medical director of antimicrobial stewardship and infection control at University of Chicago Medicine, Chicago, discussed how cardiothroacic surgeons can maintain their own good outcomes and how they can have a postive impact outside the OR on protecting their patients after surgery.

Dr. Landon reported having no financial disclosures.

 

 

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

 

 

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PHOENIX – More and more attention is being paid to preventing healthcare acquired infections (HAIs) in the hospital setting, and the role of HAIs in cardiothoracic surgery is a particlularly important area of focus.

“The good news is that cardiothoracic surgeons are really good at preventing infections. There’s been a lot of pressure over the past many years to report infections after cardiothoracic surgery, and so they’ve gotten a lot of things right,” Dr. Emily Landon said in a video interview at the annual meeting of the Society of Thoracic Surgeons.

“However, patients that undergo cardiothoracic surgery are still at risk of the infections that plague everyone in hospitals ... all of these are a problem based on whatever the hospital’s current situation is.”

Dr. Landon, who is the medical director of antimicrobial stewardship and infection control at University of Chicago Medicine, Chicago, discussed how cardiothroacic surgeons can maintain their own good outcomes and how they can have a postive impact outside the OR on protecting their patients after surgery.

Dr. Landon reported having no financial disclosures.

 

 

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

 

 

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VIDEO: New diagnostic, treatment methods for fungal infections

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ORLANDO – New diagnostic and treatment options are at the forefront of what’s new and exciting in the area of superficial cutaneous fungal infections, according to Dr. Adam Friedman.

“Although superficial cutaneous mycoses [are] extremely common, they can be quite a challenge for several reasons,” explained Dr. Friedman of the George Washington University in Washington, at the Orlando Dermatology Aesthetic and Clinical annual meeting, adding that “many of the common skin diseases are often confused for tineum, and vice versa.”

In this video interview, Dr. Friedman discusses what dermatologists should look for in terms of diagnosing and treating dermatophytes and onychomycosis, two of most common and increasingly treatable fungal infections patients are likely to present with.

Dr. Friedman did not report any relevant financial disclosures.

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ORLANDO – New diagnostic and treatment options are at the forefront of what’s new and exciting in the area of superficial cutaneous fungal infections, according to Dr. Adam Friedman.

“Although superficial cutaneous mycoses [are] extremely common, they can be quite a challenge for several reasons,” explained Dr. Friedman of the George Washington University in Washington, at the Orlando Dermatology Aesthetic and Clinical annual meeting, adding that “many of the common skin diseases are often confused for tineum, and vice versa.”

In this video interview, Dr. Friedman discusses what dermatologists should look for in terms of diagnosing and treating dermatophytes and onychomycosis, two of most common and increasingly treatable fungal infections patients are likely to present with.

Dr. Friedman did not report any relevant financial disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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ORLANDO – New diagnostic and treatment options are at the forefront of what’s new and exciting in the area of superficial cutaneous fungal infections, according to Dr. Adam Friedman.

“Although superficial cutaneous mycoses [are] extremely common, they can be quite a challenge for several reasons,” explained Dr. Friedman of the George Washington University in Washington, at the Orlando Dermatology Aesthetic and Clinical annual meeting, adding that “many of the common skin diseases are often confused for tineum, and vice versa.”

In this video interview, Dr. Friedman discusses what dermatologists should look for in terms of diagnosing and treating dermatophytes and onychomycosis, two of most common and increasingly treatable fungal infections patients are likely to present with.

Dr. Friedman did not report any relevant financial disclosures.

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VIDEO: Consider adding photodynamic therapy to your practice

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ORLANDO – Dermatologists with the right patient population should consider incorporating photodynamic therapy (PDT) into their practices, as it is becoming an increasingly popular and effective.

Although most dermatologists know about PDT, “They’re not as comfortable setting up the office” and often don’t know the best ways to use PDT to achieve optimal treatment outcomes, explained Dr. Neal Bhatia, director of clinical dermatology at Therapeutics Clinical Research in San Diego, during his session at the Orlando Dermatology Aesthetic and Clinical annual meeting.

In this video interview, Dr. Bhatia, explains the benefits of PDT, what type of patient would be best suited for this treatment, and why it’s increasingly important for dermatologists to offer this treatment to their patients – even if they’ve never considered doing so before.

Dr. Bhatia is a clinical investigator and consultant with Dusa Pharmaceuticals and Biofrontera. He did not report any other relevant disclosures.

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ORLANDO – Dermatologists with the right patient population should consider incorporating photodynamic therapy (PDT) into their practices, as it is becoming an increasingly popular and effective.

Although most dermatologists know about PDT, “They’re not as comfortable setting up the office” and often don’t know the best ways to use PDT to achieve optimal treatment outcomes, explained Dr. Neal Bhatia, director of clinical dermatology at Therapeutics Clinical Research in San Diego, during his session at the Orlando Dermatology Aesthetic and Clinical annual meeting.

In this video interview, Dr. Bhatia, explains the benefits of PDT, what type of patient would be best suited for this treatment, and why it’s increasingly important for dermatologists to offer this treatment to their patients – even if they’ve never considered doing so before.

Dr. Bhatia is a clinical investigator and consultant with Dusa Pharmaceuticals and Biofrontera. He did not report any other relevant disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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ORLANDO – Dermatologists with the right patient population should consider incorporating photodynamic therapy (PDT) into their practices, as it is becoming an increasingly popular and effective.

Although most dermatologists know about PDT, “They’re not as comfortable setting up the office” and often don’t know the best ways to use PDT to achieve optimal treatment outcomes, explained Dr. Neal Bhatia, director of clinical dermatology at Therapeutics Clinical Research in San Diego, during his session at the Orlando Dermatology Aesthetic and Clinical annual meeting.

In this video interview, Dr. Bhatia, explains the benefits of PDT, what type of patient would be best suited for this treatment, and why it’s increasingly important for dermatologists to offer this treatment to their patients – even if they’ve never considered doing so before.

Dr. Bhatia is a clinical investigator and consultant with Dusa Pharmaceuticals and Biofrontera. He did not report any other relevant disclosures.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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VIDEO: Treating your atopic dermatitis patients more effectively

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ORLANDO – A “hard and soft” approach to treating atopic dermatitis – treating more frequently while symptoms persist, then pulling back on treatment to keep symptoms at bay – is an effective way to keep the condition manageable for your patients.

“This is not an easy disease to manage, and that’s the key,” explained Dr. Adam Friedman of the George Washington University in Washington, at the Orlando Dermatology Aesthetic and Clinical annual meeting, adding that it’s important to educate patients that atopic dermatitis is “something that they will always have” and does not have one-shot cures.

In this video interview, Dr. Friedman, who is a Dermatology News board member, discusses the best way to talk to new patients about what atopic dermatitis treatment will entail, and offers methods to make management of the disease more effective and, consequently, improve patients’ quality of life.

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ORLANDO – A “hard and soft” approach to treating atopic dermatitis – treating more frequently while symptoms persist, then pulling back on treatment to keep symptoms at bay – is an effective way to keep the condition manageable for your patients.

“This is not an easy disease to manage, and that’s the key,” explained Dr. Adam Friedman of the George Washington University in Washington, at the Orlando Dermatology Aesthetic and Clinical annual meeting, adding that it’s important to educate patients that atopic dermatitis is “something that they will always have” and does not have one-shot cures.

In this video interview, Dr. Friedman, who is a Dermatology News board member, discusses the best way to talk to new patients about what atopic dermatitis treatment will entail, and offers methods to make management of the disease more effective and, consequently, improve patients’ quality of life.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

[email protected]

ORLANDO – A “hard and soft” approach to treating atopic dermatitis – treating more frequently while symptoms persist, then pulling back on treatment to keep symptoms at bay – is an effective way to keep the condition manageable for your patients.

“This is not an easy disease to manage, and that’s the key,” explained Dr. Adam Friedman of the George Washington University in Washington, at the Orlando Dermatology Aesthetic and Clinical annual meeting, adding that it’s important to educate patients that atopic dermatitis is “something that they will always have” and does not have one-shot cures.

In this video interview, Dr. Friedman, who is a Dermatology News board member, discusses the best way to talk to new patients about what atopic dermatitis treatment will entail, and offers methods to make management of the disease more effective and, consequently, improve patients’ quality of life.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

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We can do more to prevent suicide

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ADHD, Part 2: How important is a teacher’s assessment?

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Dr. David Pickar and Dr. Lillian M. Beard address the importance of flagging ADHD in the classroom, addressing family resistance to treatment, and situations that might call for the involvement of other mental health colleagues.

“I find a lot of resistance [to the ADHD diagnosis], particularly among African American families,” says Dr. Beard, physician director, Children’s Pediatricians and Associates, Silver Spring, Md.

“An untreated ADHD kid is difficult for the teacher, but it is toughest on the kid,” says Dr. Pickar, adjunct professor of psychiatry at Johns Hopkins University, Baltimore. “Families may not hear it all, but a doctor pays a lot of attention to what the teacher is saying about that child in the classroom.”

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Dr. David Pickar and Dr. Lillian M. Beard address the importance of flagging ADHD in the classroom, addressing family resistance to treatment, and situations that might call for the involvement of other mental health colleagues.

“I find a lot of resistance [to the ADHD diagnosis], particularly among African American families,” says Dr. Beard, physician director, Children’s Pediatricians and Associates, Silver Spring, Md.

“An untreated ADHD kid is difficult for the teacher, but it is toughest on the kid,” says Dr. Pickar, adjunct professor of psychiatry at Johns Hopkins University, Baltimore. “Families may not hear it all, but a doctor pays a lot of attention to what the teacher is saying about that child in the classroom.”

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

Dr. David Pickar and Dr. Lillian M. Beard address the importance of flagging ADHD in the classroom, addressing family resistance to treatment, and situations that might call for the involvement of other mental health colleagues.

“I find a lot of resistance [to the ADHD diagnosis], particularly among African American families,” says Dr. Beard, physician director, Children’s Pediatricians and Associates, Silver Spring, Md.

“An untreated ADHD kid is difficult for the teacher, but it is toughest on the kid,” says Dr. Pickar, adjunct professor of psychiatry at Johns Hopkins University, Baltimore. “Families may not hear it all, but a doctor pays a lot of attention to what the teacher is saying about that child in the classroom.”

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ADHD, Part 1: Is prevalence overstated in children?

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Primary care physicians are on the front lines for diagnosing and prescribing to treat attention-deficit/hyperactivity disorder in children. In this video, Dr. David Pickar and Dr. Lillian M. Beard discuss what primary care physicians should know to feel confident when diagnosing and treating ADHD.

“[The first time] you see a patient with ADHD respond to stimulants, you see it is lifesaving … [the result] takes your breath away,” Dr. Pickar says.

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Primary care physicians are on the front lines for diagnosing and prescribing to treat attention-deficit/hyperactivity disorder in children. In this video, Dr. David Pickar and Dr. Lillian M. Beard discuss what primary care physicians should know to feel confident when diagnosing and treating ADHD.

“[The first time] you see a patient with ADHD respond to stimulants, you see it is lifesaving … [the result] takes your breath away,” Dr. Pickar says.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

Primary care physicians are on the front lines for diagnosing and prescribing to treat attention-deficit/hyperactivity disorder in children. In this video, Dr. David Pickar and Dr. Lillian M. Beard discuss what primary care physicians should know to feel confident when diagnosing and treating ADHD.

“[The first time] you see a patient with ADHD respond to stimulants, you see it is lifesaving … [the result] takes your breath away,” Dr. Pickar says.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
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Collaborative Care, Part 2: What is 'enough' team care training?

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Medical students are better prepared for practice when they learn to integrate mental health and team-based care in the academic setting.

“All schools of health professions’ education are moving in that direction,” says Dr. Lawrence “Bopper” Deyton, senior associate dean for public health at George Washington University, Washington. “Nobody has it perfect yet, but I think we’re seeing changes in that direction.”

In this installment of Mental Health Consult, Dr. Deyton and Dr. April Barbour, director of general internal medicine and the primary care residency program at George Washington University, Washington, discuss approaches to teaching integrated mental health care.

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Medical students are better prepared for practice when they learn to integrate mental health and team-based care in the academic setting.

“All schools of health professions’ education are moving in that direction,” says Dr. Lawrence “Bopper” Deyton, senior associate dean for public health at George Washington University, Washington. “Nobody has it perfect yet, but I think we’re seeing changes in that direction.”

In this installment of Mental Health Consult, Dr. Deyton and Dr. April Barbour, director of general internal medicine and the primary care residency program at George Washington University, Washington, discuss approaches to teaching integrated mental health care.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel

Medical students are better prepared for practice when they learn to integrate mental health and team-based care in the academic setting.

“All schools of health professions’ education are moving in that direction,” says Dr. Lawrence “Bopper” Deyton, senior associate dean for public health at George Washington University, Washington. “Nobody has it perfect yet, but I think we’re seeing changes in that direction.”

In this installment of Mental Health Consult, Dr. Deyton and Dr. April Barbour, director of general internal medicine and the primary care residency program at George Washington University, Washington, discuss approaches to teaching integrated mental health care.

The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
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Collaborative Care, Part 2: What is 'enough' team care training?
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