Institute for the Family, Department of Psychiatry, University of Rochester Medical Center.
Department of Family Medicine, University of Colorado Denver School of Medicine.
Am Psychol. 2014 May-Jun;69(4):325-31. doi: 10.1037/a0036222.
The health care system in the United States has been less effective and more expensive than it needs to be, but the organizational and political will to address these shortcomings is beginning to emerge. These changes are particularly noticeable in primary care, at the heart of an improved health care system. The value of primary care turns on its comprehensiveness, which means that behavioral health care-health behavior change, mental health care, management of psychological symptoms and psychosocial distress, and attention to substance abuse-must be woven into the fabric of primary care practice. This integration is beginning to happen as psychologists and other behavioral health clinicians are incorporated as essential team members in the patient-centered medical home and other emerging models of primary care. This article introduces psychologists to the fundamental changes taking place in primary care and to the various roles that psychologists can play in the new health care system. We describe the extensive breadth and diversity of primary care by age, sex, setting, and type of clinical problem and the implications of this variety for the psychologist's role. This description is not simply a clinical exercise: Transformation of the primary care system also has policy, educational, and research dimensions. We describe how psychologists are essential to these functions as well.
美国的医疗保健系统一直以来都不够高效，费用也过高，但解决这些缺陷的组织和政治意愿正在逐渐显现。这些变化在初级保健领域尤为明显，因为它是改善医疗保健系统的核心。初级保健的价值在于其全面性，这意味着行为健康护理——行为改变、心理健康护理、心理症状和心理困扰的管理以及对物质滥用的关注——必须融入初级保健实践的结构中。这种整合正在发生，因为心理学家和其他行为健康临床医生已被纳入以患者为中心的医疗之家和其他初级保健新模式的基本团队成员。本文向心理学家介绍初级保健中正在发生的根本性变化，以及心理学家在新医疗保健系统中可以扮演的各种角色。我们按年龄、性别、环境和临床问题类型描述了初级保健的广泛范围和多样性，以及这种多样性对心理学家角色的影响。这种描述不仅仅是一种临床实践：初级保健系统的转变也具有政策、教育和研究方面。我们还描述了心理学家在这些功能中所扮演的不可或缺的角色。
