Health Care, Higher Education, and Human Resources

Pine Rest focuses on becoming leader in psychiatry training

Physician assistant residency program is the third of its kind in the country.

October 30, 2015
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Pine Rest
The Ruth & Jack Loeks Psychiatry Center opened last week on the Pine Rest campus. Courtesy Pine Rest

Right now if you were to try to make an appointment to see a psychiatrist in Grand Rapids, you’d be looking at up to six months for the next available opening.

That’s because Grand Rapids is experiencing a shortage of psychiatrists.

“There is a shortage of mental health care providers across the country, including here in Michigan and West Michigan,” said Dr. William Sanders, Pine Rest/Michigan State University College of Human Medicine psychiatry residency program director.

To help meet the growing demand for psychiatrists and to improve the quality of care in the community, Sanders said 10 years ago Pine Rest Christian Mental Health Services began thinking about what it could do.

It came up with two key solutions: attract quality providers in the form of trained clinicians and a supporting workforce, and utilize its existing affiliation with the MSU medical school to improve the academic environment in West Michigan.

As a result, last year Pine Rest welcomed its first class of psychiatry residency students, and in July 2016, it will welcome its first class of physician assistant psychiatry residents.

To meet training needs, Pine Rest recently opened a new outpatient facility with the help of the Loeks family.

The Ruth & Jack Loeks Psychiatry Residency Center, which opened last week, will serve as an outpatient training center for the MSU residents, who will use the center to complete the 12 months of outpatient training required as part of their four years of residency training.

“The outpatient clinic is the ideal place to treat patients,” Sanders said. “That is really where we envision the majority of treatment for people with mental health illness or difficulties in the future.”

The Loeks Residency Center is considered state-of-the-art, infused with all the latest technology for quality patient care.

Sanders noted each of the rooms used for meeting with patients is equipped with two computer screens so clinicians can easily access and share information with clients, while still being able to maintain eye contact and create a comfortable environment.

The rooms also include cameras and microphones for recording purposes. Supervisors can use the recordings to provide feedback to residents and ensure quality patient care and safety.

On Oct. 26, two residents began seeing clients at the center. By May, all nine of the program’s second-year residents will be seeing clients at the center.

The psychiatry residents will spend two and a half days each week providing outpatient care. The rest of their time is spent attending lectures and in other rotations, and further specialization in areas of interest to the resident.

The physician assistant program, which will accept two residents each year, is a yearlong program that will provide P.A.s with skills that can be applied specifically to the mental health setting.

During the first six months, the P.A. residents will complete morning rotations on inpatient hospital units, under the supervision of an attending psychiatrist. Their afternoons will be spent providing mental health services within the Pine Rest Outpatient Network under the supervision of a supervising psychiatrist and P.A. residency director. The residents will also take part in scheduled lectures.

During the second six months of the program each P.A. resident will work in a designated outpatient clinic under the direct supervision of a psychiatrist, learning outpatient psychiatric best care practices

“This will help meet the growing mental health need in West Michigan,” said P.A. psychiatry residency director Paul Costanzo.

Physician assistant training in psychiatry is relatively new. There are only two other P.A. psychiatry residency training programs offered in the country, one in Iowa and the other in Minnesota.

Costanzo said P.A.s are able to earn certification in the subspecialty area of psychiatry.

He said an area of tension between P.A.s and physicians is that the P.A. is working under a physician’s license, which means the physician is taking on a level of responsibility in the relationship. He said one of the benefits of having both programs is the opportunity to reduce that tension by building trust between both parties.

“The biggest thing I am excited about is the ability to collaborate with the residency program,” Costanzo said. “Probably the biggest gap we have is in fostering that relationship between a supervising psychiatrist and an assistant doing psychiatry. It asks a lot for a doctor to take on that responsibility, so I’m hoping this will be the beginning stage for that.

“They will be attending some of the classes with the physician residents and working with them in some of the clinics so they will have a better understanding, and hopefully that will create a better comfort level in being a supervising physician.”

Sanders said he expects the P.A. residents will be attending many of the first-year physician resident lectures, as well, and eventually senior physician residents may be asked to provide some of the P.A. program lectures.

“We are really excited about the P.A. program,” he said. “There aren’t enough psychiatrists, or doctors in general, so to have well-trained P.A.s being able to support the physicians — we think that will be a win for everyone.

“The patients will get extra time and an extra resource,” he added.

Pine Rest said on average about 43 percent of its 34,000 outpatient clients receive psychiatry services.

“We are hoping our psychiatrists will be able to function as team leaders and follow that integrated care model,” Sanders said.

He said a benefit of having residency programs in West Michigan is evident in industry statistics.

“Sixty percent of residents and P.A.s remain where they trained,” he explained.

Sanders and Costanzo believe the residency programs offered by Pine Rest can be among the best in the nation.

“We are working to become the center for training for mental health in the Midwest and even the country,” Costanzo said.

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