Training future psychologists and other health-care profes-
sionals is a key part of Cherokee’s mission, Freeman added.
Gilbert Newman, PhD, director of clinical training at the
Wright Institute in Berkeley, Calif., described the program he
created to prepare psychology students and psychologists to
work in integrated primary-care settings.
Many psychologists who work in primary care weren’t
trained to do so, said Newman. “They learned a lot by the seat
of their pants,” he said, adding that many think that primary-
care psychology should be a postdoctoral specialization.
Believing that students need preparation much earlier in
their training, Newman launched a primary-care training
program in 2004. A grant from the federal Graduate
Psychology Education program allowed him to expand
his efforts, as has a grant from the Mental Health Service
Administration in California, designed to enhance programs
for mental health and the homeless.
“With health-care reform, there’s a strong effort afoot
to rebuild the primary-care workforce and invest in the
community health center system,” Newman said. “We have
an opportunity here ... to really repopulate the public health
system with psychologists.”
De-emphasizing psychotherapy, the training emphasizes
consultation skills, rapid interventions, leadership and
advocacy — something Newman said is crucial given the fact
Psychologists at Cherokee Health Systems in Knoxville, tenn.,
treat a wide variety of patients and health and behavioral
conditions, said Cherokee chief executive officer Dr. Dennis
Freeman. “this isn’t traditional psychotherapy co-located in a
primary-care office,” he said. “It’s a new paradigm.”
that leaders in FQHCs and other public systems often confuse
psychologists and social workers.
Seiji Hayashi, MD, chief medical
officer in the Bureau of Primary Health
Care at the U.S. Health Resources and
Services Administration, ended with
a look at the role of behavioral health
Incorporating a psychologist into an
FQHC — especially a small, rural facility
— can be challenging, Hayashi admitted,
but doing so can be transformative.
“If we can really integrate behavioral
health into primary care, that’s a game
changer,” he said.
One of Hayashi’s own patients
illustrates the urgent need for integration.
After seeing the woman for two years,
Hayashi still couldn’t get her diabetes
under control. Finally, he thought to ask
if she ever heard voices. It turned out
she did and was seeing a psychologist
and psychiatrist at a community mental
health center. Hayashi hadn’t known
about them and they weren’t aware of
all the medications he was giving the
woman for her diabetes, hypertension and
hepatitis C. “It was an ‘Aha’ moment,” said