Top Ten Geezer Posts 2015: Happy Holidays!

Core Competency Pizza
Core Competency Pizza

The Top 10 Posts on The Practical Psychosomaticist for 2015 are, in order of most views:



Oral Version of the Trails Test for Cognitive Impairment

This has consistently been a popular post and speaks to the importance of the core competencies of Medical Knowledge. I often prefer the Mini-Cog (a combination of a test for short term recall and a Clock Drawing Task) along with checking the ability to recite the months of the year backward.

How and Why Did I Choose Psychiatry?

Maybe this one belongs in the Professionalism slice of the Core Competency Pizza. In it I share a little of my own soul-searching as well as review some of the challenges in the medical system including regulatory pressures (for example, the Maintenance of Certification)–so it could be about Systems-based practice as well as Practice-based learning and improvement. I tried to reprise the themes in the followup post, Still Learning Why I Chose Psychiatry.

QTc Interval Prolongation and Antipsychotics by Elysha Elson, PharmD, MPH

This is another Medical Knowledge core competency post and it has consistently been a highly accessed Practice-based learning and improvement exercise as well.

Pocket Cards for Delirium for Delirium Prevention, Thanks to AGS and CCSMH!

This is one from a few years ago and it counts as another slice of the Medical Knowledge and Patient Care core competency.

3D CAM: A New Delirium Screener

People are hungry for the Medical Knowledge and Patient Care core competencies…

Using the Columbia Suicide Severity Rating Scale As a Cheat Sheet

By now it should be very clear that the Maintenance of Certification (MOC) program is worse than useless for clinicians who are driven to seek excellence–not just competency. I wonder if the four practicing board certified psychiatrists and four practicing board certified neurologists recently appointed to the American Board of Psychiatry and Neurology (ABPN) MOC Clinical Advisory Committee would ever consider that? They are supposed to “provide suggestions and feedback on how MOC impacts their practice and potentially improves patient care.” I hope they will think critically, frankly examine both the merits and flaws of MOC, and make recommendations accordingly. The announcement:

“ABPN Appoints Physicians to New MOC Clinical Advisory Committee
The ABPN has appointed four practicing board certified psychiatrists and four practicing board certified neurologists to its new MOC Clinical Advisory Committee. The new committee will work with ABPN to provide suggestions and feedback on how MOC impacts their practice and potentially improves patient care.

Chosen from nominations by the American Psychiatric Association and the American Academy of Neurology, the appointees will be invited to participate in the ABPN Crucial Issues Forum on Maintenance of Certification in April 2016. Those appointed include:

  • Valerie Arnold, MD, psychiatrist
  • Bob Batterson, MD, psychiatrist
  • Lama Bazzi, MD, psychiatrist
  • Charlene Gamaldo, MD, neurologist
  • Elaine Jones, MD, neurologist
  • Eddie Patton, MD, neurologist
  • L. Russell Pet, MD, psychiatrist
  • Michael Rosenbloom, MD, neurologist

For more information, read the MOC Clinical Advisory Committee release. Congratulations to all.”

Competency or Capacity and Who Does What?

This is about a different kind of competency and it’s about a perennial issue in medicine, decisional capacity assessment. You have to eat every slice of the core competency pizza here because every competency is deployed.

Gladwell’s Principle of Legitimacy Revisited

Again this about the Practice-based learning and improvement core competency and the intrusion of the MOC, which has not been shown to change outcomes in medicine.

Pain Can Teach the Doctor

This is one that is probably about the Communication and interpersonal skills core competency, based in part on my walking a mile in the shoes of those who suffer chronic pain.

Psychosocial Evaluations for Organ Transplantation According to the Practical Psychosomaticist

This is an old post which encompasses all of the core competencies. I don’t conduct pre-organ transplant psychiatric assessments anymore, but the skills involved are readily transferrable to any other psychiatric evaluation.

The Clinical Problems in Consultation Psychiatry (CPCP) presentations are an important part of lifelong learning. Another important professional improvement activity I’m involved in more recently is the Psychosomatic Medicine Interest Group (PMIG). Our next meeting is on January 4, 2016. Don’t forget the gold lamborghinis!

Happy Holidays!

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