The Med-Psych residents have continuity clinics in two locations they maintain throughout the residency. Interns start off in the Medical Home of the Interim LSU Public Hospital alongside their categorical Internal Medicine colleagues on their "+1 week" of clinics. This clinic started as a MASH unit set up by returning Charity Hospital doctors and nurses after Hurricane Katrina and has developed into a multi-specialty clinic, housed in the former Lord and Taylor department store. Every 5 weeks while on medicine they have an entire week of clinics, where one half-day is set aside for psychiatrically comorbid patients where they check out to Dr. Alvarez to learn to develop treatment plans for both the medical and psychiatric problems. Patients are referred to this clinic from other residents or after hospital discharge from University Hospital. Interns continue that half day of clinic while on 4 months of psychiatry rotations and throughout all five years of residency.
Starting second year, the Med-Psych residents start seeing patients weekly at the Ruth Fertel Community Health Center. This is a community based clinic which started as a first aid station in front of a homeless shelter on the edge of the French Quarter and now is a Patient-Centered Medical Home and Federally Qualified Health Center. It now occupies its permanent home in the renovated building that once housed the original Ruth's Chris Steak House. Under the guidance of Dr. Dunn, they do primary and preventive care for the seriously mentally ill as well as perform psychiatric consultation for their internal medicine colleagues. Because it is weekly (except during ICU and some inpatient rotations), it affords the resident an opportunity to learn how to implement psychotherapeutic interventions in the primary care environment. In addition to joint injections, cancer screening and diabetes management, residents sharpen their skills in motivational interviewing, behavioral activation, cognitive-behavioral therapy and short term insight oriented psychotherapy.
We hope to start an integrated clinic at the VA as that hospital is being built and its outpatient operations ramp up. Tulane's Med-Psych residents are at the forefront of the integration movement, bringing high quality combined care to the populations that need it most.