Erik R. Vanderlip, MD, MPH

Family doc/psychiatrist Erik Vanderlip points to 3 big elephants in the room at the 2016 American Psychiatric Association meeting.

If we support the basic survival needs of the homeless first and stay fully invested in their progress, we could actually have a shot at success.

Because it makes medical and financial sense, says our blogger who is a psychiatrist and family physician.

The reasons reflect the silence that surrounds depression, its basic invisibility, and the mistaken notion that it can't be dealt with in primary care.

As science and innovation breed new developments in medical care, we’ll be faced again and again with the same question. Who's working on the answer?

Mr M's diabetes remained stubbornly uncontrolled despite all appropriate clinical interventions. The day I read his first psychiatric hospital admission history I was stunned to see on paper what we had all missed in the flesh. What value is adherence to treatment in the face of sheer hopelessness?

Four inpatient detentions in 4 months, but Jennifer happily caught a bus to head home. Was this case another crisis averted? Or just another flagrant waste of limited funds?

A patient no-shows. What's your gut reaction? Be honest. Relief, right? But after the relief is drowned in a flood of walk-ins and emergencies, I wonder about my role in community medicine.

Pay-for-performance medicine will, eventually judge--and pay--clinicians by the percentage of patients who fill their medications and are adherent to therapies.

Clipping the hardened toenails of a mentally ill patient made me wonder whose hands care for the feet of countless others who can't care for themselves.

One simple addition, basketball, is doing more for health and mental health in this community than months or years of therapy or any number of medications or office visits with me.

Behavioral change requires clincal systems that support tracking and follow-up over time.

My first patient had so many things wrong; he left before I could examine his heart and lungs, ask about chest pain, or reconcile his medication list. After his visit, veteran clinic staff noted they hadn’t seen Jim for years and were surprised he had come in at all. I felt the totality of my medical education had been squandered. They kindly reminded me it had just begun.