A new primary care practice on the campus of Rhode Island’s only private, nonprofit psychiatric and substance abuse hospital reimagines the design and purpose of the traditional waiting room.
For starters, it’s not called a waiting room.
“It’s a reception area,” says Butler Hospital research psychologist Lisa Uebelacker, Ph.D., who has led the development of integrating behavioral health services into Affinity Primary Care East Side. The new practice opened last November in a renovated building attached to Kane Gym on Butler’s Providence campus.
Patients who visit the office find a television screen displaying a staff-created slideshow of beautiful scenery from all over the world accompanied by a soothing music soundtrack.
“So instead of ‘Judge Judy,’ we have this really peaceful, nice welcoming place,” Uebelacker explains. “Marsha Linehan…I’m not going to get the quote exactly right but she said that everything about a clinical environment should be therapeutic. So the housekeeping staff should be therapeutic. Of course, the front desk should be therapeutic … and that’s what I feel like we’re building – this really nice environment that’s pro-health all the way around.”
Rethinking the patient experience is part of the growing interest in collaboration between mental and general health care providers seeking to improve health outcomes and achieve long-term cost savings. Affinity Primary Care East Side serves patients from the general public, Butler Hospital and Care New England employees. Affiliated with Butler, Kent, Memorial and Women & Infants hospitals, the practice supports a new primary care track for medical students and the Graduate Medical Education programs at Brown University’s Warren Alpert Medical School for training internists and psychiatrists. It is also a training site for postdoctoral fellows in clinical psychology.
The practice is supported in part by a three-year, $352,510 grant from the Rhode Island Foundation’s Integrated Behavioral Health in Primary Care project, which supports Affinity Primary Care East Side at Butler and a second site at the Family Care Center of Memorial Hospital in Pawtucket, the practice base for the Brown Family Medicine Residency Program.
Uebelacker supervises two psychology postdoctoral fellows who divide their time between the Butler and Memorial Hospital sites. They are part of an interdisciplinary team that includes two physicians, two medical assistants and an office manager.
Primary care remains the practice’s main focus, Uebelacker says. Patients first see a physician and then, if appropriate, may be referred to a psychologist the same visit or a different day.
“We’re not an independent outpatient psychologist practice,” Uebelacker says. “Our job is to provide consultation.”
Chronic illnesses often have a behavioral health component. So helping patients increase physical activity, change diet, stop smoking or reduce alcohol intake, adhere to medication regimens and get more sleep can have a major impact on their well-being. That’s where psychologists step in, Uebelacker says.
“I think that we’re ideal for primary care because our expertise is really in how to help people change their behavior.”
There are plans to develop a support group for coping with chronic illness. But first Affinity Primary Care East Side needs to attract enough patients. By early February, the practice was expected to be included in the Find-A-Doc web platform at carenewengland.org.
By Janine Weisman