Questions and Answers

Referral Related Topics

  1. How successful has referring patients to their PCP been as a general referral strategy?
  2. It seems that it is often better to go to the Primary Care Physician rather than the cardiologist with the depression screening results, do you agree?
  3. What happens when a patient referred back to their cardiologist and/or PCP but, do not appear to have gotten any follow-up?
  4. What would be the best course of action when it appears that the PCP has not evaluated the patient after a referral has been made?
  5. Where does the liability lie after the cardiac rehabilitation center makes the referral for depression evalutation?
  6. Wouldn't cardiologists resent receiving a return receipt letter as a second notification of a postive screen?
  7. What are your thoughts about the cardiologist or PCP making the behavioral health referral?

Patient Related Topics

  1. What do you do when a patient refuses to complete the depression screener, or who refuses to sign the release to consent on the bottem of the form?
  2. Why is an Adjustment Disorder diagnosis sometimes preferable to a diagnosis of Major Depressive Episode or Disorder?
  3. What do you do if some patients don't want a mental health diagnosis in their medical chart?
  4. Would group sessions be recommended for depressed cardiac patients?
  5. What happens when a patient does not want their PCP informed of a positive depression screening?
  6. What should centers do if they have a high risk patient who refuses treatment?

Policy Related Issues

  1. Is it suggested that patients who are depressed should resolve their depression prior to entering cardiac rehabilitation?
  2. Is there any consensus among the centers regarding which depression screener that they decided to use?
  3. Would you recommend giving a second depression screener to improve the specificity of the first screening results?
  4. How should we handle the cases in which the patient's depression screener results are borderline positive?
  5. What is the recommendation for patients who score in the mild depression range?
  6. Should the supervising physician/medical director at the cardiac rehabilitation center been involved with patients who score postive on depression screeners?
  7. Who and/or what defines the area of responsibility for the cardiac rehabilitation regarding depression screening?