Practical Neuropsychiatry was created out of necessity. We have found that the current system of medicine is very efficient at treating some illnesses, but only when they fall under individual systems. A stand alone heart rhythm problem can be identified and treated by a cardiologist. An isolated mood disorder is easily and efficiently treated by a psychiatrist. However, whenever a problem or a syndrome overlaps between multiple specialists, patients get lost and confused trying to advocate for themselves. This is especially painful for the patients who live between the fields of medicine, neurology, and psychiatry. A Neurologist may say the problem is obvious and has medical contributors, but is treated psychiatrically. The internist feels the symptom is confusing them and they don’t know where to start. The psychiatrist may say the problem seems “organic” or “neurologic” and patients are cast onto a wheel of uncertainty.

Ask anyone with a chronic pain syndrome, strange episodes of loss of consciousness, or atypical confusion spells and you will find a group of patients who have diligently seen every specialist, paid every copay, taken every drug, and just continue to see specialist after specialist until they abandon hope and fall into depression. No individual physician is to blame, perhaps having even treated the symptom they were responsible for, but the patient still leaves confused after a 15 minute follow-up where they are told “Everything came back normal” and heard “Nothing is wrong with you”. The core problem is that medicine has become an efficient machine for patients with an individual problem that falls under one specialist, but when patients have an “overlap syndrome” they are left behind because the insurance model incentivizes quick visits which do not allow for the more complex teaching and counseling that might help patients understand their problem and navigate next steps to finding solutions. See our page on Common Conditions we consult on and you may get an idea of why our patients have suffered so long and feel without guidance.

Our promise is simply this: We will use our training and experience in complex Neuropsychiatric overlap syndromes to help patients decide what their goals are, honestly advise them if we believe we can help them achieve their goals, and determine a shared plan for how to do this. It will then be at the patients’ discretion how to use what we offer. We, unfortunately, must limit the number of individual direct care patients we provide standard neuropsychiatric care to. However, through various models from Health Coaching to Shared Medical Appointments, we hope to fill gaps in the standard medical model while giving very high quality advice and guidance to the clients and patients who need it the most. When we believe they would be best served by some part of the standard medical machinery, we will offer our best guidance to help patients overcome any barriers they encounter. And we will try our very best to adapt to our patients’ evolving needs with open, clear, honest communication, offering our skills as educators, guides, coaches, and medical providers as appropriate.