Subspecialty Consults and Clinics Expectations
Goals and Objectives for Inpatient Consults
- Develop an understanding of substance use disorders seen in the hospital and outpatient settings
- PGY-2: Understand the principles of assessing and managing both common and complex presentations of substance use disorders in hospitalized patients and in the outpatient setting.
- PGY-3: Develop advanced processes to recognize and treat complications in patients with substance use disorders in patients with multiple medical problems
- Competency: Patient care, Medical knowledge
- Developing diagnosis skills
- PGY-2: Effectively use the bedside clinical examination and demonstrate subtle clinical findings in patients with substance use disorders
- PGY-3: Learn how to correlate bedside clinical findings with other data in patients with substance use disorders
- Competency: Patient care, Medical knowledge
- Understand the differential diagnosis of substance use disorders
- PGY-2: Develop a differential diagnosis for common clinical scenarios in patients with substance use disorders. Gain skills in how to effectively counsel patients on their substance use and harm reduction.
- PGY-3: Recognize unusual presentations of common clinical situations in patients with substance use disorders.
- Competency: Medical knowledge
- Learn pharmacological management of substance use disorders
- PGY-2: Learn the medications used in management of substance use disorders, understand how to manage complicated clinical problems, and develop specific therapeutic strategies in patients with substance use disorders
- PGY-3: Learn how to develop personalized care plans for patients with substance use disorderss and intersecting clinical problems
- Competency: Medical knowledge
- Effectively consult on inpatients, develop, and execute assessment and management plans. Gain an understanding of the processes and benefits of medications for opioid use disorder in the outpatient setting.
- PGY-2: Learn to be an effective addiction consultant. Recognize how to prioritize patient problems Develop management plans for inpatients with substance use disorders
- PGY-3: Understand interactions between patient substance use disorders and other medical issues and develop advanced strategies to prioritize management
- Competency: Patient care
- Effectively execute day-to-day management of patients
- PGY-2: Manage patients living with substance use disorders, including daily assessment and assessment of progress. Understand how to adjust patient treatment plans based on patient progress and determine the need for additional assistance such as subspecialty consultation
- PGY-3: Recognize how to manage substance use disorders problems and manage both expected and unexpected complications.
- Competency: Patient care
- Interdisciplinary care and discharge planning
- PGY-2: Learn how to communicate effectively with the interdisciplinary care team and anticipate patient needs for discharge and effective follow-up Recognize the unique needs of patients with substance use disorders and help integrate patient needs with available resources
- PGY-3: Learn how to manage advanced situations such as complex transitions of care and advocate for patients when resources are limited
- Competency: Patient care, System-based practice
- Rational ordering of lab tests and imaging studies
- PGY-2: Learn how to interpret laboratory findings and imaging seen in patients with substance use disorders
- PGY-3: Gain advanced knowledge of high value principles in the ordering of laboratory studies and imaging for evaluation of patients with substance use disorders
- Competency: Practice-based learning and improvement, Medical knowledge
- Familiarity with the electronic health record and optimization of its use
- PGY-2: Understand how to effectively use the electronic health record in the care of patients with substance use disorders.
- PGY-3: Develop an understanding of advanced medical informatics in the care of patients with substance use disorders by utilizing additional resources in the EHR
- Competency: Systems-based practice
- Communication and teamwork
- PGY-2: Develop effective and timely communication strategies with the interdisciplinary care team for patients with substance use disorders
- PGY-3: Use advanced communication methods to engage and coordinate care with the interdisciplinary care team for patients with substance use disorders
- Competency: Professionalism, Interpersonal and communication skills
Parkland Addiction Psychiatry Consults, VA Addiction Clinic, and Bluitt Flowers Suboxone Clinic
Site Director: Dr. Kapila Marambage
Location: Please use the LRC on the 12th floor between the 400 and 600 side. Please bring a personal laptop if possible as computer space in the team rounding room can be limited if you work from Zale part of the time.
Team composition
- The addiction psychiatry team is composed of one attending, addiction psychiatry APPs, psychiatry fellow(s), residents, and medical students.
Hours: 8 AM to 5 PM on Monday, Thursday, Friday; 1 PM to 5 PM on Wednesday; see below for Tuesdays and Wednesdays
- When you arrive, please text Ms. Hillary Arve, APN (214-502-3676) your name so that she can give access to the Addiction Consult list. Hillary will assign the cases that you will review. (New consults + New follow up consults from CL).
- Pre-chart your patients from 8-9 AM, no need to see in person yet
- There will be a daily invite to join the addiction huddle between 9-9:30AM over WebEx. Please be prepared to present your cases at the huddle.
- After huddle, you will meet with the group and break off into smaller teams to see patients together.
- Smart phrases to use (Kapila Marambage): New evals – KMINIOPI (Opioid UD), KMINIALC (Alcohol UD) etc. Follow ups KNFUALC, KMFUOPI etc.
- Note the particular scales commonly used:
- Mona Downs, PharmD - Addiction Psych Pharmacist will conduct individual sessions on order sets, which she will arrange with you.
- You should put in all the orders as discussed, communicate with the primary teams about the medical decision making and plans. Your notes should be completed by 2pm.
On Tuesdays, you will go to the VA Addiction clinics (Med/Peds see alternate site below).
Hours: 7:45 AM to noon
- Please meet Dr Barbosa at Building 1 on 5N in room 553a at 7:45AM.
- Park in Liberty or Freedom Garage and walk under the covered walkway straight to the back door of building 1
- Turn right as you enter the building and take the elevators (almost immediately there) to the fifth floor.
- You will come straight out of the elevators and down the hall turning right as the hall ends and progress to the end of the hall to room 553a in the Medical Director office (Dr. Barbosa's office).
- Please call Dr. Barbosa if you get lost!
- She will take you to the methadone clinic, see patients with you who need suboxone prescriptions and then you will attend an interdisciplinary meeting on high risk opioid use from 11AM-12PM. Please see the map below to help locate building 1.
On Tuesdays, Med/Peds residents will go to UTSW Addiction clinics.
Location: Empire Plaza I
- Address: 1430 Empire Central Dr, Dallas, TX 75247
- Visitor parking is on the north side of the building.
- Check-In: LC1.104. Upon entry to the building, LC1.104 is on the right.
- Let check-in staff know you have an appointment with Dr. Wakhlu, but not as a patient.
On Wednesday morning, you will go to the Bluitt Flowers Suboxone Clinic and then return to Addiction Consults in the afternoon.
PMH Bluitt Flowers Clinic
Director: Anisha Ganguly, MD
Contact: Director
Phone: 512-228-8705
Location: Bluitt Flowers COPC
- Address: 303 E Overton Rd, Dallas, TX 75216
- Meet Dr. Ganguly in the Bluitt Flowers Geriatric Clinic (not geriatrics, she just has an office in that clinic) at 8 am.
- Drive to the back of the clinic where you can tap your badge to open the gate. You can park in any spot in the staff lot. If your badge doesn't work, you can park in the front of the clinic where patients park.
- Enter through the left-most staff entrance. As you enter, there will be a door to the geriatrics clinic on the left. Her office is immediately to the right.
- If you are entering from the front of the building, ask our greeter at the front to direct you to the geriatrics clinic.