Neuropsychiatry Trainee Guide

Welcome to BWH Neuropsychiatry! We look forward to working with you.

This document outlines the most important logistical aspects of our clinical operations. In case of any questions, please do not hesitate to contact Dr. Baslet or ask your clinic supervisor(s).

Who are we?

Our Neuropsychiatry Division consists of 7 neuropsychiatrists on staff at Brigham and Women’s Hospital. We are one the core components of the Center for Brain/Mind Medicine (CBMM). You will be working with one or two primary supervisors per clinic session (4-hour clinic block). Due to cross-coverage, you will likely interact with most of us at some point. We are:

Gaston Baslet, M.D.

Jessica Harder, M.D.

Stanley Lyndon, M.D.

Geoffrey Raynor, M.D.

Shan Siddiqi, M.D.

Joseph Taylor, M.D.

Juan Carlos Urizar, M.D. (geriatric neuropsychiatry)

There are other neuropsychiatrists affiliated to CBMM that you will meet during rounds (Dr. Barry Fogel, Dr. Barbara Schildkrout, and others) that you will have the opportunity to learn from and consult with. We also have two social workers in Neuropsychiatry and you may reach out to them with clear short-term psychotherapy referrals. Click here for an overview of the services provided by neuropsychiatry social workers. You and your supervisor should discuss if a referral to Social Work is appropriate. Our two neuropsychiatry social workers are:

Margaret Latawiec, L.I.C.S.W.

Laura Morrissey, L.I.C.S.W.

We also have access to a Community Health Worker (CHW), Mr. Jean-Ford Figaro. The CHW can provide brief assistance around specific case management needs (ie, housing, food insecurity, etc) and help providing community referrals for mental health treatment (ie, need to establish psychotherapy with a provider in the community). Click here for an overview of the services provided by the community health worker.

Clinical Operations

Our on-site clinical operations take place at the BWH Hale Building, Clinical Neurosciences Center, 60 Fenwood Road, Boston, MA, first floor. Support staff at the clinic will help with requests related to the encounters that take place during your clinic time. This includes: check-in at the front desk, vitals and med reconciliation by medical assistants, and check out at the check-out desk. The check-out staff can assist with setting up a follow-up appointment and with referrals for tests and other specialists (provided that an order in Epic is in place).

Assistance for anything that happens outside of your on-site clinic time (including requests related to virtual visits) is handled by Brigham Psychiatric Specialties (BPS) Call Center support staff (physically located at 221 Longwood Ave). This includes managing phone calls from patients, making changes to your schedules, sending documents, etc. You will be assigned one primary support staff person.

As of July 1, 2021, all trainee clinics will take place physically at 60 Fenwood Road. New patients will be encouraged to schedule an in-person visit (patients may refuse). Follow-ups may be scheduled virtually, if deemed clinically appropriate, and if the patient will be physically in the state of Massachusetts. Every virtual clinical encounter should start by inquiring the patient about their physical location to ensure they are in Massachusetts (if located outside of Mass, a clinical encounter cannot take place, although emergency care can be provided over the phone as clinically indicated).

Maria T. Pires is the practice manager for BPS. For administrative requests specific to a patient (ie, move a patient appointment sooner, sending documents), you should contact your assigned primary support person. For medication-related issues (ie, completing prior authorization forms, getting information from pharmacies), the Psychiatry medical assistants could help. Click here for their names and phone numbers. Maria T. Pires should be included in messages related to changes in your schedule. Please ask your supervisors any questions on who the best person to contact is if you have questions. Any clinical requests should go through Epic’s In-Basket messaging system.

New patients are scheduled through our BWH Psychiatry Triage team (part of BPS Call Center). They may reach out to you with questions about new patients (such as which records you may want to receive beforehand). If asked, always check with your attending supervisor before accepting a new patient.

As a general rule, NEW patients (not previously seen in Neuropsychiatry) are always evaluated on a consultation basis (without expectation of treatment). If a new patient has established providers at BWH (such as PCP or neurological care), we may be able to offer treatment in our service. If a new patient does not have an established provider at BWH, we can only offer a one-time (or a two-time) consultation and referral back to the referring provider with recommendations (with very few exceptions; for instance, if a program already exists that offers a very limited form of treatment, such as short-term psychotherapy for FND).

All staff listed in this guide, and the support staff assigned to you, are reachable through MGB email. The clinic phone number is 617-732-6753; the clinic fax number is 617-738-8703. These are the numbers that should be given to patients to contact you. For electronic communication with patients, offer patients to use Patient Gateway / My Chart (and advise patients that there is an expected 48 business hour delay for a message to get to you). Do not communicate with patients via email as it is not part of their medical record.

CBMM Rounds

Trainees are expected to attend multidisciplinary CBMM rounds according to their pre-arranged schedule (Wednesdays from 10am to 12pm via Zoom https://partners.zoom.us/j/816006172 or at Hale building, 60 Fenwood Road, 2nd floor, room VTC 2006B). There is an expectation that trainees will present one new case each week during rounds (limited to 6 minutes per presentation).

On the second and fourth Wednesday of the month, we hold Neuropsychiatry management rounds from 11:30 to 12 (during the last portion of CBMM rounds). This time is reserved for presentations that pose a specific clinical management question. You should alert Dr. Baslet before rounds (via email) on the case you would like to present during Neuropsychiatry management rounds.

Tuesday evening supervision (5-6 pm) provides a more intimate discussion of topics related to Behavioral Neurology and Neuropsychiatry. These sessions are currently held via Zoom https://partners.zoom.us/j/195398040.

Time off

If you plan time off (vacation or education-related), please complete the following request form:

https://docs.google.com/forms/d/e/1FAIpQLSd0JCJp-ANjwvgRSPkdEMD5p9F9uW1L8H9T70-OrutJXfRZnw/viewform

and also inform Maria T. Pires (via email) and your supervisor as soon as you know the dates. The hospital has a mission to prevent bumping patients, so the sooner you provide us with this information, the better. The request should preferably be at least one month in advance.

If you are out sick, let your supervisor know immediately and send an email to bpspsychout@PARTNERS.ORG to let the administrative support staff know, so patients can be rescheduled.

Coverage

You are the primary neuropsychiatry provider for your patients and are expected to cover any clinical issues in between clinic days, unless you are on vacation or away for an educational activity. Attendings provide supervision and can be consulted by you for questions in between appointments with your patients.

You need to check your in-basket messages with enough frequency to answer any time-sensitive requests. The psychiatry resident on call answers emergency calls after hours and on weekends only.

In addition to new clinic patients, you will be assigned neuropsychiatry patients transferred from former trainees. If a “transfer patient” was assigned to you and the patient is already scheduled with you, we expect that you will answer any clinical requests from the patient, of course with your supervisor’s guidance. We advise that you do not contact patients not previously seen in our clinic and you always ask your supervisor regarding such requests. If you receive an Epic warning message that a patient you have not met has answered affirmatively to suicidal thoughts on a questionnaire, let the BWH Psychiatry Triage team know, and they will reach out to the referring physician.

During the time that you are away for vacation or for educational purposes, coverage will be provided by the other neuropsychiatry trainees. It is your responsibility to arrange for coverage and assign coverage properly in Epic. You should let Maria T. Pires and your primary support staff person know who is providing coverage for you (send email to BWHPsychiatricSpecialties@partners.org). Please be mindful that different trainees have different clinical loads and coverage should be proportional to your time in clinic. Your clinic supervisor can always provide guidance on how to answer a coverage question.

Clinical emergencies

During weekday nights and weekends, the on-call psychiatrist (a resident) can be available for emergency needs that cannot wait until the next working day. During weekdays during the day, you may need to involuntarily send a patient to an ED for evaluation (see how to file a section 12 if on-site or remotely below). Additionally, BPS offers urgent slots (walk-in urgent care clinic, also called LUCY) for patients that need to be seen before their scheduled appointments and for whose clinical situation is severe or urgent enough that care should not be delayed (yet do not merit a Section 12 filing). Please consult with your attending in these situations.

For non-medical emergencies (requiring the assistance of SW, such as crisis support, referral to partial hospitalization program, assistance with DCF/ interpersonal violence cases, please use the SW (non-MD) pager. See instructions below.