ATTENDING PSYCHIATRIST (MEDICALLY ENHANCED UNIT)

Job Description

Unique full time opportunity for psychiatrist comfortable with treating medically complex behaviorally challenged DMH patients on the Medically Enhanced Unit (MEU) of Tewksbury Hospital. This unit draws medically compromised psychiatric patients from throughout Massachusetts, bringing together in one place enhanced medical coverage (one full time internist and a half time medical nurse practitioner), with enriched and specialized PT/OT, psychology, and nursing resources to promote recovery and discharge to the community. Specialty consultation available (endocrinology, pulmonology, respiratory therapy, neurology, etc) on site. Opportunity for clinical leadership.

TEWKSBURY HOSPITALDEPARTMENT OF PSYCHIATRY POSITIONS
Tewksbury Hospital is a Joint Commission accredited Department of Public Health hospital located in Tewksbury, Massachusetts, about 23 miles north of Boston near the intersection of I-495 and I-93. In addition to eight DPH-operated medical units, Tewksbury Hospital has four 24- to 32-bed mental health units operated by the Northeast Area of the Massachusetts Department of Mental Health (DMH). These inpatient units provide longer-term and more intensive inpatient psychiatric treatment for DMH-eligible patients, and they also provide forensic evaluations of criminal defendants for the Massachusetts judicial system. All Tewksbury Hospital staff psychiatrists are board-certified or pursuing board certification. The caseload for a full-time psychiatrist on one of the DMH inpatient units is about 16 patients. Admissions to the mental health units are almost never shorter than twenty days, and the average length of stay for our very diverse patient population is on the order of a year or so. There are on-call coverage opportunities with additional compensation for interested staff psychiatrists, but there is no obligatory night or weekend call.

Most of our psychiatric admissions are intermediate care patients transferred from private psychiatric hospitals in the acute care system. These are patients meeting DMH eligibility requirements who have not improved to the point of being dischargeable to the community after at least a month or so of acute inpatient care. We provide these patients with longer-term psychiatric treatment, and transition to an array of different DMH community resources. The majority of these patients have schizophrenia or psychotic mood disorders of varying severity and co morbidity, but our intermediate care population is diagnostically diverse, and includes no psychotic patients with severe personality disorders generally associated with complex trauma histories. Substance abuse and medical illnesses are common co-morbidities. Because of the wide range of diagnoses and levels of severity of the problems which we treat on the mental health units at Tewksbury Hospital, the length of stay for our intermediate care patients ranges generally from a few months to a few years.

The rest of our admissions are criminal defendants committed for forensic evaluation from northeast area and other Massachusetts courts. Most commonly, the forensic evaluations are for competency to stand trial and criminal responsibility. In contrast to the intermediate care patients, our forensic patients generally require an acute level of assessment and treatment for a wide range of psychiatric diagnoses and/or substance abuse, medical/neurological conditions, malingering, etc. Designated Forensic Psychologists on the hospital staff evaluate the forensic issues and write the reports for the courts, but there may be opportunities for psychiatrists with forensic training to conduct forensic evaluations as well. Most forensic patients do not require extended hospitalization, and are discharged back to court at the conclusion of the forensic evaluation period, which is most commonly 20 days. Fifteen to twenty percent of our forensic patients do return from court for extended hospital treatment, on either a voluntary or involuntary basis, and this population is generally similar to our intermediate care patient population.

As a public sector intermediate care institution, we have no managed care pressures, and therefore provide a now uncommon opportunity for psychiatrists interested in the longer-term intensive treatment of a diverse population of psychiatric inpatients with severe and persistent mental illnesses. In addition, our forensic patients provide opportunities for exercising skills in acute assessment and treatment. The psychiatrist is the leader of a multidisciplinary team, and a wide range of treatment modalities are valued, including psychopharmacology, group therapy emphasizing skill-building, insight-oriented and cognitive behavioral psychotherapy, family interventions and Dialectical Behavior Therapy. Expert consultants in the fields of behavioral neurology and addictions are available. The Department of Psychiatry also provides consultation/liaison psychiatric services to the medical units operated by the Department of Public Health.

The psychiatrist group at Tewksbury Hospital is energetic, well trained, welcoming and very collegial. Most have trained in Boston-area psychiatric residency programs, including the Harvard/Cambridge Hospital and the Harvard/Longwood programs, and about half of our current psychiatrists maintain some level of academic involvement with their training programs. We offer a very competitive compensation package with an excellent benefits program.

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