In Scope and Out of Scope

Our PCL psychiatrists answer mental health and substance use treatment questions about assessment, diagnosis, medications, and treatment planning for adult patients. It may be helpful to know that the PCL psychiatrist may or may not have experience providing psychotherapy.

IN-SCOPE Questions

  • Are my patient’s psychiatric medications working effectively or is a particular symptom a side effect of their medications?
  • Can a particular medication be taken only as needed or should it be taken on a regular basis?
  • Is my patient’s substance use impacting their mental health symptoms? How should I approach next steps for treatment?
  • Are there effective non-medication treatment options to consider for my patient?
  • Which of my patient’s symptoms suggest which diagnoses?
  • What screening tools do you recommend I use with this particular patient?
  • My patient has tried several previous medications – what now?
  • My patient has a complex social situation (housing instability, uninsured, etc.) – what treatments can I consider in this context?

OUT-OF-SCOPE Questions

  • Can the PCL help me refer or transfer my patient to a UW Medicine psychiatrist?
    • As a statewide program, we do not have the capacity to see patients directly but recognize this is an unmet need in our state.
  • Can you talk to my patient or their family member?
    • The PCL is a provider-to-provider service, available only to health care professionals in Washington regarding their adult patients. We do not have any patient-provider relationship.
  • What type of therapy or therapeutic approach should I use with my patient? What advice do you have on building rapport or engaging my patient in therapy?
    • The psychiatrists who staff the PCL have varying degrees of experience with different types of psychotherapy so not all of them could answer all these types of questions. We recommend contacting your clinical supervisor or relevant professional organization for case consultation or clinical support resources.
  • I have questions about Duty to Warn, mandatory reporting, prescribing regulations, or other medical-legal questions.
    • The PCL is a clinical consultation service and does not provide legal advice of any kind. Please contact your practice manager, risk management or other legal resource regarding your agencies policies and procedures.
  • Can the PCL psychiatrist review written records, or can I submit my consultation online?
    • We have experience with a version of electronic consultations, and find this format works best in medical specialties where images or lab values determine treatment choices. In psychiatry, the “data” comes in part from what questions the provider asks the patient. If those questions are not documented, it can require a lengthy back and forth between providers. A phone conversation via the PCL is often quicker, can lead to a better sense of the diagnosis, and more specific, personalized treatment recommendations for the patient.