Psychiatric care is almost always team care, whether or not the team operates formally. The patient typically has a primary care physician, often a therapist, sometimes a specialist for medical comorbidity, sometimes a case manager, sometimes school or workplace personnel involved. Coordinating across the team is part of the work; failure to coordinate produces fragmented care and missed opportunities.
Map the team. Identify who's involved in the patient's care. Get releases as appropriate. Know the names, contacts, and roles. The patient who has a PCP, a therapist, a cardiologist, and a case manager has four other people contributing to their care; your work intersects with each of theirs.
Active communication, not waiting to be asked. After medication changes, a brief message to the PCP — what changed, why, what to monitor. After psychiatric hospitalization, an update to the outpatient team. After meaningful changes in clinical status, alert relevant team members. The clinician who initiates communication produces better team coordination than the one who waits for requests.
Format for the receiver. Letters to PCPs in clinically appropriate language. Brief messages through electronic systems when available. Phone calls for time-sensitive or nuanced issues. Adapt the communication to the audience and the channel.
Clarify roles when needed. Sometimes overlapping providers create confusion — who manages the medication for ADHD when the primary care doctor started it and the patient now sees you? Who handles refills when therapy is with one clinician and prescribing with another? Make role boundaries explicit when ambiguity emerges.
Avoid duplication and gaps. Two prescribers prescribing similar medications. Two therapists providing different therapy modalities without coordination. No one managing a specific symptom that fell between providers. Periodic team coordination prevents these.
Family as part of the team when patient consents. Spouse, parent, adult child often have important roles in the patient's care and benefit from being informed and aligned.
Document the communications you make. Letters, phone calls, messages — note that they occurred. The chart shows the coordination work that supports the patient's care.