By definition, a “progress note” should be a written record of the degree of our patients’ progress. We can all agree on this much, and this is pretty much where the agreement ends.

Should we use rating scales in our clinical practices? And if so, which ones? Do the benefits of scales compensate for the extra time it takes to administer them?

In this month’s interview, Dr. Brendel does a wonderful job explaining what psychiatrists need to know in order to become HIPAA-compliant. In this article, TCR really gets down and dirty with HIPAA, taking you by the hand to tell you exactly what to do, what forms to use, and where to get them.

Dr. Brendel, thanks for agreeing to educate us about HIPAA, which remains a pretty mysterious and intimidating entity for most psychiatrists! How did you get to be such a HIPAA expert?

Oxford Health Plans (a subsidiary of UnitedHealthcare) recently shocked the psychiatric community by doing a retroactive audit of psychiatric services, and demanding repayment of up to tens of thousands of dollars of reimbursements from some physicians based on insufficient documentation.

Okay, we’ll lay our cards on the table right away. Rarely has TCR been as annoyed by the launch of a new medication as we are by the launch of Equetro. The last time the pharmaceutical industry embarrassed itself this much was when Eli Lilly launched “Sarafem,” calling it a “new” medication for PMDD when it was simply Prozac with a new name and a new (pink) color (see TCR Vol. 2, No. 9).

There is a battle underway in the genteel circles of academic psychiatry. The disputed question is: Are antidepressants (ADs) good or bad for patients with bipolar disorder?

“Be careful, doctor. Don’t order lab tests that you don’t really need. You’re asking for trouble.” No, that’s not TCR talking. That’s none other than George Lundberg, M.D., former editor of JAMA. He made that statement in an editorial webcast in January 2005 on Medscape, where Dr. Lundberg is Editor-in-Chief.

Dr. Goldberg, I know you’ve spent a lot of time thinking about and treating bipolar disorder over the years, beginning when you were a researcher at NIMH, then on the faculty of Columbia University, and most recently in your private practice and your managing of Depression Central. I was hoping we could begin by discussing some of the tricky aspects of diagnosing bipolar disorder.

There have been many misguided treatments for bipolar disorder and other major mental illnesses throughout the history of psychiatry, but perhaps none has been as misguided--and as damaging--as the one practiced by Henry Aloysius Cotton, M.D.