This interview segment with Patrick Hemming, MD, involved a discussion of some of the major takeaways from his talk Depression and Anxiety Treatment by the Internal Medicine Physician, presented at the 2024 American College of Physicians (ACP) Internal Medicine Meeting.

During his ACP 2024 talk, Hemming described depressive disorders, anxiety disorders, recent changes to screening guidelines, and other elements he felt internists should be made aware of in the mental health space.

I go over screening guidelines, and the screening guidelines have changed in the last year, Hemming explained. If you go by the United States Preventive Services Task Force, they now recommend that really we should be screening all patients over 18 for depression, regardless of what your practice. Just last year, the recommendation that we should screen all patients 18 to 64, for anxiety disorders, that's new and has never been recommended before.

Hemming noted that the changes to guidelines for internists are not small and they do signify larger changes occurring in the mental health space.

Quality reporting for Medicare and Medicaid now starts to look at whether we're screening and whether we're getting people set up with treatment, Hemming said. Then that impacts payment schedules and things like that, that our practices are going to directly see results from in addition to our patients who are now being screened for new things.

Hemming later expressed that, while in psychiatric practices medication is adjusted and feedback will occur more rapidly, in primary care it is less possible to do so.

(We discussed) how we are going to follow up with patients, understanding the goals of treating some targets using things like our PHQ-9 or our GAD-7 for anxiety disorders, Hemming said. And, something very important for me in this talk is to point out that although we have created numbers for these things, this is not treating blood pressure. In blood pressure, we can create a goal for systolic blood pressure of 130 and get people under that and feel pretty good about ourselves

Hemming noted that unlike traditional situations with blood pressure, if internists are treating patients with a PHQ-9 number, this is not actually not what the patient cares about. He noted that they need to understand that such a patient may be having difficulties in their personal relationships, at work, or in their sense of achievement in life.

For additional information on this interview, view the full discussion posted above.

The quotes used here were edited for the purposes of clarity. Hemming has no relationships with entities whose primary business is marketing, selling, producing, re-selling, or distributing healthcare products used by or on patients.

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Patrick Hemming, MD: Depression, Anxiety Treatment by the Internal Medicine Physician - MD Magazine