Navigating the Clinical Component
The adult psychiatrist at Good Shepherd practices a primarily outpatient role with integrated ED consultation responsibilities and no inpatient admit coverage. The case mix is broad bread-and-butter adult psychiatry, with flexibility around visit length, hybrid scheduling, and service line growth. Behavioral health support is delivered in partnership with Community Counseling Solutions, the regional behavioral health network.
Patient Population
- Adults, 18 and older
- Outpatient panel referred from primary care, specialists, and emergency department follow-up
- Rural service population of approximately 75,000 across Umatilla and Morrow Counties
- Acute ED presentations seen via consultation (tele or on-site)
Clinical Scope
Case mix reflects general adult psychiatry with a full spectrum of diagnostic categories.
- Depression and major depressive disorder
- Anxiety disorders
- Bipolar disorder, including manic and mixed presentations
- Schizophrenia and other psychotic disorders
- Substance use and chemical dependency, typically co-managed with CCS
- Eating disorders
- PTSD and trauma-related disorders
- OCD and obsessive-compulsive spectrum disorders
- ADHD in adults
Clinical Workflow
| Detail |
Information |
| Practice Setting |
Outpatient clinic with ED and inpatient consultation |
| Practice Split |
Approximately 85% outpatient, 15% ED and inpatient consult |
| ED Consult Volume |
15 to 20 patients per month |
| Inpatient Consult Volume |
Approximately 5 per month |
| Consult Response Window |
Within 8 to 12 hours of ED arrival (preferred) |
| Admit Coverage |
None; patients requiring acute inpatient care are transferred |
| Call |
Home call acceptable; phone consult availability preferred |
| Hybrid Option |
Telepsychiatry acceptable for consults and appropriate outpatient visits |
| EMR |
Epic with DAX AI note support |
| Visit Length Flexibility |
Provider input valued on intake and follow-up durations |
Clinical Support
The adult psychiatrist operates with direct access to Good Shepherd clinical infrastructure and established regional behavioral health partnerships.
- Epic with DAX AI reduces documentation burden and supports efficient visit flow
- 24/7 Level 3 Trauma designated Emergency Department
- Hospitalist team manages admitted medical patients and phone consults psychiatry as needed
- Advanced practice providers are part of the hospitalist team, not psychiatry specifically
- Primary care and specialty referring providers housed on the same campus
Behavioral Health Partnerships
Community Counseling Solutions (CCS) is the primary regional behavioral health partner and provides therapy and crisis services that integrate with the Good Shepherd psychiatry practice.
- LCSW and LMFT therapy services, typically delivered through CCS
- Psychologist services available on a limited basis through CCS
- 24/7 crisis intervention services
- Substance use treatment at the CCS Pendleton location
- REACH (River's Edge Acute Center for Healing) in Hermiston, operated by CCS, provides acute inpatient psychiatric care for patients requiring stabilization (does not serve SUD populations)
- Outpatient individual, family, and group therapy across multiple CCS sites
Program Development Opportunities
The role carries meaningful scope to shape how behavioral health services grow at Good Shepherd.
- Explore and potentially launch a TMS (transcranial magnetic stimulation) program
- Evaluate ketamine-based treatment services
- Contribute to clinic workflow, intake structure, and panel building decisions
- Partner with leadership on long-term behavioral health strategy and reducing psychiatric transfers
- Integrate therapy skills or collaborative care approaches as appropriate to the provider's training
Absence of Psychiatric APP Support
At present, Good Shepherd does not appear to have dedicated psychiatric APPs on the adult psychiatry team. Any APPs referenced in the workflow are part of the hospitalist service and support admitted medical patients, not outpatient psychiatry. Future APP support for psychiatry may be considered as the service line grows.