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November 28, 2018

When to Refer a Patient to Specialty Care

When to Refer a Patient to Specialty Care

One of the questions that providers often have is, “When should I refer a patient to eating disorder specialty care?” A provider may ask this if they are seeing a patient that has eating disorder symptoms such as changes in weight, a preoccupation with food and numbers, and other common symptoms. A provider may also see things in physical exams or lab results that cause concern. The bottom line is that if you are concerned that there is an eating disorder present in a patient, there almost positively is. Eating disorders live in secret and in hiding. If the eating disorder symptoms are noticeable to a provider, then the patient’s eating disorder has most likely been there for a while and may pose an immediate risk. 

If a provider is concerned about an eating disorder in a patient, that concern should immediately trigger a referral to an eating disorder specialist. Historically, there has been a tendency to try to give patients a period of time to see if things get better and turn around. This impulse comes out of genuine compassion and hope for the client. However, what the data shows is that patients cannot reverse eating disorders on their own. The ability to refer and work with specialist providers devoted to eating disorder specialist care is a critical step in the recovery of a patient with an eating disorder.

While this information may be understood by providers, it can be challenging to bring up an eating disorder with a patient. This is common and asking how to approach the topic is a terrific question. Start by sharing your concern with the patient just like you would if you were concerned about another illness and its impact. It is ok to let the patient know that you want an eating disorder expert involved because, like other illnesses you may not specialize in, you don’t have the expertise the patient needs to truly know what should happen next. The first step is to work hard to get a patient to an eating disorder assessment. Providers don’t have to convince them to get full treatment, just to complete an assessment. During the assessment, specialty providers will work to get the patient into the treatment that they need. The process for a provider is to notice an eating disorder, bring it up with the patient, and work to get them an assessment.

To get an assessment, patients (or their providers or loved ones) can call The Emily Program at 1-888-364-5977 or complete our online form. That is the only step that is needed. From there, our admissions specialists will gather relevant information and facilitate the assessment, either in person or over the phone. At the conclusion of the assessment, the patient and the person doing the assessment will together move ahead with taking the next right steps.

If a provider makes a referral to The Emily Program, our team works to coordinate care with the provider. This coordination can take many forms depending on the provider’s wishes. Typically, The Emily Program will share information about the patient’s assessment, their vital signs, and their progress throughout treatment, including their discharge recommendations and plan. If closer collaboration is desired, that can be arranged as well. The most important thing to know is that early detection and intervention is crucial to lifelong eating disorder recovery. Providers are essential to a patient’s recovery as they are often who starts the patient on the road recovery.


Mark Warren headshot

Mark Warren, MD

Mark Warren is the chief medical officer of The Emily Program. He is also one of the original founders of the Cleveland Center for Eating Disorders, which became The Emily Program – Cleveland in 2014. A Cleveland native, he is a graduate of the Johns Hopkins University Medical School and completed his residency at Harvard Medical School. He served as Chairman of the Department of Psychiatry at Mt. Sinai Hospital and Medical Director of University Hospital Health System’s Laurelwood Hospital. A past vice-chair for clinical affairs at the Case School of Medicine Department of Psychiatry, he continues on the Clinical Faculty of the Medical School, teaching in both the Departments of Psychiatry and Pediatrics. He is currently a faculty member and former chair of the Board of Governors at the Gestalt Institute of Cleveland. Dr. Warren is a Distinguished Fellow of the American Psychiatric Association, a two-time recipient of the Exemplary Psychiatrist Award of the national Alliance for the Mentally Ill, and a winner of the Woodruff Award. He leads the Males and Eating Disorders special interest group for the Academy of Eating Disorders.

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