May 5, 2021
Craig Chepke, MD, speaks with Lorenzo Norris, MD, about changes
he made to his practice during the COVID-19 pandemic, and plans to
make some of those changes permanent.
Dr. Chepke is a
psychiatrist in Huntersville, N.C., and adjunct associate professor
at Atrium Health and adjunct assistant professor at the University
of North Carolina at Chapel Hill. He disclosed serving as a
consultant and speaker for Otsuka and Janssen, and as a speaker for
Norris is associate dean of student affairs and administration
at George Washington University, Washington. He has no
- Dr. Chepke discussed his strategies for adapting his practice
to the restrictions of the pandemic. He engaged in shared
decision-making with patients when modifying his practice,
including starting a drive-through pharmacotherapy clinic.
- To ensure that patients continued to have access to treatments
such as long-acting injectable antipsychotics and esketamine, Dr.
Chepke created a system in which patients could drive up to his
clinic to have the medication administered. Because esketamine
requires a 2-hour monitoring period after administration, he
adapted the safety protocol.
- After patients received their intranasal spray dosage, they
would complete the monitoring period in their car in the parking
lot outside of his office, which was close enough to the clinic for
Dr. Chepke to physically observe the patient, and to monitor vital
signs wirelessly via a Bluetooth-enabled blood pressure cuff.
- Throughout the pandemic, Dr. Chepke found ways to care for his
patients’ physical and mental health. He also adopted technologies
that help him monitor his patients' vital signs and glucose
- Especially while focusing on treatment-resistant psychiatric
illness, Dr. Chepke invites family members to participate in
evaluation and treatment. He uses this approach because he realizes
that effective treatment must involve the system in which the
- Dr. Chepke and Dr. Norris discussed ways in which clinicians
can extend hope to their patients through flexibility and
innovation, especially throughout the pandemic. Providing hope to
patients demonstrates belief in a better future.
Current Psychiatry. 2020 May;19(5):29-30.
Show notes by Jacqueline Posada, MD, associate producer of the
Psychcast; assistant clinical professor in the department of
psychiatry and behavioral sciences at George Washington University,
Washington; and staff physician at George Washington Medical
Faculty Associates, also in Washington. Dr. Posada has no conflicts
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