Barriers and enhancements to physician-psychologist collaboration in a multi-specialty medical clinic.

摘要

The complexities of patient needs, advent of new treatments and technology, and the realization that physicians have human limitations, make it advantageous to include other health professionals on the treatment team. The inclusion of psychologists can facilitate achievement of the biopsychosocial model. Physicians and psychologists must collaborate in order to accomplish this goal.; This study addresses the questions: (1) What are the barriers to this collaboration and what are some ingredients for successful teamwork? (2) How can psychologists better serve the needs of physicians in a multi-specialty medical group practice? (3) How much information did physicians receive in their training about psychological interventions and what current beliefs do they hold about psychologists and the profession of psychology? (4) What are the factors that determine physicians referral behavior?; A mixed methodology research design was used. The first phase of the project was to gather data on all new patients referred to the Department of Psychology of a medium sized multi-specialty medical clinic. Two groups of physicians who had significantly different referral patterns were determined. The second phase was to interview these two groups, separated into high referrers and low referrers, in a focus group format. The third phase was distribution of a survey questionnaire to all physicians in the clinic, and to physicians in a comparable multi-specialty medical clinic (n = 85).; Physicians said services covered by health insurance, feedback after a consultation, short term psychotherapy, and ability to treat children and adolescents were important factors when deciding to refer patients to psychologists. Most physicians received “Some” to “Only a Little” information in their training about psychological interventions. They thought patients would benefit “Often” from psychological intervention for fibromyalgia, cancer, infertility, and irritable bowel syndrome. Most physicians believed that patients resist being sent to psychologists. Physicians who were unclear about when patients should see psychologists versus psychiatrists were less likely to refer.; Psychologists who practice in medical settings should appreciate that they are visitors to another culture, and need to make the effort to build collaborative relationships. Recommendations to increase psychologists' effectiveness are discussed along with suggestions for future research.