The family physician occupies a front-line position in the detection and treatment of emotional problems and psychiatric illnesses. The practice pattern of the family physician necessitates an efficient, effective model of psychotherapy. The emphasis of the interview then shifts to how the patient is handling the problem and a demonstration of empathy by the physician. F amily physicians face the challenging task of understanding and working in all three spheres of the biopsychosocial model.
Patients often present with a complex mixture of physical and emotional problems.
Ideally, physicians recognize the contribution of psychologic and social factors and incorporate them into the medical care of their patients. Numerous studies confirm that emotional problems are prevalent in patients who present to family physicians. 1 Few of these patients are referred for psychiatric care, in part because the current managed care climate discourages specialty mental health referrals. Even when patients are referred, they are often reluctant to follow through with mental health specialists for a variety of reasons. Therefore, family physicians should develop strategies to manage these patients while simultaneously tending to their medical problems.