Involvement with the psychosocial concerns of patients. Observations of practicing family physicians on a university faculty.
BACKGROUND
Physician involvement in patients' psychosocial problems, including family concerns, is a vital aspect of comprehensive medical care. This study was conducted to better understand the extent to which experienced family physicians on a university faculty address psychosocial issues and involve family members during routine outpatient office visits.


METHODS
Five family physicians on a university faculty were videotaped during 200 office visits (40 per physician). Each visit was then rated on one of two five-point scales based on the extent to which psychosocial issues were addressed with individual patients and family members. Interrater reliability was 73%.


RESULTS
Most interviews were focused solely on medical issues. The physicians regularly elicited the patient's opinions in a collaborative manner. Psychosocial issues (ie, family, job) were discussed in approximately 25% of the interviews, emotional reactions of patients or family members were addressed less frequently, and counseling was rarely conducted. Greater involvement in psychosocial issues was associated with longer office visits.


CONCLUSIONS
The experienced physicians in this sample actively elicited patient's views of medical problems (ie, a "patient-centered" approach). The infrequent discussion of psychosocial concerns of the patient may be related to time limitations. Based on patients' opinions, specific attention to psychosocial issues may be most beneficial during well-child examinations and care of chronic illnesses.
Marvel
M K
MK
Department of Family Medicine and Practice, University of Wisconsin, Wausau.
D005180:Faculty, Medical; D005260:Female; D006801:Humans; D008297:Male; D009819:Office Visits; D010358:Patient Participation; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*; D011368:Professional-Family Relations; D014743:Videotape Recording