title: Family doctors and psychologists working together: doctors' and patients' perspectives.
abstract: BACKGROUND
  Strategies to improve primary care in the Canadian Primary Care Reform include integrating different professionals to the medical team.
  
  
  OBJECTIVE
  This demonstration project explores the perceived impact on doctors and patients, of having family doctors and psychologists work together.
  
  
  METHODS
  Two family practices of Eastern Ontario, Canada
  
  
  METHODS
  Two board certified psychologists (one per practice) were integrated in the practices for 12 months. Psychologists conducted assessments, consultations and short-term treatments, as well as knowledge-transfer sessions for doctors. Outcome measures included referral patterns, patient outcomes, patient and provider satisfaction as well as doctors' billing.
  
  
  RESULTS
  Three hundred and seventy-six participants received psychological care; most were women (68%) and between the ages of 25-64 (67%). Anxiety and depression were the most prevalent diagnoses. Reasons for referral included: psychological treatment (70%); emotional support and counselling (35%); clarification of diagnosis and case conceptualization (25%). Referrals could be for more than one reason. After intervention, 60% of patients had improvement on the outcome questionnaire-45 (OQ-45). Quality of life as measured by the EuroQol-5D also improved (P < 0.001). Over 77% of patients reported increased confidence in handling their problems after treatment. Compared with their family doctor, patients felt the psychologist had more time and was better trained (75%) Doctors felt mental health problems were diagnosed more rapidly, patient care improved as well as their own knowledge of psychological management and treatment. Doctors felt it freed up their time and improved working conditions. Audit of the doctors' billing showed reduction in doctors' mental health billing.
  
  
  CONCLUSIONS
  Having an on-site psychologist was highly satisfactory for patients and providers, resulting in improved patient care and outcomes.
authors.affiliation: Department of Family Medicine, University of Ottawa, Canada and Physician, Montfort Hospital, Ottawa, Canada. mh.chomienne@uottawa.ca
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Chomienne
authors.forename: Jean
authors.initials: J
authors.lastname: Grenier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gaboury
authors.forename: William
authors.initials: W
authors.lastname: Hogg
authors.forename: Pierre
authors.initials: P
authors.lastname: Ritchie
authors.forename: Elina
authors.initials: E
authors.lastname: Farmanova-Haynes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017060:Patient Satisfaction; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care; D011584:Psychology; D011795:Surveys and Questionnaires; D055815:Young Adult