Differing attitudes between psychiatrists and primary care providers at the interface

Market forces caused by managed care are shaping practice styles for both psychiatrists and primary care physicians. This study offers a sample of the attitudes of both groups of practitioners highlighting the differences.

Forty-two psychiatrists and primary care physicians (PCP) completed surveys. The responses of each group were compared using chi square analyses.

Psychiatrists and PCPs differed significantly on their: 1) degree of comfort in the other's traditional service domain--with PCPs more comfortable dealing with their patients' psychiatric problems than psychiatrists were dealing with their patients' medical problems, 2) perceived barriers to effective communication-psychiatrists acknowledge their own time constraints while PCPs blame their colleagues unavailability (actually an agreement that psychiatrists' availability is a limiting factor), 3) projected areas of interface in the future--with psychiatrists prioritizing collaboration on health maintenance while PCPs valued collaboration on prevention and referral as equally significant.

Conflict between needs and expectations found in this pilot study, if shown in larger studies to be representative, will impact the success of changes in practice patterns encouraged by emerging managed care initiatives. These findings suggest that the discordant expectations between psychiatrists and PCPs about the interface of their practices deserve further study.