Physicians at the medicine/psychiatric interface: what do internist/psychiatrists do?

Area of Science:

• Medical and Psychiatric Practice
• Integrated Healthcare Delivery

Background:

• High prevalence of co-occurring medical and psychiatric conditions in primary care necessitates integrated treatment approaches.
• The development of combined medicine-psychiatry residency programs aims to train physicians for dual practice.
• Limited understanding exists regarding the actual practice patterns of physicians with dual certification.

Purpose of the Study:

• To investigate the practice patterns of physicians certified in both internal medicine and psychiatry.
• To identify the extent to which dual-trained physicians utilize both medical and psychiatric expertise.
• To explore barriers encountered by physicians attempting to practice in both fields.

Main Methods:

• A survey was conducted in 1997 targeting 268 physicians board-certified in internal medicine and psychiatry.
• The survey assessed practice settings, self-identification, and utilization of dual training.

Main Results:

• Only 15% of dual-certified physicians practiced any internal medicine; the majority focused solely on psychiatry.
• Despite practicing predominantly psychiatry, 95% reported using both medical and psychiatric training.
• Physicians perceived dual training as enhancing diagnostic skills, professional credibility, and overall physician effectiveness.

Conclusions:

• Dual-trained physicians often specialize in psychiatry but leverage their comprehensive training.
• Significant barriers impede the full integration of internal medicine and psychiatry practice.
• Addressing these barriers is crucial for improving care for patients with co-occurring conditions.