Borderline personality disorder in primary care

Management of borderline patients requires skills that are at the heart of successful continuity of care. These skills include alliance-building, educating patients about their symptoms, referral, encouraging communication and cooperation in the health care team, utilizing community resources to sustain one's own professional development, and foreseeing and preventing morbidity. As trying as it may be to have a borderline patient in a practice, and as slow as progress with the patient may be, successful management of such patients will add poise, confidence, and maturity to the exercise of these invaluable primary care skills. More clinical and empirical discussion of borderline personality disorder is needed in the family practice literature. Probably no other professional is more likely to see such patients. The informed, motivated family physician, with the help of a supportive multidisciplinary team, can make invaluable contributions to reducing morbidity in borderline patients and can help avoid misunderstanding, frustration, and exhaustion in the health care team of the patient with this challenging disorder.