Patients' perspectives of behavioral science care by family practice physicians

Patients' concerns have too infrequently been considered by curriculum developers in the design of the behavioral science curriculum for family practice physicians. With these concerns in mind, the authors in this study examined by questionnaires patient attitudes regarding the level of involvement desired of family physicians for each of 45 psychosocial problems. The choices of responses offered were: Level 1, no help; Level 2, referral; Level 3, compassion, concern, and minor advice; and Level 4, expert, therapeutic help. The results demonstrated that for a majority of the problems, the patients expected their family physician to be caring and to show concern but not to be an expert (Level 3). Certain problems appeared in predictable categories, such as religion/church concerns in Level 1 and pregnancy, where expert advice was desired, in Level 4; pediatric problems dominated Level 2. Discrepancies between patient expectations and current curricular emphases were noted (for example, in counseling). Statistically significant differences were found between rural and urban populations as well as across low, middle, and upper socioeconomic classes. Educational implications derived from the data are discussed.