Barriers and enhancements to physician-psychologist collaboration.

Abstract

Have you ever wondered why it is so difficult to establish and maintain good relationships with physicians who could be good referral sources for you? Physicians in 2 multispecialty practices that include psychologists reveal what they want from psychologists and what most concerns them about working with psychologists. Strategies are outlined that psychologists can adopt to promote physician– psychologist collaboration, including seeing physicians as their customers and marketing services with an eye toward customer satisfaction. Psychologists practicing in a medical clinic sometimes wonder why some physician colleagues refer more patients than others. Psychologists in medical settings may feel as if they are marginal people in a dominant medical culture and cannot quite get a handle on what physicians want and need from them. What are the barriers to collaboration, and what are some ingredients for successful teamwork? How can psychologists better serve the needs of physicians in a multispecialty medical group practice? What current beliefs do physicians hold about psychologists and the profession of psychology? This study answers these questions. Although there is some overlap, there are strong cultural differences embedded in the two professions of medicine and psychology. Failure to understand and adjust to cultural differences in approaches to patient care can undermine even the most wellintentioned efforts at collaboration. Hamberger, Ovide, and Weiner (1999) highlighted the following four areas that they believe represent significantly different sets of values or approaches to learning and professional practice between the medical and mental health professions: (a) role of theory in practice, (b) teaching focus and learning orientation, (c) problem-solving styles, and (d) expectations for consultations. Several authors have speculated on possible barriers to collaboration (Bray, 1996; Bray & Rogers, 1995; Mauksch & Leahy, 1993; Wickramasekera, 1989), which include proximity of providers, insurance reimbursement, and patient resistance as hindering factors to referral. Drotar (1993) noted the following: