Psychiatry Residents' Perspectives of Primary Care in the Psychiatric Setting.

Abstract

Given the growing interest in integrated care, this study sought to investigate the perception of psychiatry residents towards managing general medical conditions in their psychiatric patients. Between July-October 2017, all 46 residents at an adult psychiatry program were asked to complete an online survey. Sixty-seven percent responded. Most residents (81%) indicated they were knowledgeable and/or comfortable in managing medical conditions with supervision/consultation from a primary care provider. Residents also indicated that they would "like to" (48%) and/or "should" be able to (71%) manage the general medical conditions of their patients in the future with supervision/consultation from a primary care provider. An additional 26% indicated that they would like to and/or should be able to independently manage both behavioral and general medical conditions for their patients. Nicotine dependence, hypertension, dyslipidemias, and non-insulin-dependent diabetes were among the top conditions residents felt they should be able to manage (≥ 74%). A lack of knowledge, experience, training, and supervision were the most frequent barriers residents listed in providing general medical care to patients (71%). Residents noted that supervision from a primary care physician (29%) and additional education (54%) would help increase their comfort in managing medical conditions. Psychiatry residents were generally interested in managing basic medical issues. Opportunities to expand residency training in integrated care should be considered. With new models of integrated care emerging, future studies should explore how resident attitudes might evolve over time, as well as the attitudes and opinions of practicing psychiatrists and supervisors on this topic.