The functional-organic dichotomy in new patient evaluations by residents in family practice

Abstract

The interface of psychosocial and organic medicine is increasingly represented in primary care training programs. The intent of such programs is a comprehensive model for patient evaluation, yet current medical education may foster an artificial division in the diagnostic process. The initial interview of 60 depressed or hypertensive patients revealed a functional organic dichotomy in patient evaluations. Such a reductionistic approach neglected the role of psychosocial variables on the course of organic disease, drug compliance, or patient-physician attitudes. Alternatively, somatopsychic factors or concurrent physical disease amongst depressed patients may have gone undetected. Psychiatric patients were also scheduled for follow-up visits significantly less than their hypertensive counterparts. This may reflect resident physician attitudes toward the psychiatric patient.