Les enjeux de la collaboration entre médecins généralistes et psychiatres [The challenges of collaboration between general practitioners and psychiatrists.]

Details

Serval ID
serval:BIB_AAC8F8C66615
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Les enjeux de la collaboration entre médecins généralistes et psychiatres [The challenges of collaboration between general practitioners and psychiatrists.]
Journal
Sante publique
Author(s)
Linder A., Widmer D., Fitoussi C., de Roten Y., Despland J.N., Ambresin G.
ISSN
0995-3914 (Print)
ISSN-L
0995-3914
Publication state
Published
Issued date
2019
Peer-reviewed
Oui
Volume
Vol. 31
Number
4
Pages
543-552
Language
french
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The collaboration between general practitioners (GPs) and psychiatrists in the management of chronic depression is considered as necessary but found suboptimal in the literature. The present qualitative study aims to better understand the factors influencing the decision to refer a patient with chronic depression to a psychiatrist. In order to do so, we conducted three focus groups with GPs in the French speaking part of Switzerland. The focus groups were recorded and transcribed, then coded by three members of the pluridisciplinary research team, using the software MaxQDA.We show that GPs carry out an implicit classification process of the patients, parting those who are “good cases” for the psychiatrist from those who express their suffering only by the body. The latter will only be treated at the GP’s practice. We argue that such a classification may therefore produce unequal access to psychotherapy.We identify several reasons for GPs to refer patients with chronic depression. These reasons rarely relate to the acknowledgement of a specific expertise of the psychiatrist in the management of chronic depression. It also appears that GPs perceive themselves as “specialists of the relationship”, which they consider central to the management of chronic depression. In addition, some GPs have negative representations of psychiatrists. These factors suggest the existence of issues around professional boundaries, which can work against collaboration.In conclusion, a clarification of the specificities of the GPs and the psychiatrists – through training and interprofessional meetings – would help reduce the negative representations of GPs about psychiatrists and promote collaboration, thus facilitating the referral of patients with chronic depression to the psychiatrist.
Keywords
Attitude of Health Personnel, Chronic Disease, Depression/therapy, Focus Groups, General Practitioners/psychology, Humans, Interprofessional Relations, Practice Patterns, Physicians', Psychiatry, Psychotherapy, Qualitative Research, Referral and Consultation, Switzerland
Pubmed
Web of science
Create date
10/02/2020 17:06
Last modification date
24/03/2020 7:26
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