THE FAMILY DOCTOR'S NEW ROLE ON THE TREATMENT TEAM
LEON ZUSSMAN M.D.1, and
LOUIS LINN M.D.2
1 Dept. of Obstet.and Gynec., Mt. Sinai Hospital, New York, N. Y.
2 Institute of Psychiatry, Mt. Sinai Hospital, New York, N. Y.
1. The psychosomatic role of the family doctor is reviewed.
2. Psychopharmacology has opened up a broader role for the family doctor.
3. Treatment of selected patients with major mental illnesses can now be carried out under psychiatric supervision by the family physician whom the patient has known and trusted for many years, while keeping the patient in contact with family, friends, and work responsibilities.
4. The psychiatric consultant's role includes the following responsibilities: He selects the cases amenable to this combined approach. He recommends the proper medications and supervises their administration. He guides the family doctor in the details of supportive psychotherapy. He helps the family doctor in relation to his own anxieties in the management of these difficult cases.
5. Late-life depressive reactions constitute the major diagnostic category that can be successfully treated by the family doctor.
6. Schizophrenic reactions occurring in certain supportive family settings can also be treated.
7. Selection of cases for treatment by the family doctor must be made in consultation with a psychiatrist. Follow-up Psychiatric consultations are extremely important.
8. Intensified suicidal drives and hyperactive psychotic states are some of the complications of unsupervised psychopharmacotherapy.
9. Some psychiatric problems which cannot be properly carried by the family doctor are reviewed.
10. The complexities of the clinical psychiatric issues are emphasized and the central planning role of the psychiatric consultant is pointed out.
11. The organization of a psychiatric consultation service is in progress to implement the new role of the family doctor.
