[Psychosomatic care practice and cooperation needs as seen by physicians and psychologists providing outpatient care].Psychother Psychosom Med Psychol. 2006 Jul; 56(7):299-306.PP
Cooperation in psychosocial care is gaining increasing importance due to newly established psychosomatic departments in the acute care setting and to structural changes following the Health Care Modernization Act. The presented study aims at describing the psychosomatic treatment and cooperation practice in the ambulatory sector and the cooperation possibilities with the inpatient psychosomatic care sector. Registered doctors in all specialties along with psychotherapists working in private practice in the southwestern region of the Association of Panel Doctors (Nordbaden) were surveyed about this in a written questionnaire in 2003. Respondents totaled 497 (33 %). General practitioners (GPs) and somatic specialists first estimated the psychosocial treatment necessities based on patients in their own practice. Half reported cooperation with a psychosomatic colleague, 10 % took part in a Balint-style group. GPs and somatic specialists unlicensed in psychosomatic basic care reported significantly lower numbers on the existing psychosocial care practice compared to those with the respective license. GPs and somatic specialists regard diagnostic procedures as central for improving their daily psychosomatic/psychosocial care. More than 50 % would request a brief diagnostic screening instrument. Psychiatrists and psychotherapists prefer the option of case conferences. The reported cooperation preferences of a psychosomatic department follow established setting structures with little mention of cooperation options falling outside established sectors. GPs and psychiatrists/psychotherapists share the same priority in designating a contact person in the department for crisis intervention. This expresses their feelings for greater need in direct and acute cooperation features. Somatic specialists prefer to request a second opinion from the department. The predominant diagnoses to admit patients for both psychiatrists and psychotherapists are eating disorders, pain syndromes, and personality disorders.