Evaluation of the behavioral science training family practice residents receive

The behaviors of physicians and patients associated with two primary care clinics were compared. One clinic had little behavioral science training while the other placed a relatively greater emphasis on it. Pretests were done to ensure that the clinics and patients were similar on relevant variables.

The study utilized questionnaires and various behavioral measures suggested by past research and the published goals of behavioral science training. The patient questionnaires assessed satisfaction with medical care received and the behaviors analyzed were rates of appointments kept versus not kept. The physician questionnaires assessed attitudes toward social issues in medicine and the behaviors studied were percentages of psychological diagnoses made, number of mental health referrals and number of psychoactive drugs prescribed.

Significant differences were found between the clinics. Patients attending the clinic emphasizing behavioral science training were more satisfied with certain aspects of their care and broke fewer appointments than their counterparts. More highly trained physicians (1) diagnosed more psychological problems, (2) made more mental health referrals, (3) knew of more community mental health services, and (4) were more aware of the importance of the doctor-patient relationship than their less trained counterparts. Other significant relationships were found between expressed physician attitudes and their behavior as well as among physician attitudes and their patients' expressed level of satisfaction. The results raise some questions concerning the cost effectiveness of these consequences and their relative value.