Psychiatrists' and internists' knowledge and attitudes about delivery of clinical preventive medical services

Objective: Changes in the health care environment have placed a greater res ponsibility on psychiatrists to deliver basic primary care services. The st udy assessed baseline knowledge and attitudes about clinical preventive med ical services among psychiatric faculty and psychiatric residents at a tert iary care medical center. Methods: Residents and faculty in psychiatry and general internal medicine completed a structured questionnaire, including 2 0 case scenarios, that assessed their baseline knowledge of clinical preven tive medical services, their attitudes concerning delivery of those service s, and their beliefs about the effectiveness of those services in changing patients' behavior The case scenarios and knowledge questions were based on the clinical preventive medical services recommendations outlined by the U . S. Preventive Services Task Force. Results: Psychiatrists reported more f requent assessment of and counseling about the use of illicit drugs and wea pons, and internists were more likely to query about measures related to ph ysical health such as cancer screening and immunizations. The two groups re ported similar attitudes toward the need for and the efficacy of prevention medical services. Commonly cited barriers to the delivery of preventive ca re included lack of time and education, Psychiatrists scored reasonably wel l on baseline knowledge about guidelines for preventive medical services, p articularly given their recent lack of specific education in these matters. Conclusions: Psychiatrists believe clinical preventive services are import ant and express interest in their delivery Additional educational intervent ions are needed to train psychiatrists in clinical preventive services to a void missed clinical opportunities for intervention in psychiatric populati ons that may have poor access to other medical care.