Age As a Factor in the Referral and Treatment of Psychiatric Patients by Internists*

Abstract

Questionnaires were completed by 153 internists concerning their referral and treatment of out-patients showing psychologic disturbances. Internists reported that equal numbers of their younger and older patients had psychologic disturbances; in the light of other data, this suggests that such disorders are being overlooked in some older patients. The internists also indicated that they referred equal numbers of older patients and younger patients to psychiatric facilities. Some internists treated psychologic disturbances in younger and older patients to the same degree, whereas cardiologists tended to treat more of the older group, and nephrologists tended to treat more of the younger group.The age of the physician is an important factor in his practice. Older physicians saw more older than younger patients in their practice. Older internists with certain subspecialty interests perceived psychologic disturbances more often in older patients than in younger patients. Older cardiologists personally treated psychologic disturbances more often in older patients than in younger ones. Individual interests and personalities of the internists were factors in their referral and treatment practices. Some internists referred more patients with psychologic disturbances and others personally treated most of these cases, regardless of the age of the patient.

The psychologist as a consultant in a nursing home: Effect on staff morale and turnover.

“…Nursing homes have become important sites for the care of elderly residents with psychiatric problems. This relocation is due to the reluctance of the elderly to seek treatment in outpatient psychiatric facilities (Garetz & Garetz, 1973), the reduction of admissions of older patients to state mental hospitals , and the abundance and provision for payment for services by Medicare and Medicaid (Glasscote et al, 1976;Stotsky, 1970). Teeter, Garetz, Miller, & Heiland (1976) found that 85% of Medicaid residents in two skilled nursing facilities had significant psychiatric disorders in addition to serious multiple illnesses.…”

Current Status and Correlates of Physicians' Referral Diagnoses for Physical Therapy

“…22 The purposes of this study were (1) to identify the frequency of provision of diagnoses describing both an anatomical structure and pathology by physicians to outpatient physical therapists across multiple centers located in a state lacking direct-access legislation, and (2) to characterize the relationships between specific diagnosis provision and demographic variables describing physicians and patients. Patient age 28,31,32 and sex, 12,13,15,43,44 and physician sex, 4,5,24 specialty, 4,14,30,34,38,40,41 and experience 23 have been shown to significantly affect health care utilization by patients and various decisions by physicians. Correlations among patient and physician factors, with the frequency of specific diagnosis provision, may indicate groups that would require more common or extensive medical screening or differential diagnosis by physical therapists.…”