Responding to Psychosocial Needs: Physician Perceptions of Their Referral Practices for Hospitalized Patients

Abstract

Physicians play a critical gatekeeping function related to psychosocial problem identification and subsequent referral to appropriate hospital or community services. Thirty physicians on staff at a moderate-size, multiservice medical facility were interviewed to determine their perceptions regarding identification of and referral rates for psychosocial problems of their hospitalized patients. In addition to raising questions for further investigation, this article provides a useful structure for gathering data for use by hospital social work departments in developing strategies to enhance physicians' collaboration with hospital social workers.

Results of a feasibility randomized controlled trial (RCT) of the Toolkit for Optimal Recovery (TOR): a live video program to prevent chronic pain in at-risk adults with orthopedic injuries

“…Catastrophic thinking about pain, pain anxiety, and depression are established risk factors for disability and pain in patients with traumatic musculoskeletal injuries [5–11], regardless of the severity of the injury [12, 13]. Recognizing these psychosocial factors early in the recovery process creates a window of opportunity to identify and intervene with patients who are at risk for chronic pain and disability in the acute phase when psychosocial treatments are most effective [14, 15]. A recent systematic review conducted by our team showed that there are no evidence-based interventions that address psychosocial factors in patients recovering from acute orthopedic injuries [16].…”

“…Although surgeons are now aware of the importance of psychosocial factors in recovery after musculoskeletal injuries [18], they are often uncomfortable referring patients for outpatient care [18–20]. Referrals are often done when the pain has already become chronic, patients have undergone multiple medical treatments, and psychological treatments are generally less efficacious [14, 15]. Timely psychological care is also challenging due to long wait times and lack of trained providers.…”

Physician Referral Patterns to a Breast Cancer Support Program

“…The literature on physician‐to‐physician referrals indicates that physicians play an influential role in a patient's healthcare decisions. Physicians are often the key decision makers, having a significant influence over the patient 13–15 . This role may also prove crucial to a patient's consideration of a social support program.…”

The virtual cup of coffee: Northern cancer patients' experience with social work and Telehealth.

“…A cancer patient and their loved ones come to implicitly trust, interact, and rely upon professionals to treat the cancer. Medical professionals' willingness and openness in addressing the psychosocial needs can strongly influence the cancer patient and their loved ones in acknowledging and recognizing the secondary role o f treatment: attending to the psychosocial distress of the disease (Pray, 1991). Several studies have shown that oncologists are not especially skilled at discussing psychosocial problems, or recognizing anxiety and depression.…”

“…(Ford et al, 1994;Hardman et al, 1989;Newell at al., 1998;Passik et al, 1998). Pray (1991) in a survey of physicians treating hospitalized patients found that although 90% of the practitioners were able to identify emotionally laden medical conditions, only 41% of them made referrals to social workers. Disappointing, but not surprising, was that social work referrals were made for problems typically associated with discharge planning and not psychosocial distress associated with cancer.…”