Treat or refer: patients' interest in family physician involvement in their psychosocial problems.

Seven hundred fifteen patients entering three family practice clinics (rural private practice, urban private practice, urban residency) completed a questionnaire assessing their interest in their family physicians' involvement in four representative psychosocial problems: spouse abuse or neglect, lack of exercise, a dying family member, and a sexual problem. A majority of the patients (57 to 78 percent) wanted help for the four problems from their family physicians either independently or in conjunction with a specialist, whereas only 4 to 21 percent wanted referral to specialists exclusively. Desired level of family physician involvement was predicted (R2 = .291) by a series of reason for involvement variables representing the following conceptual areas: perception of value in talking about personal problems; perception of family physician background, time, and interest; and the Health Belief Model. This study supports the conclusion that family physicians need skills in managing psychosocial problems so they can provide the type of care that most patients want.