Psychosocial problems: what help do rural and urban patients want from their family physicians?

We surveyed 399 patients of family physicians in two rural Canadian towns to determine what help with 30 psychosocial problems they wanted from their physicians. The patients completed a self-administered questionnaire in which they could choose from four levels of physician involvement: no involvement, knowledge of the problem but no help, knowledge of the problem and referral to a specialist, and treatment by the physician. Half of the patients wanted help with life-cycle problems, and over half desired treatment for sleeping problems, anxiety and depression. However, close to 50% of the patients desired no help for interpersonal problems, and over 50% wished to see a specialist for help in coping with a physical illness and long-term pain. Interestingly, English-speaking patients wanted significantly more physician involvement than did French-speaking patients. The results were similar to those of an earlier study of urban patients. Implications for family medicine training are discussed.