Physician recognition of behavioral, psychological, and social aspects of medical care.

Recognition of house officers of easily detectable medication noncompliance, psychiatric disturbances, and recent stressful life events was assessed by means of a structured interview with each patient immediately following the clinic visit, a physician questionnaire, and chart review. The study included 235 patients and 58 interns and residents in internal medicine. Although the house officers were informed of the intent of the study and had their performance reviewed weekly, they failed to recognize 79% of the underconsumption of regular medications, 34% of psychiatric disturbances, and 76% of patients' recent stressful events. Possible explantations for their failures to recognize these behavioral, psychological, and social factors include lack of awareness of their importance, lack of time and skills necessary for their identification, and inability to manage these problems. None of these explantations, however, adequately justifies such results.