G A Golden1. 1. Victoria Family Medical Centre, London Health Sciences Centre, Ontario.
Abstract
OBJECTIVE: To investigate whether a course of psychotherapy with a psychologist affected the frequency of patients' visits to their family doctors. DESIGN: Retrospective analysis of patients' medical records to determine the frequency of visits to their family doctors in the 6 months before psychotherapy, during therapy, and in the 6 months after therapy. SETTING: A teaching family medical centre in London, Ont. PARTICIPANTS: Thirty-three patients who had completed a course of psychotherapy between 1984 and 1991. INTERVENTIONS: Psychotherapy was provided by two psychologists employed at the medical centre. Patients did not pay a direct fee. The median length of psychotherapy was 12.5 1-hour sessions, and the therapeutic approach was eclectic and humanistic. MAIN OUTCOME MEASURES: Frequency of visits to family physicians before, during, and after psychotherapy. RESULTS: Frequency of visits to family doctors decreased both during and after psychotherapy. The decrease was especially apparent from before therapy to after therapy (49%, P < .001). Psychotherapy given by psychologists in a Canadian family medical centre appears to follow the pattern of the "offset effect," a reduction in medical use following psychotherapy, which has been demonstrated in other medical settings. CONCLUSIONS: Psychotherapy can be an effective and efficient part of total medical care for patients with complex psychological problems.
OBJECTIVE: To investigate whether a course of psychotherapy with a psychologist affected the frequency of patients' visits to their family doctors. DESIGN: Retrospective analysis of patients' medical records to determine the frequency of visits to their family doctors in the 6 months before psychotherapy, during therapy, and in the 6 months after therapy. SETTING: A teaching family medical centre in London, Ont. PARTICIPANTS: Thirty-three patients who had completed a course of psychotherapy between 1984 and 1991. INTERVENTIONS: Psychotherapy was provided by two psychologists employed at the medical centre. Patients did not pay a direct fee. The median length of psychotherapy was 12.5 1-hour sessions, and the therapeutic approach was eclectic and humanistic. MAIN OUTCOME MEASURES: Frequency of visits to family physicians before, during, and after psychotherapy. RESULTS: Frequency of visits to family doctors decreased both during and after psychotherapy. The decrease was especially apparent from before therapy to after therapy (49%, P < .001). Psychotherapy given by psychologists in a Canadian family medical centre appears to follow the pattern of the "offset effect," a reduction in medical use following psychotherapy, which has been demonstrated in other medical settings. CONCLUSIONS: Psychotherapy can be an effective and efficient part of total medical care for patients with complex psychological problems.