Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
In Reply: Dr Schwenk asserts that depressed
patients in primary care are different than those seen in psychiatric settings.
Although I agree, this is only because many depressed patients seen by primary
care physicians are unrecognized as such or have yet to be referred for psychiatric
treatment. Data illustrate that nearly 50% of depressed patients seek help
through a primary care physician.1 In addition,
Schwenk comments that suicidal patients are rare in primary care. However,
the undeniable trend in managed care is to place the primary care physician
at the point of entry to the health care system where he or she determines
the referral or treatment path of all patients, including those with psychiatric
illness, often in just a few minutes.
Jacobs DG. Screening for Depression in Primary Care—Reply. JAMA. 2000;284(11):1379-1380. doi:10.1001/jama.284.11.1378