Degree Type


Date of Award


Degree Name

Doctor of Philosophy




Psychology has shown increased involvement in the health care system yet suffers from a lack of knowledge regarding the nature and workings of this system and, conversely, the health care system lacks knowledge about the nature and workings of psychology. The physician's perception of psychology is seen as particularly important since he or she may serve as a significant "gatekeeper" for the psychologist in the health care sector. This exploratory investigation was designed to gather baseline information regarding physicians' attitudes towards and use of the psychologist for referral and consultation in health care. A selected group of physicians from the Des Moines and Ames, Iowa area were mailed a "Psychological Services Information Survey." Two types of information were gathered: (1) physicians were asked to rate, using a numerical scale, the importance of selected items (psychological services or clinical problems) as reasons for referral and consultation, and (2) to rate, using a numerical scale, the importance of various statements (beliefs, concerns, preferences) as deterrents to such referral and consultation. The final subject sample consisted of 82 practicing physicians from three specialty areas: (1) 30 family practitioners, (2) 27 internists, and (3) 25 surgeons. Results indicated that physicians placed highest value on referral and consultation for severe clinical problems (e.g., severe depression, suicide, alcohol and drug abuse) and low value on health psychology and behavioral medicine problems or services (e.g., adjustment to hospitalization, management of hypertension). Assessment and evaluation services, "mild" mental health problems, and liaison-teaching activities were considered of low to average value. Family practitioners and internists were alike in their ratings, surgeons were more constrained giving overall lower ratings. Patient upset at psychological referral, physician and patient preference for psychiatric referral, and economic concerns (insurance will not reimburse) emerged as the major deterrents to psychological referral and consultation although it was noted that ratings of all deterrents fell in the average to low range. The three specialties did not differ in these ratings with the exception of family practitioners indicating greater preference to treat problems themselves. Overall, these findings are considered positive in nature and provide useful information for future work.



Digital Repository @ Iowa State University,

Copyright Owner

Elizabeth Ann Kalb



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173 pages