chapter  2
The Context of Primary Care and General Hospital Settings
Pages 6

The context of primary care and general practice settings differ from that seen in psychiatric and specialist care. Patients with psychiatric disorders who attend general medical settings usually have milder illness with mixed symptom presentations, often associated with psychosocial stress. On the other hand, patients attending psychiatric centers often present with severe, chronic, and complex conditions. Physicians, general and family practitioners, also employ differing concepts and frameworks to those used by specialists. Consequently, it is diffi cult to apply the traditional diagnostic classifi cation and categories to clinical practice in primary and secondary hospital settings. In addition, the specifi c and detailed management protocols recommended by specialist psychiatric perspectives, although adapted to primary care, are detailed, cumbersome, impractical, and inappropriate for routine use. There is a need to employ physician perspectives, which are applicable in general medical settings. The focus should also be on the transfer of skill and confi dence rather than the passive acquisition of knowledge.