Referrals to the psychiatrist in the general hospital: A psychodynamic approach

Introduction. It is not clear as to the process by which the psychiatrist attracts referrals and the reasons and motivations that doctors have for referring or not. This study describes the modus operandt of referrals to the psychiatrist in the context of a university general hospital. Method. A semi-structured interview was carried out on 50 doctors (35 male, 15 female) from the teaching hospital of the Universidade Estadual de Campinas, Brazil. Data was analized qualitatively, by means of content analysis, according to the psychodynamic approach. Results. Some referrals need to be worked through in order for the doctor to overcome his resistance. Others are automatic: because something moved him deeply, the doctor directs his anguish and responsability outside himself, without realizing the motives that lead him to do so. Conclusion. Referral is used in a variety of ways and different things are expected of the psychiatrist, all influenced by unconcious aspects of the patient-doctor-specialist triad.