Bursztajn H, Barsky A J
Arch Intern Med. 1985 Jan;145(1):73-5.
There are five common ways in which a patient may object to a physician's suggestion of a psychiatric referral. The patient may reject the referral because of the social stigma of being a psychiatric patient; because the referral damages his or her self-esteem; because the patient does not understand the role of emotions in physical discomfort; because the patient feels rejected by the referring physician; or because of the effects of psychiatric illness. Following a thorough medical workup, the physician can best discharge his or her responsibility to the patient by paying attention to these possible misunderstandings. The physician can discuss the role of social stigma, offset the blows to the patient's self-esteem, educate the patient about the psychosomatic model of disease, and assure the patient of the physician's continuing interest and involvement.
患者可能会以五种常见方式反对医生提出的精神科转诊建议。患者可能因身为精神科患者的社会污名而拒绝转诊；因转诊损害其自尊；因患者不理解情绪在身体不适中的作用；因患者感觉被转诊医生拒绝；或因精神疾病的影响。在进行全面的医学检查后，医生通过关注这些可能的误解，能最好地履行对患者的责任。医生可以讨论社会污名的作用，抵消对患者自尊的打击，向患者传授心身疾病模型知识，并向患者保证医生会持续关注和参与。
