Physicians, therapists, staff and patients who were employed or receiving care in a primary care practice were asked about their direct experience with the site. Using ethnographic research methods, informants' points of view were elicited through interviews and their comments were examined using domain analysis. Two physicians were interviewed on 5 occasions, 5 therapists between 2 to 4 times, 5 patients twice, an office manager on 3 occasions and 1 nurse twice for a total of 40 interviews. The interviews ranged between 30 to 75 minutes (50 minute average) and took place over an eighteen-month period. Six categorical themes were identified: Characteristics of the Environment; Characteristics of Therapists; The Referral Process; Characteristics of Collaboration; The Psychotherapy Process; and Social Considerations. This study, the first ethnographic investigation of Family Systems Medicine, generated 5 principal conclusions. First, several marked dissimilarities between Family Systems Medicine as depicted in the professional literature and by informants emerged. Second, although the bio-psycho-social model promotes innovative awareness of social issues in health care, informants demonstrated status-quo knowledge. Third, certain aspects of the physician-therapist relationship--which includes an employee-employer arrangement--likely impedes collaboration. Fourth, patients emphasized the relevance of several issues (e.g., central location and prestige by association) that have heretofore been casually discussed in the literature. And, fifth, several problems associated with the use of ethnographies in a for-profit setting were identified. Finally, based upon a review of the findings, 4 major theoretical assertions are proposed: (1) Central location significantly reduces underutilization of health care; (2) Clinical outcomes are significantly enhanced due to / therapists' direct association with physicians ("prestige by association"); (3) Family therapists are not ideally suited to provide biopsychosocial care; and (4) The employee-employer relationship between therapists and physicians impedes collaboration. / Source: Dissertation Abstracts International, Volume: 56-07, Section: B, page: 3674. / Major Professor: Thomas Edward Smith. / Thesis (Ph.D.)--The Florida State University, 1995.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_77501 |
| Contributors | Todahl, Jeffrey Lane., Florida State University |
| Source Sets | Florida State University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | 257 p. |
| Rights | On campus use only. |
| Relation | Dissertation Abstracts International |
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